Speech-Language Pathology

Babbling
Long strings of sounds that children begin to produce at about 4 months of age.

Bilateral vocal cord paralysis (BVCP)
A type of vocal cord paralysis in which both vocal cords do not move. Learn more.

Central auditory processing
What happens when your brain recognizes and interprets the sounds around you.

Cleft palate
Cleft palate is a separation in the roof of the mouth that occurs when it fails to join, or fuse, as a child is developing before birth. Surgery to correct a cleft palate is usually performed between 9 months and 2 years of age, and may require several stages of repair. Possible long-term problems include speech problems, crooked teeth, frequent head colds and frequent ear infections. Learn more.

Cochlear implant
Implantation represents one of the greatest advances in the management of children with severe to profound sensorineural hearing loss (“nerve deafness”). By implanting a computerized device into the inner ear, functional hearing can be restored to children not benefitting from traditional amplification with hearing aids. Learn more.

Communication disorders
Disorders in which young children may not speak at all, or may have a limited vocabulary for their age. Some children have difficulty understanding simple directions or are unable to name objects. Most children with communication disorders are able to speak by the time they enter school, however, they continue to have problems with communication.  School-aged children often have problems understanding and formulating words. Teens may have more difficulty with understanding or expressing abstract ideas. The symptoms may resemble other problems or medical conditions. Learn more.

Compensatory articulation
A child may learn to produce sounds in an alternate way by using the air pressure in the throat for speech.

Craniofacial anomalies
A diverse group of deformities in the growth of the head and facial bones. “Anomaly” means “irregularity” or “different from normal.” These abnormalities are congenital (present at birth). There are numerous variations − some are mild and some are severe and require surgery.

Cue
Some type of aid (visual, auditory, tactile) that promotes a correct response.

Cul de sac resonance
Occurs when sound resonates (vibrates) in the throat or nose, and is trapped in that area with no outlet. The speech is perceived as muffled because the sound is stuck in a cavity with no direct means of escape. The cause of cul de sac resonance can vary, but it is usually due to a blockage in the throat or nose.

Disfluency
Any breakdown in the natural flow of speech. The intended message may be referred to as disfluency, or stuttering. Learn more.

Drill therapy 
A method of treatment in which the therapist leads the child in targeting specific goals. Repetitions are used to increase accuracy. Typically treatment starts with production of sounds in isolation and progresses to syllables, words and sentences.

Dysphagia
Feeding or swallowing problems that can occur in infants and children of all ages.

Dysphonia
The degree of voice disorder.

Early intervention
A key to successful treatment. If a child’s communication skills are significantly behind those of peers, it’s time to seek help. Before age 6, the brain is very flexible for language and speech learning; after 6, it’s much harder and takes longer to correct disorders. Also, habits aren’t as strong earlier, and the child’s ability to learn hasn’t yet been harmed. It’s also important to get speech therapy before a child enters school, because there can be teasing. Therapy can help avoid the emotional effects when a child has difficulty communicating.

Echolalia
Immediate, whole or partial vocal imitation of another speaker.

Eosinophilic esophagitis
A disease characterized by elevated levels of eosinophils in the esophagus. Learn more.

Expansion
An adult’s more mature version of a child utterance that preserves the word order of the original child utterance. For example, when a child says, “Doggie eat,” an adult might reply, “The doggie is eating.”

Expressive language
Refers to the ability to choose words and combine the words appropriately to communicate with sentences. Learn more.

Extension
An adult’s semantically related comment on a topic established by a child. For example, when a child says, “Doggie eat,” an adult might reply, “Yes, doggie hungry.”

Feeding team
Feeding is a complex process involving gross motor, fine motor, oral motor and reflex development, as well as nutritional and behavioral factors. An oral-motor / feeding problem may involve one or more of these factors, and may have an organic or environmental etiology. Physiological abnormalities may interfere with normal development of feeding patterns, and environmental factors may contribute to the evolution or maintenance of such problems. The technological advances used for supplementary means of nutritive support (e.g., nasogastric tube feedings) may also contribute to the problem. Such problems have been estimated as occurring in as much as one-third of the handicapped population, and approximately 21 percent of those with feeding problems have behavioral mismanagement as a primary etiology.

While it is most common for children with feeding problems to be referred to a single discipline (e.g., speech pathology, psychology), an interdisciplinary approach has been advocated and shown to be the most comprehensive treatment of choice.

The Cincinnati Children’s interdisciplinary feeding team provides a mechanism for integrating the knowledge and expertise of these varied disciplines to provide more effective and efficient treatment planning for children with feeding problems.

Fiberoptic endoscopic evaluation of swallowing (FEES)
A procedure to evaluate the swallowing process in pediatric patients with swallowing disorders due to a variety of etiologies. FEES is a procedure that evaluates the pharyngeal stage of the swallow and helps to assess the airway protection mechanisms during swallowing. Learn more.

Fluency
The natural forward flow of speech.

Gesture
Movement of any part of the body to express or emphasize an idea, emotion or function.

Grammar
Rules that outline the way words can be put together to form meaningful sentences in spoken or written language.

