Common Problems

At Lindfield Speech Pathology and Learning Centre we assess and treat children with:

If your child is having problems in one of these areas, we can help.

Literacy is made up of a student’s ability to read, spell and write as well as comprehend and generate different text types (such as stories, essays, reports and recounts). The ability to read, spell and write is an important skill in order to take part in the community (school, work). The Centre’s Speech Pathologists are trained in several effective literacy programs.

Language is made up of a student’s ability to understand word relationships, sentences and stories (that is, a student’s receptive language skills), and to express thoughts and ideas in logical, grammatically-correct sentences (that is, a student’s expressive language skills).

• Understanding questions
• Following instructions Understanding concepts (big/little, in/on)
• Understanding inhibitory words (no, stop, wait)
• Understanding indirect requests and sarcastic comments
• Following stories as a whole, drawing conclusions, making predictions
• Understanding that the meaning of a word can change depending on the context

• Using single words spontaneously
• Requesting for objects and actions
• Using Grammar
• Saying long, complex sentences (using words such as ‘because’, ‘so’, ‘but’ and ‘although’)
• Giving clear instructions
• Telling stories that include all the important details in a logical order
• Using clear, precise language to express him/her self
• Asking questions

• Using and understanding gesture
• Following the rules of conversation (e.g. taking turns, staying on topic, indicating he/she does not understand)
• Interpreting and using appropriate tone of voice, body language, facial expression and gestures
• Understanding that other people have different points of view
• Using appropriate language to show an interest in others

To check if your child may have language difficulties select the age appropriate checklist below:

• Infant Language Checklist
• Preschool Language Checklist
• Primary School Language Checklist
• High School Language Checklist

Children learn to say speech sounds at different ages. Here is a list of the ages at which most Australian children are able to say each speech sound correctly in a single word:

• 3 years – m, n, h, p, ng (as in sing), w, d, t, y (as in yes), b, g, k 3 ½ years – f
• 4 years – l, sh, ch
• 4 ½ years – s, z, j
• 6 years – v, consonant blends (for example, spot, bread, clue, jump)
• 8 years – voiced th (as in this and mother)
• 8 ½ years – voiceless th (as in thumb and teeth)

An articulation difficulty occurs when a child cannot pronounce a particular speech sound correctly. Sometimes this is due to a problem with the mouth or nose (for example, a child who has a cleft palate or tongue tie could have difficulties with some sounds). However, most articulation difficulties have no obvious physical cause. The most common articulation difficulty is a ‘lisp’ (that is, difficulties saying the s and z sounds). It is normal for children under eight years of age to say some sounds differently to adults.

Children with dyspraxia have difficulties co-ordinating mouth movements for speech, even though they are able to suck and swallow effectively. Children with dyspraxia characteristically:

• make inconsistent errors (for example, they say words a different way each time)
• make errors that are not typical of slow speech development (that is, they do not sound like younger children)
• use ‘searching’ mouth movements when they speak (for example, they try several tongue placements before saying a word)
• have difficulties making fast, alternating mouth movements (for example, when saying words of more than one syllable, such as buttercup)

Most children with unclear speech do not have dyspraxia. A speech pathology assessment is needed to determine whether a child has dyspraxia.

Autism Spectrum Disorders (ASDs) are a group of Pervasive Developmental Disorders (PDD). These include classical Autism, Asperger’s and PDD-NOS (not otherwise specified), this can also be known as Atypical Autism.

Autism Spectrum Disorders are diagnosed using the Diagnostic and Statistical Manual (DSM-IV) which concentrates on three main areas of assessment; Communication, Social Interaction and Restrictive, repetitive & stereotypic behaviour patterns. Within each of these areas a number of specific indicators are used to measure both the type and severity of ASD:

• Language not following normal pattern of development (e.g. delayed, unusual vocabulary, confusion of personal pronouns)
• Echolalia (parroting words and phrases)
• Inability to use language in play
• Impairment in comprehension
• Odd vocal tone and unusual voice patterns
• Tendency to talk too much or too little
• Literal interpretation of language
• Reluctant to seek out others to have their needs met
• Inflexible thinking

