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Best Online Speech Therapy Platform

  • Online Speech Therapy – Does it Work?

    • Research shows that structured Online Speech Therapy sessions are effective
    • Highly Beneficial when there’s no access to good Speech Therapists nearby
    • More convenient in terms of time and energy
    • Clients can take therapy from the comfort of their homes
  • How to take Speech Therapy Sessions Online?

    • You don’t need to install any software, just click on start session at the time of your appointment
    • The whiteboard and video is integrated into our platform
    • All our Speech Therapists are qualified with the requisite degree in their area of proficiency
  • Online Speech Therapy – Why is it Preferable?

    • Many parents now prefer Online Speech therapy services for their children with speech issues. Online Speech therapy services have many benefits that online interaction provides, besides being as effective as face-to-face communication.
    • It is a great choice to prefer online speech therapy services if you have no speech therapy center nearby. We suggest you start with our free speech therapy consultation service to know if your child needs speech therapy. Our therapists might recommend Online Speech assessments to assess the level of speech-related problems and then would design online therapies that are needed for your child.
  • Best Online Speech Therapy for Autism

    • Best online speech therapy is possible with the best speech therapists and their best efforts through scientifically proven methods, techniques, and strategies. Individuals with Autism have difficulties understanding and using words, longer utterances to communicate, repetition of words, maintaining eye-contact, and initiating conversations, etc. Speech and language therapists at Wellness Hub provide the best online speech therapy services according to the needs of the client. Besides for those with Autism, different kinds of therapies for different people like late talkers, for those with voice-related issues, Apraxia, aphasia, dysarthria, stuttering, learning difficulties are also offered.

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How do I Proceed with Speech Therapy at Wellness Hub?

If you are just beginning, choose a free consultation with one of our Speech Therapists

Schedule a Speech Assessment as required/suggested

Book sessions with the best Speech Therapists in India at your convenient time

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Best Speech Therapy Near Me

Speech Therapy sessions for Stuttering, Autism, Apraxia, Aphasia, Dysarthria, Late Talkers, and those with Language and Expression Problems, Swallowing Difficulties, Voice Related Issues, and Learning Disabilities are offered at Wellness Hub.

Select from India’s top Speech and Language Therapists/Pathologists and book a session at your convenient time.

Best Online Speech & Language Therapists for clients in Hyderabad, Mumbai, Chennai, Pune, Bangalore, Delhi, Kolkata, Lucknow, and other parts of India and Indians all over the World.

Speech Therapy at Wellness Hub is Convenient, Affordable, and Reliable

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Ensure good Wi-Fi for seamless therapy experience

Log in a few minutes before the scheduled time

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Best Speech Therapy – Wellness Hub

Speech Therapy at Wellness Hub is driven by India’s best Speech & Language Therapists enabled by robust Video Conferencing and intuitive Whiteboard tools

Select from our curated list of Speech Therapists and use our holistic Platform for Seamless Appointment Booking, Secure Payments, and Sessions Management

Wellness Hub is India's most trusted platform for Online Speech Therapy and Special Education Services

Not sure about the apt therapist, assessment, or service? You may take a free initial consultation or ping our client care at care@mywellnesshub.in

What is Autism?

What is Speech Therapy?

Speech therapy is a training program for communication problems and speech disorders. Speech therapies are offered by Speech therapists or Speech-language therapists/pathologists. Speech-language pathologists, or SLPs, work with people who have problems with speech (that includes fluency, articulation, and voice), language (includes understanding language, expressing and social communication), thinking, and swallowing. Speech therapists work to prevent, assess, and diagnose many issues such as speech, language, social communication, cognitive-communication, and swallowing disorders in both children and adults. The therapist gives strategies to deal with obstacles more effectively, to both client and the parent/caretaker.

What are Speech disorders and why are they caused?

