In our centre, Speech Therapy is focused on the provision of scientifically substantiated services with a view to covering the needs and wants of children who face difficulties in speech, language, communication and/or feeding, drinking and swallowing.
Our Speech Therapists provide their clinical services according to the optimal scientifically documented data available, always taking into consideration the unique wants and values of the child and family.
Our specialist Speech Therapists focus on the following areas:
- Disorders in Articulation and Phonological Disorders
- Production of speech sounds where, for instance, the child replaces /s/ with /th/ e.g. ‘thoup’ or the child simplifies words such as ‘lane’ instead of ‘plane’, or syllable and sound reversals such as ‘melon’ instead of ‘lemon’
- Breathing and Phonation disorders
- Breathing and phonetic coordination
- Pitch, intensity and quality
- Resonance disorders
- Speech flow disorders
- Comprehension and Language Expression Disorders
- Pre-linguistic communication – focused attention, purposeful communication, interaction
- Pragmatics – use of language, social aspects of communication
- Phonological awareness
- Reading and Writing
- Cognitive functions
- Succession – Sequencing
- Executive functions
- Feeding and swallowing disorders
- Difficulties in sucking, drinking and/or chewing
- Muscle weakness for adequate mucous formation
- Sensitivity in the acceptance and management of different food textures e.g. eating only puréed food
- Anatomy and functionality (stability, strength, mobility and muscle tone) of the oral, pharyngeal, laryngeal and oesophageal areas
- Craniofacial abnormalities e.g. lip and palate cleft
The clinical decisions our Speech Therapists make include:
- Prevention and early referral to appropriate and specialized health professionals
- Detection of difficulties/disorders
- Therapeutic plan development, intervention and monitoring
- Collaboration with a host of health professionals
The causes leading to the manifestation of communication and swallowing disorders are:
- Neonatal complications (e.g. prematurity, low birth weight, exposure to substances)
- Developmental disorders (e.g. specific language disorder, autism spectrum disorders, dyslexia, mental delay/learning disorders, attention deficit disorders/hyperactivity)
- Hearing disorders (e.g. hearing loss or deafness)
- Oral cavity disorders (e.g. lip/palate cleft, dental abnormalities, macroglossia, stomato-kinetic dysfunction)
- Respiratory disorders (e.g. bronchial respiratory dysplasia, chronic obstructive pulmonary disease)
- Pharyngeal abnormalities (e.g. obstruction of the upper respiratory tract, peri-oropharyngeal deficiency/weakness)
- Laryngeal abnormalities (e.g. pathology of the vocal cords, tracheal stenosis, tracheostomy)
- Neurological diseases/disorders (e.g. cranial injury, cerebral palsy, stroke, dementia, Parkinson’s disease, amyotrophic lateral sclerosis and multiple sclerosis)
- Psychiatric disorders (e.g. psychosis, schizophrenia)
- Genetic disorders (e.g. Down Syndrome, Fragile X-chromosome Syndrome, Rett Syndrome, etc.)
Our speech therapists collaborate closely with the family, as well as with other health professionals, with a view to reducing the impact said difficulties may have on various aspects of daily life, by limiting the overall participation and well-being of individuals (RCSLT, 2014). Therefore, within the context of a holistic therapeutic intervention and aiming at the overall development and well-being of the individual, our Speech Therapists work closely with Physical Therapists, Occupational Therapists, Special Needs Educators, Teachers, Psychologists, Nutritionists, as well as other medical/paramedical specialities in order to achieve an interdisciplinary therapeutic intervention for the development of the most appropriate therapeutic program.
The most contemporary methods are used in the department of Speech Therapy:
The Greenspan Floortime approach
The DIR model is often referred to as the ‘Floortime’ method, even though it is essentially a basic strategy of a more comprehensive approach to Autistic Spectrum Disorders (ASD). The name is an acronym for the Developmental, Individual-difference, Relationship-based model. This model was developed by Stanley I. Greenspan and Serena Wieder and, although not as widely known as other interventions for children with ASD, it has been used in the USA and Europe for decades. The main aim of the model is to build the foundations for healthy child development, as opposed to strategies that place more emphasis on treating only the symptoms (Greenspan & Wieder, 2006).
Neuro-Muscular Electrical Stimulation (NMES)
Neuro-Muscular Electrical Stimulation is a method whose basic principle lies in the channelling of electric current of mAmp tension along a muscle or a muscle group in order to maintain muscle tone when the corresponding neural stimulation is not sufficient. In this way, it is possible to strengthen the muscle and to avoid possible atrophy. This principle has been known for decades and has full application in Physical Therapy, while there is a plethora of scientific articles for its implementation.
A therapeutic application that uses the elasticity of cotton tapes on the skin in order to affect muscles and nerves.
