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Speech Services:


These are general descriptions of language deficits that can be addressed in therapy. Please contact us for more information.

Speech includes the quality and clarity of sound production. There are many factors that can contribute to specific deficits. Some of which include: 


• Articulation:

 A child with an articulation disorder may exhibit sound distortions, substituting one sound for another or omitting a sound.


• Phonological Processes:

A pattern of sound errors. Very young children often present with phonological processes, however, they should remediate as their speech matures.


• Myofuctional/Tongue Thrust

A reverse swallow or tongue thrust may negatively affect dentition/and or speech production. A tongue thrust may need to be remediated in order for sound production to be corrected. A child with a tongue thrust may benefit from orthodontics in addition to myofunctional speech therapy.


• Dysfluency/Stuttering:

Repetition of a sound, syllable, word or phrase.


Please refer to the following link for more information about speech disorders:


Motor Speech Disorder:

Childhood apraxia of speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, but his/brain has difficulty coordinating the muscle movements necessary to say those words. (ASHA, 2013)


Apraxia of Speech (CAS):

CAS may occur as part of another diagnosis or less commonly as an individual diagnosis. Please refer to the information below for some of the characteristics of CAS.


Speech Signs of Apraxia:

There is no definitive blood test or brain scan that can lead to a clinical diagnosis of apraxia.  We have to rely, therefore, on a list of signs and symptoms to help us zero in on the disorder.  It is difficult to assign an age range to a list such as this as the total child and a constellation of signs need to be considered.  For instance, taken alone, it is not unusual for a toddler to say “tuck” for “truck” and “wah” for “water.” However, if your child fits the criteria of a late talker and has many of the following signs, he or she should be evaluated, as there is a good possibility that he or she has apraxia.


Does your child...

  • favor the use of one syllable for all words (for example, “da” may be generic for “daddy,” “brother,” “dog,” and book”)?

  • often omit a sound or syllable, perhaps saying “wah” instead of “water,” distorting vowels, and saying “tuck” for “truck”?

  • reverse sounds or syllables, saying “shif” for “fish” or “miskate” for “mistake’?

  • add extra sounds or syllables in words?

  • find it difficult to produce words with a number of syllables?

  • make more errors when trying to craft longer statements?

  • find speech easy one day and hard the next?

  • correctly say a difficult word but be unable to repeat it?

  • speak too slowly or too fast, or place inappropriate stress on certain syllables or words?

  • exhibit “groping” behaviors trying to find the proper mouth position, silent posturing, or dysfluencies (stuttering)?

  • display expressive language disturbances:  limited vocabulary, grammatical errors, or disordered syntax?

  • only use restricted combinations of consonants, only saying b, p, m, t, d, and h?

  • comprehend language much better than he or she is able to express himself or herself?

  • have signs of hyptonia (low muscle tone), especially in the trunk, and/or oral hypotonia, little facial expression (low muscle tone in oral cavity, cheeks)?

  • display gross- and fine-motor incoordination  (generalized dyspraxia, “clumsy child” syndrome)?

  • have sensory integration dysfunction and self-regulatory issues (difficulty calming himself or herself, for example)?

  • use both of his hands (most children exhibit a preference for one hand-“hand dominiance”-by age two)?

  • come from a family with a history of speech, language, and learning problems?”


(Above information taken from the book, The Late Talker, by Marilyn C. Agin, M.D., Lisa F. Geng, and Malcom J. Nicholl)

We use an eclectic multi-modality approach when working with children who present with CAS using techniques such as: PROMPT, integral stimulation, multi-sensory cueing, progressive approximation, shaping, and phonetic placement techniques. These techniques focus on multiple repetitions of the target sounds that are necessary to promote muscle memory for sound production and are highly effective in treating CAS.  We have attended numerous courses on CAS and have been trained by expert therapists and physicians in the field. CAS therapy includes games and play to keep the children’s interests while practicing speech and having fun!

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