Psychiatric Evaluation

COMMON QUESTIONS

WHAT DIFFICULTIES ARE TYPICALLY REFERRED TO SPEECH LANGUAGE PATHOLOGISTS (SLPS)?

1. Articulation
2. Auditory processing
3. Following directions
4. Word finding
5. Vocabulary and Speech grammar / syntax
6. Asking and answering “wh-” questions (i.e. who, what, where, when, why, how)
7. Listening and reading comprehension
8. Sequencing and Narratives
9. Fluency (i.e. stuttering / stammering)
10. Voice (e.g. hoarse, nasal)
11. Pragmatic skills (i.e. the use of language in social contexts including conversational skills, and the use of body language)
12. Feeding and swallowing

These difficulties could be due to:

1. Developmental conditions such as Downs Syndrome, Autism, Cerebral Palsy
2. Neurological conditions such  as Multiple Sclerosis, Parkinson’s Disease, Alzeimher’s Disease
3. Brain Trauma such as stroke, traumatic brain injury
4. Medical conditions such oro-pharyngal cancer, cleft lip & palate, pre-term birth

WHAT DO OCCUPATIONAL THERAPISTS WORK ON?

Occupational therapists evaluate kids' skills for playing, school performance, and daily activities and compare them with what is developmentally appropriate for that age group. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life.

Occupational Therapists work on:

1. Sensory Processing Disorder (more below)
2. Behavior: Teaching children positive ways to redirect their actions instead of acting out
3. Attention: To improve focus and concentration
4. Fine motor skills: To improve grasp and release of toys, gripping a pencil, cutting, sticking etc.
5. Hand-eye coordination: To improve play and academic skills such as hitting a target, batting a ball, copying from a blackboard, etc.
6. Activities of Daily Living (ADL): Bathing, getting dressed, brushing teeth, self feeding
7. Sensory Processing Disorder (SPD, formerly known as "sensory integration dysfunction") is a condition that exists when sensory signals don't get organized into appropriate responses.

WHAT KIND OF CLIENTS DO YOU WORK WITH?

We work with adults and children, many of whom are individuals with:

1. Autism
2. Attention Deficit Hyperactivity Disorder
3. Childhood Apraxia of Speech
4. Down Syndrome
5. Craniofacial anomalies
6. Cerebral Palsy
7. Aphasia (i.e. neurologically acquired language disorder)
8. Dysphagia (i.e. swallowing difficulties)

WHAT IS THE DIFFERENCE BETWEEN SPEECH AND LANGUAGE?

Language refers to one’s understanding and expression of ideas including: the form (i.e. word structure and order), content (i.e. meaning), and use (i.e. functional and social application).

Speech refers to the verbal means of communication including: articulation (i.e. the way in which sounds are produced), voice, and fluency (i.e. the flow of speech). A child can have trouble with speech skills, language skills, or a combination of both.

HOW EARLY SHOULD I BEGIN SPEECH THERAPY?

This depends on the communication milestones that are expected at every age. We can begin working with children as early as 12 months of age for communication skills. However in the case of feeding/swallowing issues, we provide intervention as early as a few weeks to a month of birth.

HOW MANY SESSIONS ARE REQUIRED PER WEEK?

Greater frequency of sessions leads to more effective progress. However the frequency of sessions also depends on the type and severity of the communication or feeding disorder and the age and attention span of the child. Children can attend therapy from 1-5 times per week.

In most instances however 1-2 times per week is an appropriate frequency to make optimal progress toward meeting set goals and objectives.

WHAT CAN I DO AT HOME?

Parents are encouraged to watch and participate in every speech session especially for younger children so that a language learning environment can be created at home. For older children and adults, parents or care givers are encouraged to discuss treatment plans and progress at the end of the session. Home practice worksheets and ideas are provided by the therapist.

DO AAC DEVICES IMPEDE SPEECH DEVELOPMENT?

Contrary to popular belief, recent research has shown that the use of AAC programs does not inhibit communication, but rather facilitates it. Augmentative and Alternative Communication (AAC) is a method of communication that does not involve direct speech from a person. It involves the use of gestures, facial expressions, sign language, writing, and/or electronic devices to communicate. AAC is used when speech is not developing typically, or is not likely to develop typically due to a pre-existing condition. Even when it is unclear whether or not a child will eventually develop typical speech, as is frequently the case, the child may still benefit from an AAC program.

There are several advantages of using an AAC program. It enhances a child's cognitive, social and academic abilities by increasing his/her communication skills. It also teaches functional communication; this is particularly beneficial to a child with severe disabilities who is unable to learn the early cognitive and social skills on which conventional communication is based. By providing the child with a socially acceptable way of communicating his/her needs and desires, an AAC program reduces frustrations and problem behaviors in a child, which may otherwise arise due to the inability to communicate.