Areas of Focus

1. Early Speech and Language Development
2. Speech Sound Difficulties and Disorders

3. Language

4. Social Skills
5. Stuttering
6. Voice Disorders
7. Bilingual Learning
8. Autism Spectrum Disorder
9. Primary School Language and Academic Development
10. High School Language and Academic Development
11. Literacy and Learning
12. Auditory Processing Disorder

1. Early Speech and Language Development

If you suspect your child is not quite reaching their early communication milestones, then advice and investigation from a speech pathologist is essential.

Early speech and language development includes many areas which fall under the categories of Receptive Language (understanding what others say), Expressive Language (communication output – gestures, speaking, signing) and Pragmatic Language (social contexts). As speech and language develops, these 3 categories intertwine making each area as important as the other for overall communication development.

From birth to 12 months, you should be noticing your little baby:

  • Listening to speech and sounds around them
  • Startling or becoming still to loud or unexpected noises
  • Turning to you when you speak
  • Smiling at the sound of your voice
  • Making different cries for different situations
  • Responding to different tones of your voice
  • Responding to sounds through toys and objects, song and games
  • Make gurgling sounds or ‘playing’ with their voice
  • Cooing and babbling
  • Swiping at objects and repeating actions
  • Responding to her name
  • Recognising familiar people
  • Starting to point and gesture
  • Participating in songs and games such as peek a boo
  • Recognising the names of familiar objects
  • Babbling changes to more specific sounds with consonants and vowels
  • Looking at and mouthing objects
  • Searching for partly hidden objects
  • Starting to respond to requests (give it to me) and questions (more water?)
  • Banging two objects together
  • Throwing or dropping toys purposefully
  • Using their first words
  • Referencing between objects and adults

Between 1-2 years of age, you should be noticing your little toddler:

  • Pointing to pictures in books
  • Understanding yes and no
  • Saying yes and no with words or gestures
  • Showing you a few body parts when asked
  • Recognising self in a mirror
  • Following simple commands (Bang the hammer! Give me the block)
  • Understanding simple questions (Where’s the ball? What’s in the bag?)
  • Searching for hidden toys
  • Combining two words (More bubbles)
  • Exploring toys – mouthing, shaking, banging
  • Listening to short stories
  • Enjoying songs and rhymes – and likes them repeated!
  • Noticing sounds that belong to familiar items (phone ringing, microwave beeping)
  • Using words that are becoming clearer
  • Starting to take turns

More speech and language age norms for children aged 0-5 years 

The stages that children are expected to reach milestones are quite specific but the ages in which these milestones are exactly met vary greatly from child to child. You might find that talking your worries through with other parents, relatives or friends provides you with conflicting information that may cause you further stress instead of clarification. A consultation with a speech pathologist will provide you with specific information about how your child is progressing for their age and actions can be put into place to either provide therapy (if necessary) or to provide home based strategies and to monitor your child’s progress.

Lift Off provides early intervention speech pathology services to toddlers and preschool aged children from the age of 12 months.

Speech and language programs are developed for children who are not reaching their communicative milestones and may present with other difficulties such as speech delays, receptive and expressive language difficulties or developmental delays.

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2. Speech sound difficulties and disorders

As a whole, communication is the process of being able to understand other people, instructions and directions; and is also the process of being understood by others. This encompasses areas of language both receptive and expressive, and speech or articulation and clarity which determines whether a child is being understood or not when they verbalise. Without language, we can’t produce speech. Thus, it is all connected!

Most children make predictable pronunciation errors when they are learning to talk. Speech sound disorders occur when errors in speech continue past a particular age. The most common speech sound disorders include problems with articulation and phonology.

Articulation is the production of speech
sounds through movement of the oral structures which in turn produces the consonants and vowels of speech. Articulation difficulties are at a phonetic (production) level and refer to the inability to make specific speech sounds. For example making a “w” for an “r” sound (wabbit for rabbit).

Phonology refers to the organisation of speech sounds into patterns and contrasts so that we make sense when we talk. Phonological difficulties are at a phonemic (patterns of sounds) level and refer to the inability to use the sounds correctly in speech. For example, a child may substitute sounds made in the back of the mouth like “k” and “g” for sounds in the front of the mouth like “t” and “d” (tup for cup or doh for go).

