Who Are Speech-Language Pathologists, and What Do They Do?

Speech-language pathologists, also called SLPs, are experts in communication. 
SLPs work with people of all ages, from babies to adults. SLPs treat many types of communication and swallowing problems. These include problems with:
Speech sounds—how we say sounds and put sounds together into words. Other words for these problems are articulation or phonological disorders, apraxia of speech , or dysarthria .

Language—how well we understand what we hear or read and how we use words to tell others what we are thinking. In adults this problem may be called aphasia .

Literacy—how well we read and write. People with speech and language disorders may also have trouble reading, spelling, and writing. 

Social communication—how well we follow rules, like taking turns, how to talk to different people, or how close to stand to someone when talking. This is also called pragmatics.

Voice—how our voices sound. We may sound hoarse, lose our voices easily, talk too loudly or through our noses, or be unable to make sounds.

Fluency—also called stuttering, is how well speech flows. Someone who stutters may repeat sounds, like t-t-t-table, use "um" or "uh," or pause a lot when talking. Many young children will go through a time when they stutter, but most outgrow it.

Cognitive-communication—how well our minds work. Problems may involve memory, attention, problem solving, organization, and other thinking skills.

Feeding and swallowing—how well we suck, chew, and swallow food and liquid. A swallowing disorder may lead to poor nutrition, weight loss, and other health problems. This is also called dysphagia.
https://www.asha.org/public/Who-Are-Speech-Language-Pathologists/​

Does My Child Need Speech Therapy?

Children develop at their own rate. Some children walk and talk early. Others take longer. Most children learn skills within an age range, such as between 12 and 18 months. A child who takes longer to learn a skill may have a problem. It is important that you know what to expect. Below are some signs of speech, language, and hearing problems. You'll see the expected age range next to each skill.

Language Disorders
Language is made up of the words we use to share ideas and get what we want. Language includes speaking, understanding, reading, and writing. A child with a language disorder may have trouble with one or more of these skills.
Signs of language problems include:

Birth–3 months	Not smiling or playing with others
4–7 months ​	Not babbling
7–12 months	Making only a few sounds. Not using gestures, like waving or pointing.
7 months–2 years	Not understanding what others say
12–18 months	Saying only a few words
1½–2 years	Not putting two words together
2 years	Saying fewer than 50 words
2–3 years	Having trouble playing and talking with other children
2½–3 years	Having problems with early reading and writing. For example, your child may not like to draw or look at books.

Speech Sound Disorders
Speech is how we say sounds and words. It is normal for young children to say some sounds the wrong way. Some sounds do not develop until a child is 4, 5, or 6 years old. Signs of a speech sound disorder in young children include:

1–2 years	Not saying p, b, m, h, and w the right way in words most of the time
2–3 years	Not saying k, g, f, t, d, and n the right way in words most of the time. Being hard to understand, even to people who know the child well.

Stuttering
Speech is how we say sounds and words. It is normal for young children to say some sounds the wrong way. Some sounds do not develop until a child is 4, 5, or 6 years old. Signs of a speech sound disorder in young children include:

2½–3 years ​

Having a lot of trouble saying sounds or words Repeating the first sounds of words, like "b-b-b-ball" for "ball"  Pausing a lot while talking  Stretching sounds out, like "fffffarm" for "farm"

Hearing Loss
Some children have a hearing loss at birth. Others lose their hearing as they get older. Some signs that your child may have a hearing loss include:

Birth–1 year	Not paying attention to sounds
7 months–1 year	Not responding when you call her name
1–2 years	Not following simple directions
Birth–3 years	Having speech and language delays

​https://www.asha.org/public/early-identification-of-speech-language-and-hearing-disorders/

How Can I Help My Child Learn?

Language

• Talking, reading, and playing with your child.
• Listening and responding to what your child says.
• Talking with your child in the language that you are most comfortable using.
• Teaching your child to speak another language, if you speak one.
• Talking about what you do and what your child does during the day.
• Using a lot of different words with your child.
• Using longer sentences, as your child gets older.
• Having your child play with other children.

Sounds

• Saying sounds the right way when you talk. Your child needs good speech models.
• Not correcting speech sounds. It is okay if your child says some sounds the wrong way.

​https://www.asha.org/public/early-identification-of-speech-language-and-hearing-disorders/

What Is Autism?

