• Repetitions (repeating sounds, syllables or words)
• Prolongations (E.g. maaay I have)
• Blocks (which are usually silent periods where the person appears stuck)

• Your child is not yet at school and the stutter has been ongoing for a number of months (consultation should be sought prior to one year after onset)
• Your child has 12 months or less before they commence primary school
• Your child is at school
• Your child’s confidence or willingness to talk is being affected
• Your child’s stutter began after a brain injury
• You are an adult

Stuttering therapy is most successful between the ages of 3-5 years old

Your child is likely to take longer to say things then they have previously. — It is important to be patient; give them time to get out their words out. Hints or cues to get the words out are unlikely to help them get it out.

Your child may avoid speaking so that they don’t stutter. — Stuttering is confronting for some children as they have no conscious control of it.

Your child may be affected by bullying or negative comments/options. — Unfortunately there are negative stereotypes and attitudes that exist in society around stuttering.

Your children may also experience other speech sound or language difficulties. — Many children who stutter also have co-occuring speech and language difficulties, this can complicate and exacerbate symptoms and there effects on your child.

Assessment

Monitoring

As a result of natural recovery, some young children (less than 3 years) will simply require monitoring. Speech Pathologists will monitor for recovery, change in nature of stutter, severity of stuttering, the effects on the other areas of communication development and the effects on the child emotionally.

Therapy

For children in preschool and the first years of schooling the Lidcombe Program has the best available evidence in terms of its effectiveness. This treatment is parent mediated and involves specific instruction in how to reduce stuttering behaviour. There are other treatment approaches available that involve acknowledging and altering the stuttering behaviours.

For older children and adults, therapy from a psychologist may also be recommended. Research evidence suggests that for teenagers and adults therapy from a psychologist in conjunction with therapy from a Speech Pathologist can reduce psychological harm and improve stuttering treatment outcomes.

For further information please consult Speech Pathology Australia’s fact sheet on Stuttering.

• Speech Sound Difficulties
• Language Difficulties
• Psychology

• Missing key information
• Taking a long time to respond
• Difficulty distinguishing between important and unimportant information
• Appearing to be listening but are unable to complete task

A child requires the ability to following instructions of increasing length, so they are able to participate in all environments. If a child has difficulty following instructions this may impede their ability to complete school work appropriately as they may misinterpret the key information and may struggle to complete the tasks correctly. This inability to comprehend instructions may impact on future employment.

Assessment

The assessment protocol used will vary upon the child’s age. Although a Speech Pathologist will always assess both their receptive language (ability to comprehend instructions, sentences, and key concepts and vocabulary) and expressive language (ability to express themselves in a way that is accurate, grammatical and appropriate for their age). This is because these skills are intertwined, e.g. a child’s ability to use the word ‘before’ correctly in a sentence will reflect their ability to follow a direction containing ‘before, particularly when that instruction is complex and out of routine.

Treatment

There are a vast array of treatment that a Speech Pathologist may implement to improve a child’s comprehension of instructions depending on their assessment results and factors related to the child.

• Attention Deficit Hyperactivity Disorder (ADHD)
• Auditory Processing Disorder (APD)
• Working memory difficulties

• Limited number of consonant sounds
• Using mostly nouns
• Doesn’t imitate new words
• Uses few gestures to communicate

• This may impact on the child’s ability to have their needs and wants met.
• Late talkers may have difficulty expressing their feelings and thoughts and can therefore become frustrated.
• A child’s ability and difficulties with communication may impact their interactions with others.

Assessment

Assessment of your child’s expressive language skills (i.e. their play, gesture, vocalisations and words) and receptive language skills (i.e. their ability to follow instructions and understand conversation and stories).
 

Therapy

Speech Pathology therapy for late talkers will involve a combination of direct therapy and parent training. Parent training will involve teaching parents how to optimise the interactions between themselves and their child. These strategies will help the child to improve and develop their expressive communication. Depending on the difficulties of the child and the preferences of the parent, augmented communicative strategies can also be implemented. Augmented communication, such as key word sign, are used to supplement but not replace spoken words. Key word signs can be helpful to children who are late talkers for developing their expressive vocabulary and their ability to combine words.

