Specialist Therapy Approaches

Speech and Language Therapists use a variety of methods to provide therapy.  The type of therapy you receive will be determined by your assessment and diagnosis.  All therapy is designed to meet your needs, there is no ‘one size fits all’ approach.

Speech therapy for children who are Autistic or neurodiverse:

Children who are Autistic or have social communication difficulties have an individual style of communication, social interaction and play.  They may have specific sensory needs and benefit from different learning styles.

Therapy will build on interaction and language skills, attention and play.  You will be central to your child’s therapy and learn how to build interaction and language into your everyday life.

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Speech therapy for children with language difficulties

Children slow to develop their understanding of language or slow to speak may be described as having Speech and Language and Communication Needs.  Children may have additional difficulties with attention and listening skills, play, expressive language and developing vocabulary.

Following assessment, a plan for therapy will be discussed (if appropriate), this will focus on your child’s individual needs.  Advice and support will also be offered to families, education staff and other agencies to develop a language rich environment to support your child’s language development.

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Speech therapy for children with speech sound difficulties

Children typically develop speech sounds in a developmental pattern.  Sounds are substituted in a systematic way e.g. the word ‘car might always be pronounced as “tar”.  Some children have specific difficulties with their speech and their development does not follow the normal patterns (speech disorder) or is slow to develop (speech delay).

Your child will be assessed to identify if their speech is within the typical range for their age or if they have a specific speech disorder or a speech delay.  Therapy will be designed for your child and may include: listening and discrimination skills, awareness of speech sounds and development of speech sounds. 

Advice and support will be offered to parents, education staff and other agencies. This will focus on your child’s individual needs; offering training and support to allow them to support your child’s speech development and literacy needs.

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Speech therapy for children with Childhood Apraxia of Speech/Verbal Dyspraxia

Childhood Apraxia of Speech is a difficulty with the planning of muscle movements for speech.

Children may be slow to develop speech or have no speech at all.  Language may be late to develop.  Children with Dyspraxia often have good understanding of language and are aware of their speech difficulties.

Your child will receive careful assessment, this may be carried out over a period of time alongside therapy.   Therapy will focus on developing the precise motor planning for speech and will build upon your child’s abilities. 

Advice and support will also be offered to parents, education staff and other agencies. This will focus on your child’s individual needs; offering training and support to allow them to support your child’s speech development and literacy needs.

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Speech therapy for adults with  language difficulties after a stroke or with other conditions.

The effect of a stroke is different in every individual.  Speech therapists carry out specific assessments of communication skills spoken language, understanding, speech, reading and writing.  Your views and those of your family are taken into account when setting goals for therapy. 

Early therapy may be focussed on repairing brain function for speech or language.  Later on, the focus may change to adapting and supporting communication in every day life.

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Details of specific therapies

More details of specific therapy approaches can be found below.  The approaches are based on clinical research and proven to be effective. You may be offered one or more of these as part of your therapeutic plan.

Speech therapy for children who are neurodiverse.

• Hanen More than Words. Help your child to develop their communication and social skills in your everyday routines.  Hanen can be delivered to a single family or a group of families.  www.hanen.org
• Intensive Interaction therapy (IIT).  IIT is a person-centred speech and language intervention used to develop sociability and communication.  It is effective with adults and children with severe learning disabilities and autism, who struggle to interact with people.  Therapy develops basic social communication skills, reduces stress and negative behaviours, develops an individuals feelings of self worth, and encourages positive interactions. www.intensiveinteraction.org
• Sensory Integration. Some children have an underdeveloped sensory system which affects their ability to regulate and respond to sensory input (smell, sound, vision, emotion, feelings).  Occupational Therapists are specialists in sensory processing and carry out assessment and therapy.  As a speech and language therapist, it is important to understand a child’s sensory needs.  This enables us to adapt therapy approaches and the therapeutic environment to enable the child to get the most out of therapy.  www.sensoryintegration.org.uk
• Communication passports. A communication passport is a highly personalised book about the owner and gives important information about their needs, wants and interests.  It can be a low tech book on paper or an interactive book on an iPad.  The owner takes an active part in compiling their passport and is supported by their family, care staff and speech and language therapist. www.communicationpassports.org.uk
• Visual supports.  Visual supports are helpful for individuals with Autism, delayed development and learning difficulties.  Timetables (schedules) provide a structure for daily activities. Choice boards enable an individual to actively communicate their preferences.  www.autism.org.uk
• Social stories are visual scripts which allow an individual to understand a situation and its consequences in a visual format.  They help individuals to understand what might happen in a situation and provide guidelines on how to behave.  This gives information and structure which supports understanding and reduces anxiety around new experiences.
• Total Communication encourages the use of all communication methods to support an individuals ability to understand language and express themselves.  It is used to support individuals with speech language and communication needs, ASD, Down Syndrome, Learning Difficulties and other conditions.  A total communication approach utilises speech, body language, facial expression, sign and gesture, symbols, written words, objects and sensory information.

