Thebabyspot.ca sat down with Toronto,Canada Speech Language Pathologist, Lynn Carson, who answers all of our questions about Speech Language Pathology and provides additional resources for parents. Visit Lynn on twitter and check out her social media below!
1) Lynn, please tell our readers what a speech language pathologist does…
Asking what a speech-language pathologist (S-LP) does is a very big question. That’s because S-LPs take on many different roles in their communities and can have a very broad clinical practice.
S-LPs have a minimum of a master’s degree in their field that provides them expertise in typical speech and language development, swallowing and disorders of communication. We also receive education in anatomy, physiology, acoustics, audiology, counseling, research and much more, as well as clinical training in the field.
This education and training qualifies us to assess and treat delays and disorders in speech, language, communication and swallowing for both children and adults. We are also qualified to provide education and training to families, consult to community agencies and other professionals and conduct research studies that contribute to our profession.
As members of a regulated health profession, S-LPs must be licensed and insured to practice within their province. When working with the public we must adhere to legislation and by-laws set out by our regulatory body (in Ontario that is the College of Audiologists and Speech Language Pathologists of Ontario), as well as all relevant government legislation.
This includes following privacy guidelines, procedures for informed consent to assessment and treatment, confidentiality and record keeping.
You can find S-LPs working in rural and urban communities all across Canada. We provide services both directly and indirectly in settings like schools, hospitals, clinics, treatment centers, nursing homes, administration and policy development, private practices and even conducting research in universities.
As you can see, what S-LPs are qualified and trained to do can be quite extensive. That’s why many S-LPs have a more narrowed scope of practice. My scope of practice includes working with children, ages 0-10 years. I work with children who have difficulty pronouncing their speech sounds correctly, for example saying “akkle” instead of “apple”. I work with children who have language delays or disorders, for example toddlers who are late to talk, children who have difficulty communicating in sentences or using grammar and children who use alternative forms of communication (e.g., pictures or iPad). This also includes broader language intervention for children with special needs, such as autism, Down syndrome and cerebral palsy. I also help children who have difficulty with pre-reading or reading skills, for example being able to hear the different sounds in words, understanding stories and being able to read independently and fluently.
2) How did you Start Talking Together?
After graduation I went straight to work in private practice. I worked in a clinic setting where clients came, either by referral or on their own, and I provided them with clinical services in that setting. I loved working directly with children and their families but two things happened that made me want to adjust the way I practiced. First, I felt constrained in the clinic setting. A major part of treatment, especially with young children, is home practice. Each week I would send parents with homework to continue practicing their children’s treatment goals at home. Sometimes home practice was really easy for families, but sometimes it was not. Parents with really young children, single-parent homes, families where both parents worked long hours full-time, and others, seemed to struggle to keep up. They would say they didn’t have time, they weren’t sure if they were “doing it right” so they just stopped or that their children weren’t motivated to practice treatment goals with them at home. I could tell it was frustrating for these parents, who obviously wanted to be involved in their children’s treatment but had trouble bringing what we did in clinic back to their own house.
The second thing that happened was that I had two wonderful children of my own! I have a 3 year old daughter and a 1 year old son who keep my husband and I busy at every turn. As the children came into our lives and we grew as a family, I now had to deal with similar challenges facing some of the families I worked with. Balancing work and family, finding time to meet everyone’s needs in between dinner, dance class and play dates, as well as the long commute to work (45mins each way when I worked at the clinic).
It was really these two things combined that inspired me to open my own private practice; Talking Together. Professionally, this situation works much better for me. I am now able to deliver clinical services to families right in their own homes. This gives me a better opportunity to see the child communicate in their natural environment and to tackle, head on, any issues parents may have that could be a barrier to successful intervention. This situation is also better for me personally. I provide clinical services in the west Toronto area where I live so I don’t have to commute anymore, which gives me more time with my children every day. I am also close by if they ever do need anything; like being picked up early if they are sick or bringing the princess wand they left at home that they need for show and tell.
3) Who can benefit from in home speech and home pathology lessons?
I think most families can benefit from in-home speech pathology services. Primarily, there is the benefit of saving time. When you have to go to a clinic you have to account for travel time there and back. Some parents even have to drive to pick their children up from a different location (e.g., school, daycare, etc.), drive them to the clinic, then drive from the clinic home. With home practice you can schedule a time where everyone needed for treatment is home and cut out all the extra drive time.