• Autism Spectrum Disorder (ASD)
• Social communication difficulties
• Anxiety

• Refusing food based on sensory characteristics (such as texture, smell, taste, temperature)
• Prolonged mealtimes
• Taking small volumes of food, over-packing or pocketing food in the side of the mouth
• Difficulty chewing foods

• Malnutrition — Fussy eating can impact on a child’s overall development. They may lack vital micro and macronutrients such as magnesium, iron and calcium.
• Family stress — Fussy eating can cause a large amount of family stress. Children may receive different meals from the rest of the family, mealtimes may take an extended period of time and dining out can be difficult or impossible. All of these factors and more can cause disruption to family life and conflict.
• Stagnated or poorly developed feeding skills — Fussy eaters can also reduce the feeding skills they are developing. For instance, a child who does not like the texture of meat may avoid it and thus poorly develop the strength and coordination required to chew red meat.
• Negative social consequences — If left untreated fussy eaters are likely to experience negative social consequences of their restricted diets. They may not be able to eat at birthdays, attend restaurants with friends or be excluded from sleep overs.

Assessment

Treatment

Depending on the results of the assessment treatment may include one or a combination of behavioural strategies, varied and incremental exposure to foods, desensitisation with food play, parent education, and development of feeding skills. An Occupational Therapist may also be involved in the child’s care to assist with sensory sensitivities and significant difficulties with regulation around food. A dietician and GP may also be involved in the child’s care to ensure intake is sufficient for growth and development.

• Feeding skills difficulty
• Sensory Processing Disorder
• Anxiety
• Dietician

• Identifying the main ideas or key information in text
• Making inferences regarding the written text
• Understanding story structure
• Poor mental imagery
• Over reliance on pre-existing knowledge to supplement reading comprehension

Difficulties with poor reading comprehension can affect a child’s

• Academic success
• Attitude towards reading
• Late identification of difficulties (as they may progress well through home readers, while meaning is being supplemented by pictures)
• Interest in reading for pleasure

Assessment

Assessment of reading comprehension difficulties will involve evaluation of your child’s:

• Reading comprehension
• General reading skills (accuracy and rate)
• Oral language skills (comprehension of written and verbal text, and language)

Treatment

Treatment will focus on areas of breakdown and may include:

• Improving oral language
• Improving general reading skills
• Improving mental imagery
• Improving comprehension of questions
• Improving understanding of text structure
• Improving ability to search for keywords

• Attention Deficit Hyperactivity Disorder (ADHD)
• Auditory Processing Disorder (APD)
• Visual Processing Difficulties – impact reading ability and further comprehension
• Language delays and difficulties
• Working memory difficulties

• Safety concerns — e.g. coughing, gagging, vomiting or choking on food, they also may present with recurrent chest infections.
• Difficulty transitioning to different textures as a result of delay in skill development — e.g. difficulty transitioning to solid foods from purees.
• Prolonged mealtimes
• Taking small volumes of food, over-packing or pocketing food in the side of the mouth
• Difficulty chewing foods

• Malnutrition — Feeding skill delay can impact on a child’s overall development. They may lack vital micro and macronutrients such as magnesium, iron and calcium as a result of limited access to foods.
• Family stress — The safety concerns sometimes associated with feeding skill delay can be distressing for both child and family. Children with feeding delay may be restricted from social events involving food and/or require altered family meals.
• Fussy eating may develop — Children with feeding skill delay may experience negative events with different foods as a result of their ability to safely and comfortably consume them. Fussy eating can sometimes be the result.
• Negative social consequences — Children with feeding skill delay may require food and feeding utensils appropriate for a much younger child. For instance, a child in primary school may require a pureed meal.

Assessment

Treatment