The communication is generally made by sounds or the words produced by the sounds. Such sounds that contribute to verbal communication can be understood as speech. The inability of a person to produce speech is considered as a Speech disorder. Speech disorders can be caused due to a number of reasons like muscle weakness, hearing loss, autism, brain injuries or infections, and degenerative diseases.

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What is Autism?

Why do you need Online Speech Therapy?

Speech and language therapy can address the problems with speaking, language, and swallowing that is offered by speech therapists or speech-language pathologists. Online speech therapy can offer the treatment to many kinds of speech and language disorders like articulation disorder, fluency disorders or any other disorder to aphasia and Dysarthria, online. Online speech therapies are widely used because they are convenient and include more parental involvement. Parents or caretakers can actually be a part of the session, see what’s going on, and can take tips from the therapists on how to improve their child. Online speech therapies with video interfacing and interactive whiteboard help your child to get more out of it. People from rural areas who have little or no access to speech therapists nearby can book online sessions with the best speech psychologists in India through online speech therapy platforms. Online speech therapy can also help clients who have mobility issues. Speech therapies can be offered to both children and adults.

The amount of time taken and the impact on the outcome of speech therapy can depend on

Personality type

Frequency of the therapy

Severity of the speech disorder

Underlying medical condition

Treatment of an underlying medical condition

What are the types of Speech Therapies?

A Speech-language Pathologist or Speech Therapist can use different kinds of speech therapies to treat different speech disorders. All the various types of speech therapies are used to improve speech, language, and communication in clients by helping them to overcome their speech and language related issues. The types of speech therapies include

Articulation Therapy

Stuttering Therapy

Learning Disability Therapy

Aphasia or Stroke Therapy

Auditory Verbal Therapy for hearing impaired

Cerebral Palsy

Voice Therapy

Down Syndrome

Autism Spectrum Disorder

Dysarthria

Mental Retardation /Intellectual Disability

Articulation Therapy

An articulation disorder is a speech disorder characterized by difficulty in producing speech sounds correctly, sounds may be omitted, distorted, or substituted. The difficulty in producing a few sounds with no patterns is often described as an articulation disorder.

The Speech-Language Pathologists (SLPs) can teach the person how to produce the error sounds correct by teaching them how to position different oral structures for a particular sound and the manner in which they can produce them correctly. Usage of the sounds in syllables, words, sentences, and connected speech are taught in a systematic approach.

Stuttering Therapy

When different kinds of issues like the repetition of sounds, syllables or words occur, and the prolongation of sounds and interruptions in the speech, known as blocks occur, it can be characterized as a speech disorder known as Stuttering. Though the person who stutters can speak his/her mind, that production of normal flow of speech is not possible. These speech disruptions are generally accompanied by struggle behaviors, such as rapid eye blinks or tremors of the lips.

Stuttering has varied treatment procedures, most clinicians combine certain effective components of treatment to create somewhat personal programs; airflow management, gentle phonatory onset, and rate reduction through prolonged syllables are common elements across diverse contemporary treatment programs.

Learning Disability Therapy

When you have a learning disability, you have difficulty in reading, spelling, writing, mathematics, social skills, listening, and/or speaking. The individuals who initially have speech and language problems can later face reading and writing problems too. Most people with learning disorders have normal to above- average intelligence.

A Speech therapist helps children with appropriate training to overcome difficulties of reading, writing, and calculations and improve their language skills. The SLP will work on what your child learns in class and may work with your child alone or in the classroom. This may include changing lessons to help your child understand them, also can help your child find ways to organize and focus on his/her work.

Aphasia or Stroke Therapy

Aphasia is an impairment of language, affecting the production or comprehension of speech and the ability to read or write. Aphasia is always due to stroke, injury to the brain, head trauma, brain tumors, or infections, particularly in older individuals.

The main goal of Speech-Language Pathologist in the treatment of aphasia is to repair or restore language processes that are affected. A comprehensive approach to rehabilitation is most important to improve the overall communicative, cognitive, and psychosocial abilities of aphasics. A Speech-Language Pathologist is an integral and active member of the rehabilitation team.