Every person with autism is different. All will have problems with communication and social skills but not in the same way. Autism is a spectrum disorder because it can cause mild problems, severe problems, or something in between.
People with autism may focus on one topic, like trains or a television show. They may have some behaviors that they do over and over, like flipping objects or smelling things. They may not like changes in their schedule or changes in the food they eat. Some may talk well but not be able to make friends. Others may not talk at all.

​https://www.asha.org/public/speech/disorders/Autism/

Does My Child Have Autism?

He will have problems in the areas of communication, social skills, and behavior. He also might not like to eat different foods. Your child may also need help with fine and gross motor skills, like writing and running.

Communication
Your child may have trouble understanding, talking, reading, or writing. You might notice that he has stopped saying words that he used to say. Your child may have problems:

• Understanding and using gestures, like pointing or waving.
• Following directions.
• Understanding and using words.
• Having conversations.
• Learning to read or write. Some children with autism read early but do not understand what they read, called hyperlexia.

Your child also may do the following things:

• Repeat words he just heard or words he heard days or weeks earlier, called echolalia (pronounced ek-o-lay-lee-a).
• Sound robotic or talk in a singsong voice.
• Have tantrums instead of telling you what he wants.

Social Skills
Your child may have problems relating to other people. She may seem to be in her own world. It may be hard for her to

• focus with someone on the same object or event, called joint attention;
• play with others and share toys;
• understand how others feel; or
• make and keep friends.

Behaviors
Your child may

• have trouble changing from one activity to the next;
• flap his hands, rock, spin, or stare;
• get upset by certain sounds;
• like only a few foods; or
• have an interest in only a few things. He may talk about only one topic or keep staring at one toy.

Eating
Your child may only eat certain foods. She may not like anything lumpy or crunchy. Or, she may refuse to try new foods. She may do this to act out, or she may not like the feel of different textures in her mouth.

​https://www.asha.org/public/speech/disorders/Autism/

What Causes Autism?

Autism is a lifelong problem. You may not know what caused it in your child. Some possible causes include the following:

• Genetic problems or syndromes.
• Severe infections that can cause brain damage. Examples are meningitis and encephalitis.
• Problems during pregnancy. Your child may have been exposed to an illness like rubella or to harmful chemicals.

You may have an older child, cousin, or other family member with autism. There are cases where autism runs in families.

​https://www.asha.org/public/speech/disorders/Autism/

Is My Child's Speech & Language Developing Properly?

KINDERGARTEN (By the end of kindergarten, your child should be able to do the following tasks in each area.)
Speaking

• Follow 1–2 simple directions in a row.
• Listen to and understand stories.
• Follow a simple conversation

Speaking 

• Speak clearly enough so that most people understand what he says. 
• Answer simple yes/no questions.
• Answer questions like, "What did you have for lunch today?"
• Retell a story or talk about something he did.
• Take turns talking and keep a conversation going.
• Show interest in and start conversations.

Reading 

• Know how a book works. For example, we read from left to right and top to bottom in English.
• Understand that sounds make up words.
• Pick out words that rhyme, like cat and hat.
• Tell you the first sound in words, like mmmm for milk.
• Says the sounds for some letters, like buh for B. 
• Identify upper- and lowercase letters.
• Recognize some words by sight.
• "Read" a few picture books from memory.
• Pretend to read by talking about pictures in a book.

Writing 

• Print her first name.
• Draw a picture that tells a story. Write about the picture. Your child may write a letter or word to stand for a whole sentence or idea.
• Write upper- and lowercase letters. They may not be clear or neat.
• Write or type letters in no set order, like Mu zEos lx.

FIRST GRADE (By the end of 1st grade, your child should be able to do the following tasks in each area.)
Listening 

• Remember what they hear.
• Follow two- to three-step directions in a row.

Speaking 

• Speak clearly so that anyone can understand him.
• Answer harder yes/no questions.
• Tell and retell stories that make sense.
• Share her ideas using complete sentences.
• Use most parts of speech, or grammar, correctly.
• Ask and answer who, what, when, where, and why questions.
• Stay on topic and take turns in conversation.
• Give directions.
• Start conversations.

Reading 

• Say words that rhyme.
• Name all sounds in short words.
• Put sounds together to make words.
• Match spoken words with written words.
• Point to letters, words, and sentences.
• Sound out words when reading.
• Read 100 common words by sight.
• Read grade-level books.
• Understand what he reads.