Secondly, since intervention is occurring within the home, treatment goals can be built right into the families’ daily routines. There are two big advantages to this. One, the S-LP can model treatment techniques in the same setting, using the same materials, that the parent will use during home practice, making carry over of treatment goals in the home much more likely to be successful. Second, if the treatment goals are built into daily routines it is a lot easier for parents to find time to help their children practice. They won’t have to try and carve out some new, specific time to work on treatment goals because they will learn how to practice during activities they do on a regular basis anyways.
Finally, I think children feel more comfortable at home; especially young children. They are in a safe, familiar environment making it more likely for them to communicate the way they naturally would. This gives the S-LP a chance to put together an intervention plan that includes goals that are relevant to the way the children are communicating at home on a regular basis.
As with many things, there are pros and cons to both clinic and in-home settings. There can be many distractions at home that you would not find in a clinic, like TVs, iPads, computers and phones. It is also a less controlled environment so there is the potential to have people interrupting treatment while it is in progress. That being said, I think with good communication between the S-LP and the parent these problems can be minimized or even eliminated.
4) What happens during the therapy?
Therapy is a unique experience for each child. That’s because each child’s treatment is based on their own personal strengths and areas to grow.
Before children get to the therapy phase, they are assessed by the S-LP. In an assessment the clinician usually conducts an interview with the parent to determine a case history, including when the child’s speech and language milestones occurred, relevant medical history and family situation. The child may be observed interacting with the parent or may interact with the S-LP during preferred play and games so the S-LP can assess their current communication abilities in a natural context. The S-LP may also conduct formal assessments. These are specific tests that assess a child’s speech and language skills in relation to other children their age. Tasks could include pointing things out in pictures, naming objects or being asked to follow specific instructions.
All this information is collected and analyzed by the S-LP after the assessment. The results indicate if a child’s speech, language or communication skills are within the normal range or if a delay or disorder may be present. They also show in what areas, specifically, intervention is required, and where the child has strengths.
The S-LP goes over the assessment results in detail with the parents and provides lots of opportunity for parents to ask questions. If treatment is recommended parents can discuss therapy options with the S-LP at that time.
Together with the family, the S-LP will create an intervention plan based on the assessment results that include specific goals for the child in therapy. Therapy goals are then strategically built into a child’s preferred activities, games, and daily routines. For example, if a child’s goal was to learn to say the ‘s’ sound correctly in the beginning of words (e.g., ‘sun’), and they loved playing with action figures, the S-LP would set up a natural play scenario where words that started with ‘s’ would be elicited often (e.g., superman, soaring, sink, safe, soon, soldier, etc.). As the S-LP and the child played together, the S-LP would be able to model the correct pronunciation of the target words and give the child a chance to practice saying them correctly on their own during a fun, motivating activity. Parents would also learn how to do this so they could continue practicing at home, as well as how to incorporate goals into other routines and activities the child enjoyed.
5) How long is a session? How many times a month would you need to see a client?
How long and how often a child receives therapy depends on a combination of factors. This includes the type of disorder, the severity of the disorder, the age when treatment begins and the rate of home practice.
In general, therapy sessions can be either 30, 45 or 60 minutes in length, occurring on a weekly basis. Therapy sessions can be shorter or longer, and more or less frequent depending on what is in the best interest of the child or the availability of the service provider.
6) How do I know if my child needs speech therapy?
I think parents usually have a good feeling about whether or not they should be concerned about their children’s speech and language. If a parent is feeling like they have questions, or they would like to hear from a professional, they should always trust their instincts and call an S-LP. You don’t need a doctor’s referral. Any parent can call any time.
I think the thing that is most confusing for parents is that there is such a wide range of ‘normal’ speech and language development that it is hard to know when a child is behind or not, especially when they are young. Some children at 18 months maybe using full sentences and some children may be using single words and both are considered to be developing typically!
There are certain milestones for speech and language development that parents should be aware of. If your child is not meeting their milestones at any given age you should consult your physician and a speech-language pathologist.
I know it can be frightening for parents if they think their may be a concern with their child’s speech and language development. As a parent myself, I completely understand the scary feeling that my child may not be developing the same way as their siblings or their peers. As well as the stress about the unknown…..”Will they get better on their own?”, “If we do therapy how long will it be?”, “Do we have time for this?”, “Can we afford this?”.
Since the early years in a child’s life are the most important for speech and language development it’s crucial they are seen by a professional right away if they need help to avoid any larger future problems.
6) Approximately how young can you detect a child will need speech therapy?
How early can a child begin to receive your services?
Beginning from birth children start learning language, therefore, as S-LPs we know that from the minute they are born if a child is not reaching their speech and language milestones, intervention is required.