Auditory Verbal Therapy for hearing impaired

Hearing loss is a problem caused by noise, aging, disease, and heredity. Individuals with hearing loss may face a hard time to have conversations with friends and family. They have trouble hearing, understanding, and responding. Speech therapist provides auditory-verbal therapy to hearing impaired who use hearing aids or cochlear implant. They teach listening, spoken language skills, and develop communication through speech.

Cerebral Palsy

Cerebral Palsy is a congenital, non-progressive neuro-motor disorder resulting from damage to a child’s brain before, during, or shortly after the birth. Cerebral Palsy causes speech disorders in many like respiratory control problems, laryngeal dysfunction resulting in voice problems, difficulty in talking, communicating, and articulation. It also produces effects on the body that impair movement, coordination, balance, and posture.

Speech therapists design training programs with suitable techniques of language, articulation, and phonological disorders, Dysarthria, and voice disorders. They also counsel parents about the effects of cerebral palsy on communication and their role in stimulating language at home and work closely with the team of specialists serving children with cerebral palsy.

Voice Therapy

Voice problems occur with physical changes in vocal folds that result from vocal abuse. Such problems arise when the vocal cords do not vibrate normally. If there is a problem with pitch, volume, tone, and other qualities of your voice, you might have a voice disorder.

Speech therapist assesses type and severity of voice problems and uses appropriate therapy techniques to improve vocal quality, loudness, resonance, or pitch.

Down Syndrome

It is a condition in which a child is born with an extra copy of their 21st chromosome. This causes physical and mental developmental delays and disabilities.

Speech therapists with a team of various specialists can develop an accurate picture of a child’s strengths and weaknesses to develop specific goals and objectives to overcome difficulties with language like grammar, tenses, articulation, and feeding problems.

Autism Spectrum Disorder

Autism, or autism spectrum disorders (ASD), characterized by difficulties with social interaction, communication, restricted and repetitive behaviour. Speech-language therapy addresses challenges with language and communication. It can help people with autism improve their verbal, nonverbal, and social communication. The overall goal is to help the person to communicate in more useful and functional ways.

Dysarthria

Dysarthria is caused by paralysis, weakness, or inability to coordinate the muscles of the mouth. Their speech is slurred, slow, and difficult to understand. A person with dysarthria may also have problems controlling the pitch, loudness, rhythm, and voice qualities of his or her speech. It may be a sign of a neuromuscular disorder such as cerebral palsy or Parkinson’s disease. It may also be caused by a stroke, brain injury, or brain tumour. Speech therapists plan and implement speech therapy with a focus on oral motor skill development for improving speech clarity, articulation, communication, cognitive abilities, and others.

Mental Retardation /Intellectual Disability

Mental Retardation (MR) is characterized by significant impairment of cognitive and development due to abnormalities in the structure or function of the brain. They also have speech delays and language impairments. A Speech therapist will plan and implement an individualized educational plan for improving communication and cognitive abilities.

What is the success rate of Speech therapies?

The success rate of speech therapy varies depending on the factors like the disorder being treated and also the age groups. Some speech disorders may begin during childhood and improve with age. Some other speech disorders continue into adulthood and they require long- term therapy and maintenance. A communication disorder caused by a stroke, brain injury, or other medical conditions may improve with treatment, as the condition improves. Speech therapy for young children has been most successful when started early and practiced at home with the involvement of a parent or caregiver. With early intervention, an individual can be benefitted as speech therapy can improve communication and boost self-confidence.

Best Speech Therapy Near Me...

Speech Therapy sessions for Stuttering, Autism, Apraxia, Aphasia, Dysarthria, Late Talkers and those with Language and Expression Problems, Swallowing Difficulties, Voice Related Issues and Learning Disabilities

Select from India’s top Speech and Language Therapists/Pathologists and book a session at your convenient time.