Writing 

• Write about her ideas.
• Print clearly.
• Spell words that he uses a lot.
• Begin each sentence with capital letters. End sentences with periods or question marks.
• Write stories, journal entries, or notes.

SECOND GRADE (By the end of 2nd grade, your child should be able to do the following tasks in each area.)
Listening 

• Follow 3–4 directions in a row.
• Understand direction words, like here, there, over, next to, before, or later.
• Answers questions about a second grade-level story.

Speaking 

• Speak clearly.
• Answer harder yes/no questions.
• Ask and answer who, what, when, where, and why questions.
• Use more complex sentences.
• Explain words and ideas.
• Give directions with 3–4 steps.
• Use words to inform, persuade, and entertain.
• Stay on topic, take turns, and keep eye contact during conversations.
• Start and end conversations.

Reading 

• Know how letters make sounds in words, called phonics.
• Recognize many words by sight.
• Use clues when reading to figure out words. For example, looking at pictures or titles to help read a word.
• Reread parts of a story and fix mistakes.
• Find information to answer questions.
• Explain important points of a story, like the main idea, characters, and plot.
• Use personal experiences to guess what might happen next in a story.
• Read and retell a story in the correct order.
• Read grade-level stories and poetry silently and out loud smoothly.
• Read on his own.

Writing

• Write clearly.
• Use different sentences to write essays, poetry, or short stories.
• Use basic punctuation and capitalization.
• Organize writing with a beginning, middle, and an end.
• Spell words correctly that he uses a lot.
• Stop spelling by sound and start spelling correctly. For example, she may move from "grl" to girl."

THIRD GRADE (By the end of 3rd grade, your child should be able to do the following tasks in each area.)
Listening 

• Pay attention in groups.
• Understand grade-level information.

Speaking 

• Speak clearly. Know when to talk with a soft or loud voice.
• Ask and answer questions.
• Be a part of conversations and group discussions.
• Use words related to school subjects. For example, math, science, or history words.
• Stay on topic, use eye contact, and take turns in conversation.
• Summarize a story.
• Explain what she learned in school.

Reading 

• Understand phonics, or how sounds and words go together.
• Use word analysis skills. This means knowing root words, prefixes, and suffixes. For example, he can add the prefix "bi" to the root word "cycle" for "bicycle." Or, he can add the suffix "ist" to the root word "cycle" for "cyclist."
• Use clues from a story to help understand what she reads.
• Predict and explain what will happen next in stories. Compare stories and tell how stories are different.
• Ask and answer questions about what he reads.
• Use what she knows to learn about new topics.
• Read grade-level books with few mistakes.
• Reread and correct errors.

Writing 

• Plan, organize, revise, and edit.
• Write stories, letters, and short reports.
• Use details in writing. Spell simple words correctly. Correct most spelling without help. Use a dictionary to correct spelling.

FOURTH GRADE (By the end of 4th grade, your child should be able to do the following tasks in each area.)
Listening 

• Listen to and understand information.
• Form opinions based on what she hears.
• Listen for specific reasons, such as to learn, enjoy, or convince.

Speaking 

• Use words correctly in conversation.
• Use language for many reasons, like asking questions, arguing, and joking.
• Understand some figurative language. This is language that uses words in new or different ways. For example, "This classroom is a zoo!"
• Take part in group discussions.
• Give correct directions to others.
• Summarize ideas in his own words.
• Organize information so it is clear.
• Give clear speeches.

Reading

• Read for specific reasons.
• Read grade-level books smoothly and with few mistakes.
• Use what he knows to understand new material.
• Follow written directions.
• Take brief notes.
• Link what she learns in one subject to other subjects.
• Learn meanings of new words by looking at word origins, synonyms, and other meanings.
• Use reference materials, like a dictionary.
• Talk about the author's reason for writing a story and about the writing style.
• Read and understand different types of writing, like fiction, nonfiction, and poetry.
• Make inferences from texts. This means that she guesses what a writer means when it is not stated clearly. She uses clues in the story and what she knows from her life to guess.
• Talk about what she reads in her own words, called paraphrasing.

Writing

• Write stories and explanations. Write many paragraphs about the same topic.
• Develop a plan for writing that includes a beginning, a middle, and an end.
• Organize writing around a main idea.
• Edit final copies for grammar, punctuation, and spelling.

