What we do… in a not-so-small nutshell
Welcome, so glad you could make it to my small corner of the world wide web. I will be the first to say that running a website, and writing a blog is all very new to me. I always appreciate anyone who has come along for the ride. Allow me to introduce myself. My name is Emily, I am a registered Speech Language Pathologist and owner of Wellington County Speech Therapy. I started my practice in Fergus, Ontario inside of Optimum Health Centre in 2017, expanded to The WOMB Guelph in 2023 and I have never looked back.
I wanted to take an opportunity to chat about what it is we do at Wellington County Speech Therapy, and hopefully give you a clear picture of the speech language pathology world.
Let’s dive right in. The scope of practice for a speech language pathologist is often broader than we originally think. Here are some of the areas we treat within our clinic:
1. Speech – of course, this one might be a given! But did you know that there is more to speech therapy than meets the eye. In the initial assessment I am to determine what the underlying challenge is causing the speech sound delay. Sometimes I am just aiming to identify if there is a delay at all? Some of the reasons behind speech delays can be: Oral motor delays (these can be your lisps, but also include conditions like Childhood Apraxia of Speech), sound delays rooted in language (referred to as phonological delays) or delays related to anatomical structures (tongue ties, cranio-facial differences, dentition impact etc.)
2. Language – this can be broken down into receptive language, or how well your child understands language, and expressive language, how well language is being produced. Receptive language can often be tricky, kids are very clever and often find ways to hide their challenges in comprehension. They do this by following along with routines, watching others before acting, or using coping strategies such as making jokes or doing something silly. Sometimes, behaviour challenges are receptive language challenges in disguise. Expressive language can be a little more salient to our ears. When we hear grammatical or syntactic errors such as “Me want that” we immediately recognize that something is wrong. It can also encompass things like low word count, or limited vocabulary.
3. Infant Feeding – this is an area that is not the case for every speech pathologist. Work in infant feeding requires additional training to ensure we are using best practice to meet the needs of our clients. When working with infants we are aiming to work on supporting breast or bottle feeding with a good latch, mature suck-swallow-breathe pattern, and adequate nutrition intake. Sometimes we must target a hypersensitive gag reflex or identify tethering of tissues such as tongue ties that are hindering that child’s ability to feed. Once we hit 6 months of age (or even a little before) we move the focus to positive interactions with solid foods, always aiming to remain functional. When working with infant feeding it is always nice to have a team approach, for that reason lactation consultants, dentists, body work practitioners (such as osteopaths, chiropractors, or registered massage therapists), and occupational therapists are often a part of the team. This can be a very vulnerable time for families, so we always aim to meet babies and parents where they are at. One thing to note, medically fragile infants should always be closely monitored by a physician. Outpatient feeding therapy is not always appropriate for every baby!
4. Reading – This is one that I find surprises people. We help with reading! When you stop to think about it, why wouldn’t we? The basic building blocks of reading are called phonological awareness skills. These are skills that are developed in preschool years and continue throughout school age. The ability to process and manipulate sounds are essential to learning to read. It is the reason why when we teach “hat” “mat” “bat” “cat” you do not have to sound out each letter every time. Just swap the first one. Kids that do not establish these skills have trouble becoming skilled readers and often end up behind grade level. We provide a structured literacy approach that allows us to build up these skills and support reading development. Don’t forget about reading comprehension and reading fluency as well!
5. Voice – This is another area that is not always true for every speech pathologist. Additional training and experience are required for more in depth cases and imaging may also be required before treatment can occur. In our clinic we are happy to provide information about vocal hygiene and make referrals when appropriate to ENT (Ear Nose and Throat Doctor) for imaging or more information.
6. Behaviour – this is a topic that comes up for almost every kiddo within sessions. They are kids, of course behaviour can be challenging. Behaviour is communication. When we take that perspective, we can try to understand what is going on for that child. Often, we support behaviour as it comes up for families, but from time to time it is the primary focus of our visits.
7. Augmentative and Alternative Communication – also known as AAC. AAC is the use of forms of communication outside of talking. This might be a picture board, an iPad communication program, or a low-tech button press. AAC is used when a child is struggling to verbally communicate, either due to low intelligibility from a severe speech sound disorder, limited oral motor skills related to diagnoses such as Childhood Apraxia of Speech or Down Syndrome or if they are just alternative communicators as in the case of Level 3 or Level 4 Autism. We assess and determine which system would work best for each child and support the use of the systems within sessions. We can also make referrals to the publicly funded options for AAC devices or support a family with a device they have been working with at school or home.
8. Social communication/Engagement – I describe social communication and engagement as “pre-talking” skills. We need to convince kids that other people are fun. That we want them around and that we want to build meaningful relationships with others. This does not always look the same for everyone. For some kids, it is about helping them understand the perspectives of others or working through figurative language, humor and/or sarcasm. For other kids it is about meeting their needs at their level. If they enjoy lining up toys or spinning around, we aim to support them in regulating themselves through those activities. We like to add in communication that brings another playmate into the activity. Play is whatever that child finds fun. It doesn’t matter if it is typical or expected, if they find it fun, they are playing! And we are always happy to play with them!
If you are still with me, thank you. As you can see there is perhaps more than meets the eye with the scope of Speech Language Pathology services.
What do you think? Is it what you expected?
Always happy you are here!
Emily