Best Online Speech & Language Therapists for clients in Hyderabad, Mumbai, Chennai, Pune, Bangalore, Delhi, Kolkata, Lucknow and other parts of India and Indians all over the World

Speech Therapy at Wellness Hub is Convenient, Affordable and Reliable

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Best Speech Therapy - Wellness Hub...

Speech Therapy at Wellness Hub is driven by India’s best Speech & Language Therapists enabled by robust Video Conferencing and intuitive Whiteboard tools

Select from our curated list of Speech Therapists and use our holistic Platform for Seamless Appointment Booking, Secure Payments and Sessions Management

Wellness Hub is India's most trusted platform for Online Speech Therapy and Special Education Services

Not sure about the apt therapist, assessment or service? You may take a free initial consultation or ping our client care at care@mywellnesshub.in

Online Speech Therapy

When you experience different emotions like happiness, excitement, sadness, surprise, tension, bewilderment, or even anger, the tool of communicating all these emotions is the speech. But what about those people, having difficulties in hearing, speaking, or understanding? It is hard even to imagine how tough it would be for them. Speech therapy and audiology helps in diagnosing and treating the root of communication difficulties in children and adults. Speech language pathologists or speech therapists, provide speech therapy for kids and adults. Online speech therapy has been an effective way of providing speech therapy for adults and children in the recent days as it also includes speech therapy exercises, stuttering treatment or stammering treatment, stroke speech therapy etc., along with speech therapy in Hindi. Wellness Hub offers you a wide variety of speech therapies with a team of speech pathologists and psychologists.

A profound difference between animals and human beings is the speech and the interesting distinguished feature of such speech will be the language and its accent. When someone tries to convey something like their ideas, feelings or emotions, it has to be put in a meaningful frame of words in any language that the receiver can understand. Speech therapy is such a technique that helps the individuals to effectively communicate over-coming all the speech-related difficulties they have. Online speech therapy helps to make this speech therapy happen at the comfort of being at your home.

Communication difficulties may arise due to hearing loss, stammering, cognitive deficits, delayed development, cerebral palsy, syndromes, articulation disorders, autism, learning difficulties and others. Speech therapy is used for the treatment of speech and communication disorders. The kind of speech therapy given depends on the disorder. Speech-language pathologists (SLPs) are the therapists who specialize in treating language problems and speech disorders. Once the problem with speech is detected, speech therapists assess the best ways to improve communication and enhance the person’s capabilities.

Necessity of Early Intervention

We learn languages and the non-verbal cues since we’re babies. Observing and listening to such words, makes us try spelling them. Parents or grandparents keep talking something to the infants so that they would pick the sounds, recognize the voices, and understand the intonation. The basic speech and language skills are developed during the childhood. But people who have problems with their speech or may be hearing find it difficult to put their expression in speech to communicate with others.

Babies start to babble at nearly six months of age and try to spell their first words at 10 to 15months of age. The toddlers try to learn some new words and combine them to speak sentences by the age of 18months. But when a toddler aging around some 18-30months, has a good understanding of language, both verbal and non-verbal, and has good play skills, motor skills, thinking and social skills, but speaks very less to his or her age, then he or she is generally considered as a “Late Talker”. Such children are mostly confused with their “expression of language” and get puzzled with the usage, meaning, pronunciation etc. as they don’t talk or talk very little. Early intervention is essential to make them better speakers. If children having speech and communication problem with less than two years of age are treated, they will be able to get better soon and can get admitted to normal schools along with the other children.

Identifying early signs of developmental delays will help us to start intervention as early as possible. It can prevent further delay and maximizes the outcomes of therapy as neural synaptic connections happen better during the first three years of life. As the learning happens, the synaptic connections increase in the brain, and this acceleration process in turn will help in fast and easier learning. The first few years are hence critical in the development of child.

It is important for a parent, to have a keen observation regarding the development of their child’s motor, pre-linguistic and linguistic skills, social and cognitive skills. Sometimes, impairments can be detected as early as six months. Some children who do not have problems with typical developmental symptoms may vary in development but may acquire adequate abilities with delay. Though some might develop later, some children might not. So, such ones can be understood as ‘at risk’ babies.