FIFTH GRADE (By the end of 5th grade, your child should be able to do the following tasks in each area.)
Listening 

• Listen and draw conclusions in different classes. 

Speaking 

• Make planned speeches. She should know her audience and include information for that group.
• Deliver a speech. He should keep eye contact and use gestures and a loud voice.
• Take part in class discussions.
• Summarize main points.
• Report about information from group activities. 

Reading 

• Read grade-level books smoothly and with few mistakes.
• Learn meanings of new words by looking at word origins, synonyms, and other meanings.
• Decide what information is important when reading.
• Read different types of text, like fiction, nonfiction, and poetry.
• Describe how a character and a plot develop.
• Talk about poetry and what poems might mean.
• Study an author's language and style.
• Use reference materials to support opinions.

Writing 

• Write for a variety of reasons.
• Use many different words when writing.
• Vary sentence structure.
• Revise writing to make it clearer.
• Edit final copies.

​https://www.asha.org/public/speech/development/fifthgrade/

What Can I Do To Improve My Childs Speech & Language Development?

In Early Grades K–2

• Talk with your child a lot.
• Read different types of books. Read every day, and talk with your child about the story.
• Help your child learn sound patterns of words. You can play rhyming games and point out letters as you read.
• Have your child retell stories and talk about his day.
• Talk with your child about what you do during the day. Give her directions to follow.
• Talk about how things are the same and different.
• Give your child chances to write.

In Later Grades 3-5

• Keep your child reading. Find books and magazines that interest your child.
• Ask your child what he thinks about what he hears or reads. Connect what he reads to events in his life.
• Help your child connect what she reads and hears at school, home, and other events.
• Talk out loud as you help your child read about and solve problems.
• Help your child recognize spelling patterns. For example, point out the beginnings and endings of words, like "pre-" or "–ed."
• Get your child to write letters, keep a diary, and write stories.

​https://www.asha.org/public/speech/development/suggestions/

What Is Social Communication?

Imagine these situations:

You invited your friend over for dinner. Your child sees your friend reach for some cookies and says, "Better not take those, or you'll get even bigger." You can't believe your child could be so rude.

You talk with a neighbor about his new car. He has trouble staying on topic and starts talking about his favorite TV show. He doesn't look at you when you talk and doesn't laugh at your jokes. He keeps talking, even when you look at your watch and say, "Wow. It's getting late." You finally leave, thinking about how hard it is to talk with him.

Both your child and your neighbor speak well. What they may have trouble with is social communication, also called pragmatics. These are the rules that we follow when we talk. There are rules about when and how you should talk to people. We use facial expressions or gestures to share how we feel. We learn how to let someone know when we change the topic. Knowing and using these rules makes it easier to communicate.

Social communication includes three major skills:

Using language for different reasons, such as:

• Greeting. Saying "hello" or "goodbye."
• Informing. "I'm going to get a cookie."
• Demanding. "Give me a cookie right now."
• Promising. "I'm going to get you a cookie."
• Requesting. "I want a cookie, please."

Changing language for the listener or situation, such as:

• Talking differently to a baby than to an adult.
• Giving more information to someone who does not know the topic. Knowing to skip some details when someone already knows the topic.
• Talking differently in a classroom than on a playground.

Following rules for conversations and storytelling, such as:

• Taking turns when you talk.
• Letting others know the topic when you start talking.
• Staying on topic.
• Trying another way of saying what you mean when someone did not understand you.
• Using gestures and body language, like pointing or shrugging.
• Knowing how close to stand to someone when talking.
• Using facial expressions and eye contact.

https://www.asha.org/public/speech/development/Social-Communication/

Can Social Communication Skills Be Improved?

A person with social communication problems may:

• Say the wrong thing or act the wrong way when talking. He may laugh at the wrong time or start talking about something else.
• Tell stories that do not make sense.
• Use language in limited ways. She may not say hello, goodbye, or thank you. She may yell instead of asking for what she wants.

Children may break some of these rules as they learn. If your child has a lot of problems with these rules, he may have a social communication disorder. He may also have other speech or language problems. He may have trouble talking with others or making friends.
A speech-language pathologist, or SLP, helps people with social communication problems. The SLP can test speech and language skills. The SLP can then help your child learn how to use language with different people and in different situations.