Speech and Language Evaluations and Treatment
A Speech and Language Standardized Evaluation Tool is required in order to make a Speech Therapy Plan of Care, and devise specific treatment goals and objectives. Following a Speech Language Evaluation, correspondence with your child's pediatrician will occur. The pediatrician will be asked to sign an order for Speech Therapy, if the child is identified as having a Speech/Language delay and the therapy plan recommends treatment. When the order is returned, therapy can begin. We are currently a fee for service facility. We are hopeful to soon be in-network with most private insurances, Medicaid, Medicare and obtain contract with the Raleigh CDSA. You are able to submit a request for insurance reimbursement, even if we are not in-network with your provider, when we follow these practices. Fees for evaluations and treatment follow set fee schedules for Private Insurance and Medicaid. As we are intending to soon be an "in-network provider", we can not alter our Speech Therapy evaluation and treatment fee schedule, even if you are a "self-pay," client.
Speech and Language Evaluations are recommended to follow a free screening session that identifies a weakness in one of the below areas.
Our Speech and Language Therapist can provide a wide range of Assessments in the areas of ;
- Receptive and Expressive Language
- Articulation (speech sound production)
- Phonological Awareness
- Pragmatics and Social Skills
- Preschool Language
- Augmentative and Alternative Communication (low tech communication boards, high tech voice output devices - see AAC Evaluations)
What Can these Evaluations Determine?
Receptive and Expressive Language Delays - This evaluation result determines if your child can understand and use language; the ability to combine words to make sentences, comments, ask/answer questions. In the school system environment , students are only eligible when they exhibit Moderate or Severe Delays in Receptive or Expressive Language. In the private therapy environment, we can seek insurance reimbursement for Mild, Moderate or Severe Delays.
Articulation Disorder/Delay - This evaluation result determines if your child exhibits sound production errors which are inappropriate based on their age. For example they make produce a "t" instead of "c or k," in the word "cookie," pronouncing it "tootie." They may also exhibit a lisp or distortion of air flow on production of "s, sh, ch or j." Substitutions of sounds or distortions are classified as Mild, Moderate or Severe Articulation Disorders/Delays. This reduces your child's speech intelligibility and makes it difficult for a listener to understand what they are saying. Articulation therapy will target the specific sounds found to be produced in error by your child. Letter/sound association is also taught to ensure carry over into reading and spelling skills, in addition to correcting verbal productions. Apraxia of speech or Dyspraxia of speech, which is the in-coordination of the lips, tongue, teeth to produce sounds, resulting in a groping movement, and an inconsistent ability to make verbal sounds for speech production can be targeted in a similar manner.
Phonological Processing Disorder - Often a result of chronic ear infections delaying the auditory development, or inability to attend to auditory information due to sensory processing disorders, some children have difficulty identifying, processing and then producing all the sounds and syllables in a words. This results in difficulty producing multi-syllable words, deleting initial or final consonant sounds in words, patterns of sound errors (stopping and fricative sounds, fronting all posterior/glottal sounds) and can lead to difficulty in kindergarten basic skills for pre-reading. In addition to teaching correct verbal production, the therapist will target syllable awareness, closed/open syllable awareness, vowel and consonant awareness and production based on your child's specific difficulties.
Pragmatics and Social Skill Delays - Children with delayed speech and language skills or other developmental disorders and Syndromes (Ex; Fragile X, Autism, Down Syndrome) benefit from direct social skills instruction. Teaching is tailored to the individual child, in areas such as Conversation skill practice (Initiation and greetings, reciprocal conversation, asking/answering questions on context, using closure/farewells), Social skills (using social stories, discussing character's feelings/emotions and problem solving) as well as determining if a visual cue such as a color coded emotional regulation prompt (Zones of Regulation *see below) paired with sensory motor activities for regulation, would be beneficial. We are hopeful to offer group as well as individual social skills groups in the near future. We also utilize Social Thinking, by author Michelle Garcia Winner (*see below) to provide a curriculum foundation for our lessons.
Preschool Language Delays - Children with delayed Speech and Language, may simply have a delay in development or this can be the result of a contributing diagnosis (Ex; Autism, Down Syndrome, Cerebral Palsy, Chronic Ear infections). Preschool language skill intervention and therapy are provided with a combination of structured play, targeting functional language skills (making requests and completing activities of daily living), and to enhance the first 100 words typically spoken by developing children (Browns Theory of Language Development *see below)
Augmentative and Alternative Communication Needs- (low tech communication boards, picture exchange communication, high tech voice output devices - see AAC Evaluations) Augmentative and Alternative Communication can be a bridge or an avenue to achieve communication skills when verbal communication is not functional. Some children with complex disorders or motor-speech disorders, or Autism, develop communication in an atypical pattern. These children can have a disproportionate, higher receptive understanding of language and little or no verbal, expressive communication. We can help you explore a variety of low and high tech communication tools. We can also work with device companies (PRC, Dynavox), to trial high tech devices and obtain a Medical Device Necessity Letter (similar to that when requesting other medical devices; wheelchairs, walkers) for insurance reimbursement. We have worked with clients that need financial assistance and can write grant applications for you as well. Lower cost alternatives such as apps on tablets that you already own can also be utilized.