High-Risk Infant Follow-Up Program  
High-Risk Infant Follow-Up Program at Cincinnati Children’s was established to care for low-birth-weight infants and evaluate their long-term outcome. Since then, the program has expanded to offer tertiary level outpatient clinical care, consultation services and specialized medical and developmental supervision for high-risk infants.

Home Program
Helping parents and children unscramble speech disorders is the work of the speech and language pathologists at Cincinnati Children’s. They help families manage with one-on-one sessions coupled with trained parental help.  They teach parents to be therapists at home.

Hypernasality
Occurs when too much sound resonates (vibrates) in the nasal cavity (nose) during speech. This type of resonance makes the patient sound as if he is talking through the nose. This can be due to an abnormal opening between the nose and the mouth during speech due to velopharyngeal dysfunction.

Hyponasality
Hyponasality occurs when there is not enough sound resonating (vibrating) in the nasal cavity (nose) during speech. This type of resonance makes the patient sound “stopped up.” This can be due to blockage or congestion in the throat or nose.

Language disorder
Difficulty understanding the meaning conveyed in speech. The child may be unable to understand others’ speech. Other indications of possible language disorder are a limited vocabulary, use of inappropriate words or reliance on short phrases and sentences. The child may also put sentences together incorrectly. Learn more.

Mean
The average in a group of numbers or scores.

Nasal air emission
Sounds (including nasal rustle or nasal snort) associated with hypernasality. Nasal air emission refers to the audible release of the air pressure through the nasal cavity and nose during speech.

Nonverbal
Without oral speech.

Oral apraxia
Affects the ability to voluntarily control nonspeech movements. The child might have difficulty sticking out and wagging his tongue. Or the child may have difficulty sequencing movements for the command, “Show me how you kiss, now smile, now blow.”

Oral-motor
Muscular movements of the mouth during speech and feeding.

Oral myofunctional disorders
Differences in the position or function of the muscles of the face or mouth, including the lips and tongue. These differences in dental, skeletal and muscular structures may interfere with appropriate swallowing, speech and oral rest postures. At times, these often-subtle differences may negatively impact dental and facial growth patterns.

Phonemes
Sounds in a language that distinguish between words.  For example [p] and [b] are English phonemes that distinguish between the words “pea” and “bee.”

Phonation
The act of producing sound with the vocal folds.

Phonology
The study of speech sounds in a language.

Play therapy
Method of treatment in which the child is allowed to play freely with a select group of toys. The clinician follows the child’s lead during the therapy session.

Pragmatics
Set of rules governing the use of language in context.  For example, waving your hand from side to side means “hello” or “goodbye.”  Making eye contact allows the listener know you are interested in what she is saying.

Receptive language
The ability to understand the speech of others. Learn more.

Resonance
The quality of the voice that results from sound vibrations in the pharynx (throat), oral cavity (mouth) and nasal cavity (nose). The relative balance of sound vibration in these cavities determines whether the quality of the speech and voice is perceived as normal or as abnormal due to a type of “nasality.”

Sign language
American sign language (ASL). Communication method used by the deaf in which gestures (signs) function as words.

Stuttering
A child with stuttering has an abnormal number of repetitions, hesitations or prolongations in the natural flow of speech.  The child is often tense during speech and avoids speaking because of a fear of stuttering. Learn more.

Speech-Language Pathologist (SLP)
An individual who is qualified to diagnose speech, language and voice disorders and to prescribe and complete therapy programs. An SLP has a degree and certification in speech and language pathology. May also be called a speech therapist, speech clinician or voice therapist. 

Standardized test
A test that has standardized procedures for administration and scoring. An individual’s performance can be compared to that of others who are the same age. 

Syllable
A unit of speech consisting of a vowel that stands alone or is surrounded by one or more consonants (e.g., “i,” “in,” “me”).

Unilateral vocal cord paralysis (UVCP)
A type of vocal cord paralysis where one vocal cord does not move.

Velopharyngeal insufficiency (VPI)
The inability to separate the nasal cavity from the oral cavity during speech. The result is abnormal resonance and the production of distracting noises during speech. Decreased intelligibility results due to the distortion of consonants and vowel sounds.

Not all velopharyngeal insufficiency requires treatment. In those cases where speech intelligibility is affected, various treatment options are available and need to be tailored to the findings obtained on a nasopharyngoscopy.

Speech therapy may be an option in patients in which articulation errors are the source for the hypernasality. Speech therapy is often necessary to correct compensatory speech problems that develop secondary to velopharyngeal insufficiency. Speech therapy is generally required after surgical intervention so the patient can obtain maximum benefit.

Physical intervention varies from procedures lasting less than 10 minutes to those requiring 1½ hours. The areas where the patient is losing sound energy from the oral cavity into the nasal passages require some form of treatment to obstruct this abnormal escape. Generally, tissues from the back wall of the throat are rotated in such a way that the patient is able to separate the nasal cavity from the oral cavity during speech. Learn more.

Voice
The sound generated when air pressure is forced through closed vocal folds, which are two muscles in the larynx, causing them to vibrate.  Voice provides the power and sound to deliver a verbal message.

Voice disorder
The vocal folds do not vibrate efficiently or evenly to produce a clear sound. It is characterized by abnormal vocal pitch, loudness, quality or resonance. Learn more.