Speech therapy for children with language difficulties

• Makaton.  Makaton is a system of signs and symbols which are used alongside speech.  Makaton is helpful for individuals who have difficulty with speaking, understanding language, attention and listening or memory.  It enables individuals to communicate effectively and be an active member of society.  Makaton is widely used in schools, nurseries, hospitals and the community. www.makaton.org
• Hanen It Takes Two to Talk. For children of pre-school age with delayed language development. Parents develop practical strategies to help their child learn language in every day activities. Hanen can be delivered to a single family or a group of families. www.hanen.org
• Colourful Semantics.  This is a therapy approach for children with language delay or language disorder.  It provides a visual colour coded structure to help children to learn about sentences and how to put them together.  Colourful Semantics can be helpful to build vocabulary, understand word meanings and word order, develop questions and storytelling.  Colourful semantics can be supported by makaton signing and is easily integrated into school settings providing a useful link to literay.
• Shape Coding.  This system was developed by Dr Susan Ebbels at Moor House School and College.  It supports children and young adults with language disorders.  The focus is on using visual shapes and colours to show the rules for building sentences.  This develops the young persons ability to use grammar in spoken and written language and to develop their ability to express themselves using sentences.

Speech therapy for children with speech sound difficulties

• Auditory discrimination works on developing the child’s ability to hear the difference between sets of sounds.  This is essential prior to work on speech production.
• Phonological contrasts.  Therapy is based on pairs of words which differ in a specific sound and also in meaning.  e.g. minimal pairs therapy, minimal oppositions therapy, multiple oppositions therapy.
• Complexity approaches work on developing the most complex sounds. This produces change in other groups of more simple sounds.
• The Cycles Approach targets patterns of speech sound errors.  Focussed auditory stimulation is also included, this involves listening to target words based on the speech sound targets.
• Metaphon Therapy develops a child’s knowledge of sound contrasts in the structure of language e.g. long sounds versus short sounds, noisy versus quiet.

Speech therapy for children with Childhood Apraxia of Speech/Dyspraxia

• 3D Apraxia Therapy - Kay Giesecke approach.  A child centred approach developing syllable shapes or or building upon syllable shapes which the child uses.  Therapy is based on proven motor planning techniques, including cueing, motor learning and backward chaining.  The treatment also develops grammar, prosody (intonation, rhythm) and how speech sounds change within phrases and sentences.  Parental participation and training to deliver the daily therapy at home is key; ensuring the child progresses with their speech.
• Nuffield Dyspraxia Programme.  This is an assessment and therapeutic intervention plan for children with a speech disorder or dyspraxia.  The approach is based on frequent and repetitive practice with an individual therapy programme designed for each child. Parents and school support staff are involved in practice between therapy sessions.

Speech therapy for adults with language difficulties after a stroke or with other conditions.

• Cognitive Neuropsychology.  This is a framework which Speech Therapists use to describe specific language difficulties in Aphasia.  It is possible to identify the individual cognitive process that is affected and this allows targetted therapy to be developed.
• Verb Network Strengthening Treatment (VNeST). This techniques focusses on verbs.  In sentences, verbs are connected to nouns.  VNeST strengthens all of the words which are connected to verbs, this helps individuals to think of the words faster and more independently.
• Semantic feature analysis can be used to treat word finding difficulties (anomia) in people with mild to moderate aphasia.  It involves describing features of a word in a structured way.  This strengthens the neural networks around the word and helps with word retrieval.
• Mapping Therapy focusses on identifying different parts of a sentence and ordering them correctly.
• Script Therapy. Working on monologues or dialogues to improve fluency in real life situations.
• Naming Therapy.  Uses cues (based on sounds, spelling or meaning) to help say the name of an object or picture.
• Oral reading for Language in Aphasia (ORLA).This therapy improves speaking, understanding, reading and writing.  It involves reading sentences aloud with the therapist through steps of  increasing complexity.
• Conversation Partner training helps to improve communication in conversation.  It supports, trains and coaches the family/conversational partner to support expression and communication.  This enables their loved one to communicate to the best of their ability and take an active part in conversation.
• EVA Park. Eva Park is a safe virtual (online) world where patients engage in specific therapy approaches, or improve their communication skills within everyday situations.  The patients log into EVA Park (they are represented by an avatar) and move around the world to interact and practice conversation in different places; doctors surgery, disco, hairdresser, cafe etc.  It’s like real life, but more fun!  Eva Park is essentially a clinic room and allows you to access regular therapy with your speech and language therapist.  Patients can access EVA park in between sessions for practice.  (It is in your own home, no need to get to a clinic!) EVA Park was created at City, University of London with funding from the Stroke Association. EVA Park research at City was also supported by funding from The Tavistock Trust for Aphasia and from City, University of London. www.evapark.city.ac.uk
• React2 is an interactive online therapy programme for adults and children.  It covers a variety of communication skills; understanding spoken and written language, naming and expressive language.  The speech therapist sets up a programme of exercises based on the client’s level of ability.  This can be practiced in therapy and as home practice between sessions. www.react2.com