It attempts to mimic skin quality
It provides a superficial deep stimulus to the exterior, interior, superior and posterior
It can help in the normalization of natural functions if it is correctly applied to the target tissues
It can be worn for lengthy periods, providing a continuous therapeutic effect with minimal counterindications
It is used quite often in all rehabilitation units
The aims of feeding therapy include the provision of adequate nutrition, the development of the normal stomato-kinetic functions of feeding and the development of the normal stomato-kinetic functions of speech, through a specific protocol of functional activities, as well as through the training of the child’s caregivers.
Oral Placement Therapy
Oral placement therapy is aimed at children who present deficits in the modular structures of the face and oral cavity, leading to speech and feeding impediments. Through specific functional exercises of the modular structures we can achieve the necessary mobility, flexibility, precision and endurance of the structures with immediate results in feeding and speech.
PECS – Picture Exchange Communication System
PECS is a system of alternative and/or incremental communication for individuals with non-verbal communication or who are in the emerging stages of verbal communication. It begins by teaching the individual to hand the image of a desired object to a ‘communication companion’, who immediately responds to the exchange as if it were a request. The system moves on to the teaching of distinguishing between pictures and of how to place them together in order to from sentences. In more advanced stages, individuals learn how to respond to questions and make comments.
PODD – Pragmatic Organisation Dynamic Display
The PODD system is a complete system for organizing words and symbols in a communication book or a speech production device that provides an integrated language for independent communication to individuals with Complex Communication Needs (CCN). The aim of the PODD is to provide a comprehensive language/vocabulary for continuous communication at all times, for the full range of messages, on various topics and in multiple environments.
The Makaton is a program that enables all individuals presenting a broad spectrum of developmental difficulties in speech and communication to cultivate these skills and to use them in a simple but very functional way, so as to be able to participate in social life, to have fun, to have choices and assert their rights. The Makaton can be applied to all environments such as the home, the school, the workplace, etc. Its didactic approach focuses, at a primary level, on the acquisition of basic communication and language skills and at a higher level, on the conquest of reading and writing.
TEACCH – Treatment and Εducation of Autistic and Communication Handicapped Children
This method accentuates the need for the provision of structured education, in order to create a predictable environment, which will help the child to move and function safely during the performance of her activities. After all, it is a well-known fact that the autistic child finds it difficult to set rules that allow for appropriate direction in daily contexts. Daily life appears extremely unpredictable to the child and even minor changes can give rise to feelings of stress, confusion and disorganization. What is needed, therefore, is a stable environment. Moreover, the TEACCH method is based on the organization of individual work stations, the use of visual aids (such as photographs, objects and lists, due to the difficulties in the auditory processing of information these children face), the individualization of the teaching program through the creation of personalised daily schedules, as well as the development of group activities in order to enhance social interaction. The basic premise of this program is that autism is a developmental disorder, which can be tackled effectively through a psycho-educational approach that focuses on the evaluation of all aspects of the individual and his environment and can be applied from infancy through to adult life.
GRID 3 – Open Environment of Alternative Incremental Communication
GRID constitutes one of the most comprehensive software applications for alternative and incremental communication. Its potential as a tool for alternative communication, as well as for the therapeutic/educational process, is only limited by the time dedicated to the creation of activities and usage grids and communication charts. The environment is open-ended, allowing the therapist/educator to fully adapt it to the user’s environment.
WHEN SHOULD PARENTS BE ALARMED (ASHA, 2004)
Up to the 1st year of age
- Does not turn her gaze towards a sound source
- Does not follow adult conversations and enjoys ‘peek-a-boo’ games
- Does not recognize familiar objects and execute simple commands
- Does not mimic different sounds, does not produce chains of syllables during bubbling and/or does not say simple everyday words
Up to the 2nd year of age
- Does not recognise basic body parts
- Does not respond to simple questions such as ‘what is this?’ or ‘where is it?’
- Does not produce simple two-word phrases
- Does not produce a variety of vocal sounds
Up to the 3rd year of age
- Does not comprehend opposite meanings e.g. big-small, up-down
- Does not perform complex 2-step commands
- Does not produce 2-3 words to express wishes and other important events
- Her speech is unintelligible to people outside the family
- Does not formulate questions
Up to the 4th year of age
- Does not recognize animals, colours, shapes and other concepts in everyday vocabulary
- Does not narrate daily routine events by producing 3-4 phrases on average
- Does not respond to questions “who?, what?, where?’
- Does not formulate questions with ‘when?’ and ‘how?’
- Does not use personal and possessive pronouns
- Does not produce plurals
Up to the 5th year of age
- Does not comprehend temporal, spatial, quantitative concepts
- Does not follow complex 3-4 step commands
- Does not name numbers and letters
- Does not narrate a short story