Some children may need to rely on other modalities of communication instead of talking. This may be temporary or some children may need to use these modalities permanently. There are low tech options which include sign language, communication boards, Picture Exchange Communication System (PECS), writing or high tech options such as TouchChat or Proloquo2go.

Children with Autism Disorder may have difficulty in the following areas:

Language skills: difficulties understanding language, limited vocabulary, limited words in a sentence. Some children may be able to speak in full sentences, understand everything that is said to them and have an extensive vocabulary however, they may have difficulty with the social aspect of language such as knowing how to stay on topic, continue conversations, read body language and talk about various topics.

Play: Children with ASD may also be very rigid- preferring to play in a certain way or with certain toys. They may also have difficulty knowing how to play appropriately with others.

Non-verbal: difficulty sustaining eye contact, joint attention, not responding to their name.

Language delays can be broken down into three main areas:

Expressive language (speaking) including, but not limited to:

• limited vocabulary or words

• limited number of words in a sentence

• difficulty putting words into a sentence

• difficulty with pronouns or tenses

Receptive language (understanding of language) including, but not limited to:

• difficulty following instructions

• difficulty answering questions

• difficulty identifying different objects

Pragmatics (the use of appropriate communication in social situations) including, but not limited to:

• Staying on topic

• Talking about various topics of interest and not only their favorite topics

• Taking turns in conversation

• Providing background knowledge to prevent misunderstandings in conversation

There are also language-based learning disabilities such as the ability to read, spell, write

Sometimes parents may want parent-only sessions to go over strategies that they can practice at home. Children may also have a team working with them such as teachers, behavioral interventionists or behavioral consultants. The Speech-Language Pathologist can help the team create goals and provide training on how to target those goals.

Children with Apraxia of Speech know what they want to say however, they have difficulty planning the movement. This means that the brain is unable to translate the right messages for the muscles to move appropriately. This can cause the lips, tongue or mouth to move inaccurately distorting the speech sounds. The errors are usually inconsistent and unpredictable. Children with Apraxia of Speech are usually difficult to understand. For more information, you can visit the Asha website.

Dysarthria is a motor speech disorder where the muscles needed to speak are paralyzed, weak or damaged. Children with Dysarthria have difficulty executing the movements. This can cause difficulties pronouncing words, volume control, breath support and pitch control.

Articulation or speech sound disorders are when children have difficulty producing age- appropriate speech sounds. Their words may be mispronounced if sounds are substituted for another, sounds are left out or sounds are changed. All children develop differently however, this is a rough guide on the ages when different speech sounds are acquired. Sometimes children also have patterns of sound errors called Phonological Processes. You can read more about that here.

Traumatic brain injuries may be caused by an accident or during child birth. Those that have a TBI may have difficulty with language, critical thinking, problem solving, paying attention, speech and pronunciation or social communication issues.

Selective mutism is when a child is comfortable speaking in certain environments with certain people and does not speak in other situations.

Children with a hearing loss may have difficulties developing speech and language. They may have difficulty pronouncing sounds, delays in picking up vocabulary, understanding different sentences and producing sentences.

Stuttering occurs when the flow of a sentence is disrupted. This can occur when children repeat syllables, whole words or phrases, prolong sounds or stop and make no sound in the middle of a sentence. Sometimes children between 18-24 months old may develop a stutter when they have a sudden increase in vocabulary and this should resolve itself. If stuttering becomes worse and continues after 3 years old, it may be a good idea to contact a Speech-Language Pathologist.

Down Syndrome, Fragile X, Kabuki Syndrome, Genetic deletions