• Poor awareness of the social rules of conversation (e.g. unable to read facial expressions, poor use of gesture and pointing, poor awareness of personal space, lack of empathy, poor eye contact, turn taking)
• Limited interest in interacting & playing with others (appears to be a “loner”)
• Play is on their own terms
• Inability to understand and express emotion
• Difficulty in understanding peoples point of view
• Limited imaginative play sequences

• Fixation on specific objects or topics of interest (e.g. Thomas the Tank Engine, gadgets, spinning fans)
• Attachment to particular objects (e.g. constantly carrying around one toy)
• Repetitive motor mannerisms (e.g. handing flapping, spinning, toe walking, lining up toys)
• Inflexible routines or rituals (e.g. gets upset if routine is broken)
• Over or under sensitivity to noise, taste, smell, light, textures and touch
• Abnormally high or low pain threshold

Our aim at Lindfield Speech pathology is to help build a child’s communication and social skills so as to aid them in their understanding and interaction with the world. Our Speech Pathologists focus on improving and enhancing Communication, Language and Social Interaction. This is achieved through detailed ongoing assessments and individual weekly therapy sessions during which they work on developing expressive and receptive language skills, enhancing understanding and use of concepts (e.g. colours, size and prepositions) and improving use and understanding of social communication (e.g. turn taking, social cues, eye contact and play).

Our speech pathologists obtain information from parental reports, formal assessments and informal observations in order to generate individual goals for each child.

We strongly support parent involvement in therapy in order to help generalise skills into other settings outside of our clinic room.

NDIS: Lindfield Speech Pathology and Learning Centre are able to accommodate clients on a self managed plan or a plan managed plan.

Medicare: All Speech Pathologists in this centre are registered Medicare providers. There are a number of Medicare Schemes under which children may be eligible for partial reimbursement for Speech Pathology Services. These schemes require referral by a GP or Paediatrician. Further information is available through the Department of Health and Ageing, Enhanced Primary Care Program website.

Private health funds cover speech pathology assessments and treatment. The amount of your refund, if any, will depend on your fund’s rules and the level of your cover.

Our aim at Lindfield Speech Pathology & Learning Centre is to develop a child’s social interaction skills so that they can participate in their community (school, work). Our speech pathologists can work with your child on social skills in both individual or group therapy.

Conversation skills allow an individual to participate and maintain an interaction with others.

• Listening
• Starting a conversation
• Taking turns
• Asking questions
• Being relevant
• Repairing a conversation
• Ending a conversation

Body language is an important skill for social interaction; in fact over 90 percent of how we communicate with others is conveyed through both body language and ‘how we talk’. Body language involves the appropriate use of;Language not following normal pattern of development (e.g. delayed, unusual vocabulary, confusion of personal pronouns)

• Eye contact
• Facial expression
• Gesture Distance
• Touch
• Posture

How we talk refers to the elements of speech that help convey our message (that is, when you are excited your rate increases, when you are sad your volume decreases). It is important that these features match the verbal message you are trying to convey so that the listener does not become confused;Language not following normal pattern of development (e.g. delayed, unusual vocabulary, confusion of personal pronouns)

• Volume
• Rate
• Clarity
• Intonation (pitch of voice)
• Fluency

Assertiveness is the way an individual stands up for themselves and expresses their rights without impacting on the rights of others.Language not following normal pattern of development (e.g. delayed, unusual vocabulary, confusion of personal pronouns)

• Expressing feelings
• Standing up for themselves
• Inappropriate refusals
• Handling rejection
• Apologising
• Requesting to join in
• Disagreeing

Auditory processing refers to what the brain does with the information it hears. Auditory processing is different to ‘hearing’. A person can have normal hearing (measured with an audiometer during a hearing test), but have difficulties with auditory processing.