Generally, the cause of speech sound disorders is unknown. Some speech sound disorders may result from:

  • Sensory deficiencies (hearing impairment)
  • Developmental Disorders (such as Autism)
  • Motor planning disorders (dysarthria, CAS)
  • Structural deficits (cleft palate)
  • Neurological disorders (cerebral palsy)

It is common to present with minor errors during speech development but these errors can’t always be outgrown. Speech therapy may be necessary to assist in learning correct sounds and sound patterns. It is important that your child’s hearing has been recently tested to rule out hearing loss as a possible cause of their speech difficulties.

Childhood Apraxia of Speech (CAS) – also known as Dyspraxia

CAS is a motor planning speech disorder where the brain has difficulty planning to move the oral structures (lips, jaw, tongue) needed for speech. This affects a child’s ability to voluntarily make the right movements, when needed, during speech. Children with CAS have difficulty producing their speech sounds, remembering how to make sounds and where to place their oral structures for a correct sound, and organising their speech sounds.

CAS paired with a language delay makes the condition very challenging. A child with a combination of difficulties experiences marked difficulties in social interaction as well as problems with processing sensory input. CAS interferes with the planning necessary for voluntary movements. There may be an interference between the brain’s plan to make a sound or movement and the messages sent to the muscles for speech that are supposed to carry out the task. If a child doesn’t have the language to understand how to be taught to make these movements, this can be very frustrating when trying to communicate.

At Lift Off, we provide in-depth assessment and tailored speech pathology programs for children of all ages who present with speech sound disorders.

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3. Language

Language is the way in which we communicate, in a spoken or written manner through words, gestures or symbols.

Receptive language is the ability to comprehend (understand) vocabulary, instructions, concepts and questions. It involves understanding the words and sentences of what others say to them or what is read.

Expressive language is a child’s ability to express themselves, typically through speech by putting words together, using grammar correctly, retelling a story or an event, labelling objects in their environment, describing actions and events that occur, answering questions such as ‘Who, What, When, Why and How?’, and overall expressing their needs and wants. This is especially important in social language too, where a child is expected to greet another or take turns in a conversation.

A child may use language correctly but may have difficulties understanding the rules for social communication. This is the area of pragmatics.

Pragmatics involves using language (greeting, informing, demanding, requesting, promising), changing language (according to different social situations), and following rules during conversations and storytelling (turn taking, staying on topic, understanding body language). A child may have pragmatics problems if they use language that is inappropriate in particular situations in relation to their age.

At Lift Off, we offer specific programs tailored to the needs of your child.
Language goals may target:

  • Language stimulation – teaching children how to interact with others
  • Receptive and expressive vocabulary
  • Using sounds, words and sentences to comment, question and   request
  • Following instructions and directions
  • Understanding and asking questions
  • Understanding and using concepts
  • Recalling and retaining information
  • Verbal expression
  • Giving instructions and answering questions
  • Understanding word relationships and contexts
  • Structuring verbal sentences and using correct grammar
  • Pragmatics – teaching social communication
  • Comprehension
  • Memory and auditory processing

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4. Social Skills

Social skills involves appropriately communicating and interacting with others verbally (with speech and language) and non-verbally (through gestures and body language).

In order to socialise effectively with peers, a child needs to be aware of themselves and others around them. They must understand the social rules of communication and demonstrate appropriate play skills, especially as they get older.

At Lift Off, we provide individual and group programs that focus on teaching appropriate social skills for children to use in all environments.

Goals may include:

  • Greeting and eye contact
  • Turn taking and participation
  • Requesting and commenting
  • Active listening and attention
  • Playing together
  • Using appropriate speech (volume, tone, intonation)
  • Initiating, developing and maintaining conversational skills
  • Increasing vocabulary
  • Understanding rules and boundaries
  • Understanding body language
  • Identifying and expressing feelings
  • Developing assertiveness
  • Cooperating and complying with others

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5. Stuttering

Stuttering is a physical communication disorder in which the flow and fluency of speech is affected. Most people produce general “disfluencies” at times during speech but those who have a stutter (or stammer) produce disfluencies that impact their communication and daily activities. The level of challenge varies across individuals. These difficulties may be characterised by:

  • Whole word or part word repetitions (“h-h-h-how are you?”)
  • Sound prolongations (“mmmmmy turn”)
  • Abnormal stoppages of sounds and syllables (no sound but mouth in correct position to speak) within phrases and sentences that can last several moments
  • Interjections where a person may have difficulty smoothly joining words around other words (“at the beach we – um um ah you know like ah – built a sandcastle”)
  • Unusual facial and/or body movements associated with the effort to speak

Stuttering usually starts in early childhood. The exact cause of stuttering is unknown however there are factors that most likely contribute to the development of stuttering which include:

  • Genetics (approximately 60% of people who stutter have a family member who also  stutters)
  • Child development (children with other speech and language problems or developmental delays are more likely to stutter)

Stuttering may occur when a combination of factors comes together and may have different causes in different people.