For some children, we know immediately that they will need speech pathology services. For example, children born with a cleft lip or palate will have an S-LP involved with their family from birth. In the beginning the S-LP will provide education, training and resources to families about feeding since the cleft will prevent the infant from latching or sucking in a typical way. As the baby grows they will require a series of surgeries at different ages to repair the cleft. The S-LP will monitor speech and language development for the child during this time and provide intervention that is needed.
There are also some children who are born with a developmental disorder and who will have long-term language learning challenges, such as Downs syndrome. In these cases an S-LP can become involved when they are babies to help them reach their full potential in speech and language as they grow and develop.
Even parents of children who are not born without special needs should be aware of the speech and language milestones. If for some reason your child is not reaching their milestones you should consult a professional. Speech and language milestones are one indicator professionals use to determine if there are other concerns to be aware of. For example, if an infant is not babbling (e.g., repeated consonant-vowel sounds together like “bababab” or “dadada”) by around 6 months old, this could be an indication of a hearing impairment. As well, language delays and social communication difficulties in toddlers are a few of the red flags for autism and these children may require additional assessment by a developmental pediatrician.
7) A parent of a child with special needs may be under a lot of stress and hearing conflicting information in regards to aid for their child’s learning capabilities. How can a speech language pathologist help children with special needs reach their potential?
That is a great question and something many speech-language pathologist encounter on a regular basis, especially with more and more children receiving diagnoses, and at earlier ages.
The ability to communicate effectively is an extremely powerful thing. For those of us who are able to communicate naturally and without any difficulty, we may take for granted how lucky we really are. Everyday we can access our wants and needs, share our thoughts and discuss our ideas and feelings as we navigate through the world. Communication with others is an essential part of what makes us human and one of the most important ways we stay connected with other people.
When someone has a communication disorder they are not able to get the things they want and need easily, they may have trouble sharing their thoughts or not even be able to convey their feelings. As they navigate the world each day, and encounter different people, they will face a variety of difficulties as a result of their communication impairment.
Speech-language pathologists help by giving people with communication impairments a voice. Whether it be remediation of speech, language or social communication skills, S-LPs help these children get their messages across clearly so they can interact with the world more easily; like expressing their feelings when they are frustrated, making it easier to understand and learn in school or being able to participate with other children their age in games, on teams and in their community.
S-LPs also consider the child within the family context and can help parents navigate a very complex system as they try and access resources for their children. It is part of our job to be familiar with what other therapies are available to families, which ones are based in sound research evidence and which ones are more likely to be a passing phase. We can help parents create a network of support by letting them know how to access reliable resources within their community, connect them with other families whose children have a similar diagnosis and let them know about helpful organizations they may want to become involved with. Since S-LPs also have training in research we can help parents learn how to critically review the information they are reading online. There is so much out there and when you learn what to look for you can start to more easily weed out the valuable information from the less substantial.
All these things combined will help a child reach their full potential and it is one of the major reasons I enjoy doing my job.
8) If there was a message you would want to give potential clients, what would it be?
Early identification is the key! The earlier a communication delay or disorder is identified, the better chance the child has for improvement. Developing speech and language skills is a cumulative, life-long process. The language skills you acquire when you are a baby sets the stage for the language skills you are ready to learn as a toddler. The language skills you learn as a toddler sets the stage for the language skills you are ready to learn as a preschooler, and so forth.
Think about speech and language development like building a house. You want to have a strong foundation so your house will remain sturdy as you build up. If you do, then you will always be able to build on top of this foundation, without any concern. If you don’t have a strong foundation, you are going to struggle as you continue to try and build, and there will likely be problems for you to deal with later on.
Even though it may be stressful, parents should not wait to talk with a professional if they think their child needs help. It just may be the important step a child needs to help them build their foundation for the future.
I am always happy to speak with families about how my services may be right for them. For families in other areas of Ontario, or Canada, they can find a practitioner in their area using the Speech-Language and Audiology Canada website (www.sac-oac.ca) or searching the database of the provincial regulatory body. In Ontario that is the College of Audiologists and Speech-Language Pathologists of Ontario (www.caslpo.com).
It is hard for families to know what are the reliable sources they should be listening to, especially when it comes to finding information online. Here are links to reliable websites that provide families with the speech and language milestones their children should be reaching at different ages, free resources for parents and answers to some frequently asked questions. They are a good place for parents to start!
Social media is a fantastic way for families to stay informed about speech and language. On my pages I provide tips for parents, free resources, the latest news and research in the field and lots more on a daily basis.