Auditory processing skills include:

• Sound localisation (knowing which direction a sound comes from)
• Auditory discrimination (knowing that two sounds are different)
• Auditory temporal processing (recognising rapid changes in sounds)
• Auditory sequential processing (identifying the sequence of sounds)
• Auditory memory (remembering sounds)
• Auditory attention (focusing on sounds)

A child with ‘normal hearing’ could have difficulties with auditory processing if he or she:

• Is slow to respond to questions or follow instructions
• Forgets complex instructions
• Is easily distracted during listening tasks
• Is better at listening in individual or small group situations than in large group situations
• Has particular problems listening when there is a lot of background noise (for example, in the classroom or at the swimming pool)
• Confuses similar-sounding words (for example, ‘comb’ and ‘cone’) during listening tasks
• Has difficulties saying complex words (for example, says ‘mazagine’ for ‘magazine’)
• Has difficulties ‘sounding out’ spelling and reading words Has difficulties with dictation tasks

It’s important to realise that these difficulties can have other causes (for example, a child with a language delay or Attention Deficit Hyperactivity Disorder might show similar behaviours).

Often several professionals (such as an audiologist, speech pathologist, educational psychologist and paediatrician) need to be consulted to determine whether or not a child has an Auditory Processing Disorder.

Watch the video for Tips about Auditory Processing Disorder for parents.

Stuttering is a disruption to the flow of speech. The World Health Organisation defines it as a ‘disorder in the rhythm of speech, in which the individual knows precisely what he wishes to say, but at the time is unable to say it because of an involuntary, repetitive prolongation or cessation of a sound’.

There is no known underlying cause for stuttering. Stuttering is most likely due to some problem with the neural processing (brain activity) that underlies speech production. Stuttering is not thought to be caused by psychological factors such as nervousness or stress, or parenting practices or the way parents communicate with their children when they are young. However, psychological factors such as anxiety or stress can make stuttering worse. Stuttering has a genetic link and affects three times as many boys as girls.

You may hear or see the following behaviours in a child who is stuttering:

• Repeating sounds, part-words and words
• Stretching or sounds
• Struggling to get words out
• Avoiding particular words, situations or talking in general
• Inappropriate pausing
• Frustration with the effort of talking
• Physical signs of effort (e.g. facial grimacing and eye-blinking).

Many young children have speech that includes ‘disfluencies’, such as repetitions of words. It is also true that a stutter can sometimes disappear without any treatment.

The most widely accepted and recommended treatment for children with stuttering is the Lidcombe program.The Lidcombe program is a parent-based program which is most effective for preschool and early primary school-aged children. The program focuses on reinforcement and rewards and requires that the parents spend time each day talking with their child.

The Lidcombe program promotes fluent speech while maintaining and developing a child’s confidence in speaking.

Dyslexia is a type of specific learning difficulty in which the person has difficulties with language and words.

The most common characteristic is that people have difficulty reading and spelling for no apparent reason. The person may be intelligent, able to achieve well in other areas and exposed to the same education as others, but is unable to read at the expected level.

Common problem areas include spelling, comprehension, reading and identification of words.

Some of the symptoms of dyslexia or SLD in a preschooler could include:

• Delayed speech
• Problems with pronunciation
• Problems with rhyming words and learning rhymes
• Difficulty with learning shapes, colours and how to write their own name
• Difficulty with retelling a story in the right order of events.

Some of the symptoms in a primary school age child could include:

• Problems with reading a single word
• Regularly confuses certain letters when writing, such as ‘d’ and ‘b’ or ‘m’ and ‘w’
• Regularly writes words backwards, such as writing ‘pit’ when the word ‘tip’ was intended
• Problems with grammar, such as learning prefixes or suffixes
• Tries to avoid reading aloud in class
• Doesn’t like reading books
• Reads below their expected level.

Some of the symptoms in a high school student could include:

• Poor reading
• Bad spelling, including different misspellings of the same word in one writing assignment
• Difficulties with writing summaries
• Problems with learning a foreign language
• Reading and spelling problems
• Doesn’t like reading books
• Avoids tasks that involve writing, or else gets someone else to do the writing for them
• Better than average memory
• Often, a greater than average spatial ability – the person may be talented in art, design, mathematics or engineering.