At Lift Off, we offer evidence based treatment for children who stutter. It is essential that parents are involved in the treatment process to encourage confident communicators and to assist in developing and promoting fluent speech across all environments.

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6. Voice Disorders

A healthy voice is essential for participation in school and extra-curricular activities.  Children use their voices to answer questions in class, express emotions and interact with their friends.

A disordered voice is when a child sounds significantly different from other children the same age and gender. Characteristics may include:

  •   A hoarse or harsh voice
  •   Pitch that is too high or too low
  •   The child may have to use too much effort to talk
  •   The child may lose his/her voice after a lot of talking, or be unable to raise the volume of his/her voice.
  •   A voice that sounds nasal: not enough air coming from the child’s nose like it’s blocked
  •   A voice that sounds nasal: too much air coming out of the nose when they talk

The most common cause of vocal problems is vocal misuse and abuse.  Anyone who uses their voice excessively may develop related voice problems.  Children in particular may yell and scream, talk too loudly, and make strange noises with their voices (excessively) as they play. These misuses and abuses may result in changes to the vocal folds.

At Lift Off, we provide programs that assist children in repairing their voice and teach them how to use it in the best way. The speech pathologist will:

  •   Help the child understand what they have been doing with his/her voice that has caused the problem
  •   Work closely with the child and their parents/ teachers to modify those behaviours
  •   Teach the child better ways to use his/her voice
  •   Teach the child specific exercises to improve breathing and sound production

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7. Bilingual Learning

Learning two languages will not cause speech and language problems. Children can be bilingual but sometimes one language is stronger than the other. Being able to develop skills in two languages depends on the amount of exposure your child has to both languages as well as the opportunities to practice.

It is common for children to be stronger in one language than the other but if your child is having difficulties with both languages, you may need to see a speech pathologist to review your child’s speech and language development.

Our wonderful therapist, Iris is fluent in Cantonese and can assist families who have children learning to be bilingual.

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8. Autism Spectrum Disorder

Lift Off provides speech pathology services to children who have a diagnosis of Autism Spectrum Disorder (ASD). We work with children who are both verbal and non-verbal.

ASD is a developmental disability characterised by difficulties in communication, social interaction and repetitive behaviour patterns.

Intervention encompasses all areas of speech and language development to target and encourage age appropriate acquisition of communication based skills through an intensive program.

Our programs focus on:

Functional Communication

  • Delayed speech and vocal development
  • Delayed language development
  • Reducing echolalia (repeated sounds, words, phrases)
  • Using language appropriately and effectively
  • Interpretation of language and comprehension
  • Learning to comment and request appropriately
  • Decreasing frustration behaviours
  • Communication inflexibility

Social interaction

  • Understanding and use of non-verbal communication such as eye contact, gestures
  • Social communication and awareness
  • Interaction and play skills
  • Understanding and expressing emotion

Repetitive behaviours

  • Reducing repetitive vocalisations
  • Reducing repetitive play sequences
  • Inflexibility in routine

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9. Primary School language and academic development

At Lift Off, we assist and support your child’s ongoing academic learning. We do this by identifying specific areas of weakness and provide them with the confidence they need to excel. Specifically, we:

Support the development of language comprehension and vocabulary:

  • Verbal information recall
  • Following instructions
  • Improving comprehension (understanding) and interpretation of text
  • Understanding the relationship between ideas
  • Providing students with reading comprehension strategies
  • Understanding word meanings
  • Improving memory and word retrieval
  • Increasing vocabulary

Support the development of written work. This may include:

  • Writing formal styles of language such as narratives, reports, recounts, expositions

Focus on language expression:

  • Providing appropriate responses to questions
  • Giving instructions for games or directions
  • Increasing detail and providing accurate information

Focus on behavioural issues or coping strategies that may manifest or result from academic weakness:

  •  Processing information
  •  Asking for assistance or clarification
  •  Maintaining attention and focus
  •  Encouraging participation
  •  Decreasing frustration
  •  Assist with disorganised behaviour and routines

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10. High School language and academic development

At Lift Off, we assist and support your child’s ongoing academic learning. We do this by identifying specific areas of weakness and provide them with the confidence they need to excel.

Specifically, we:

Support the development of written expression which may include:

  • Writing extended responses or essays
  • Taking notes, summarising and study skills
  • Writing formal styles of language such as narratives, reports, recounts, expositions

Written expression is an intricate skill and can be a trigger for behavioural issues when difficulties arise such as avoidance, reluctance to read and write, and overall reduced motivation.

Specifically, our written expression programs focus on:

  • Planning, scaffolding and drafting written work
  • Learning about and writing text types
  • Sentence writing
  • Paragraph writing
  • Short story writing
  • Editing
  • Language in written tasks
  • Vocabulary and word meanings
  • Reading Comprehension and written answers
  • Naplan preparation

We also assist and support your child’s ongoing academic learning by:

Focusing on language expression:

  • Providing appropriate responses to questions
  • Giving instructions for games or directions
  • Increasing detail and providing accurate information

Focusing on behavioural issues or coping strategies that may manifest or result from academic weakness:

  • Processing information
  • Asking for assistance or clarification
  • Maintaining attention and focus
  • Encouraging participation
  • Decreasing frustration
  • Assist with disorganised behaviour and routines

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11. Literacy and Learning

The NSW Department of Education and Training defines literacy as the ability to understand and evaluate meaning through reading and writing, listening and speaking, viewing and representing.

In other words, literacy refers to the process of gaining meaning from text. This involves understanding spoken words and decoding written words for reading development.

As your child moves from preschool to primary school and then to secondary school, it is necessary for their literacy skills to develop accordingly. It is not uncommon for some students to feel ‘left behind’ in the classroom.

It is important that all students are taught literacy skills in a manner that engages their interest and enhances their knowledge. Students need to understand that there is a purpose behind what they are learning. To learn successfully, students are required to read, learn, understand and write about new information. A weakness in any of these areas can often result in behavioural and/or motivational problems which may only delay them further.

At Lift Off, we assist and support your child’s ongoing academic learning. We do this by identifying specific areas of weakness and provide them with the confidence they need to excel.

Specifically, intervention may focus on:

  • Building upon language skills
  • Developing foundation literacy skills
  • Phonological awareness and phonics: sounds vs. letters, rhyme, syllabication, blending and segmenting of sounds
  • Decoding
  • Reading accuracy: the accurate pronunciation of a written word
  • Reading fluency: the combination of accuracy and speed to ensure an automatic output
  • Word formation patterns
  • Spelling patterns
  • Word meaning and vocabulary
  • Grammar: the ‘rules’ relating to the structure of language
  • Reading comprehension
  • Written expression

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12. Auditory Processing Disorder

Auditory processing disorder (APD) sometimes known as Central Auditory Processing Disorder (CAPD) is the inability to process auditory information where the brain does not properly coordinate with what it hears. It is not a problem with hearing or deafness; in fact most children with APD have normal hearing.

Children with APD may display a variety of listening difficulties such as understanding speech in noisy environments, following directions or taking on instructions, discriminating between speech sounds, taking on verbally presented information (especially in a classroom), remembering sounds or focusing on sounds.

Careful, specific and accurate diagnosis is necessary to identify APD and to rule out other disorders that may present similar symptoms. These include cognitive or language disorders or the effects of ADHD or Autism. It is important to note that not all communication disorders or intellectual disabilities are the result of APD.

A speech pathologist can contribute to the diagnostic process by assessing speech development, language abilities and written and oral language. The final diagnosis of APD is made by an audiologist and the child must be between 7 and 8 years of age before this diagnosis can be officially made (due to the constantly changing brain function in younger children).

Treatment of APD is highly individualised and specific to the child. At Lift Off, we focus on three particular areas:

  • Assisting in changing or modifying the learning or communication environment. This may involve liaising with parents and school to improve access to information that is presented verbally.
  • Strengthening the areas of language, problem solving, memory, attention and other cognitive skills to help with compensatory techniques for self-awareness to overcome the barriers of APD
  • Treatment of the specific auditory deficit including individualised therapy in a clinic and within varied environments such as home and school.

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