Kinds of Disorders

Here are some kinds of disorders that can be identified during the childhood. When such problems are identified it is better to provide early intervention for them as the chances of permanent recovery are high during the childhood.

Articulation Disorders

We can see that most of the children learn to say the different sounds in a language with minimal effort. The sounds like ‘pa’, ‘ma’, ‘wa’ are developed quickly than the sounds like ‘ra’, ‘fa’ etc. and the clusters like ‘tr’, ‘cr’ and so on. However, some children find it difficult to develop the correct production of the speech sounds when compared with their growing age. Children with articulation disorders may substitute one sound for another, may be distorting a sound, omitting a sound or adding a sound. As this makes it difficult for the listener to interpret the meaning, the communication gets affected.

Stuttering

Stuttering results in disruption to the smooth flow of speech. There can be blocks (I came home……yesterday), repetitions (ba-ba-ba-ba-ball), prolongations (boooooook), filled pauses (I want to um um go home) etc. The habits and behaviors like not maintaining proper eye- contact while speaking, avoiding certain words or situations, and tensing muscles are also observed in them. Though many people have dysfluencies while speaking, it should be observed if the child is exhibiting these dysfluencies for more than six months and beyond the age of around 3 to 4 years. In such cases, it is advisable to consult a Speech-Language Therapist.

Learning disabilities

Learning disabilities are the problems that create difficulty in reading, writing, spelling, math, following long instructions, sequential tasks, etc. in children. Even though most of the children who have learning difficulties have a normal IQ level, they still have these difficulties.

Apraxia

Apraxia is a kind of inability to perform everyday movements and gestures that is developed due to some neurological conditions. To be precise, simple daily tasks like buttoning the shirt or tying a shoe lace would be difficult for them. Any kind of head injury or neurological disease can lead to Apraxia.

Apraxia of Speech is a kind of speech disorder due to a neurological condition that won’t let a child to co-ordinate the complex oral movements in creating sounds that could spell syllables and the words. Apraxia can also be a genetic disorder that might affect an infant at birth.

Aphasia

Aphasia is a neurological condition that highly affects the individual’s ability to communicate, i.e., to speak, to write and to understand the language, both verbal and written. When a person experiences a brain stroke or head injury, or maybe some slow-growing malignant tumor in the brain can result in Aphasia. The main treatment of Aphasia is speech and language therapy.

Dysarthria

Dysarthria can be understood as a group of speech disorders that are the resultant of muscle weakness. This neurological condition weakens the speech muscles. Dysarthria occurs when the damage done to the nervous system weakens the muscles related to face, lips, tongue, throat or upper respiratory tract that help in the production of speech sounds.

ADHD – Attention Deficit Hyperactive Disorder

ADHD is a disorder in which the individual has difficulties in sitting at a place, maintaining attention and concentration for a good amount of time and staying focused on a particular task, difficulties in planning, organizing and completing tasks, are restless, have poor on-seat behavior, difficulty in waiting for a turn and seem to be unaware of hazards most of the time.

Autism – ASD (Autism Spectrum Disorder)

Individuals with Autism, referred commonly as Autism Spectrum Disorder (ASD) have difficulties in social interaction and communication, limited and repetitive patterns of behavior, and sensory issues. These individuals fall on a broad spectrum as there is a wide range of symptoms and severity of the symptoms that they exhibit. Some children may have mild symptoms whereas, some may show severe symptoms. Some kids appear to be developing normally until they turn 18 to 24 months, after which, the symptoms of autism appear. Whereas in some children the signs of autism appear in early infancy, such as poor eye contact, lack of response to their name, or lack of attachment to the parents, etc. Some of them may be able to communicate verbally, but others may lack the ability to communicate verbally. Those with autism may have difficulties in understanding and using words and longer utterances to communicate, maintaining eye-contact, following directions, initiating conversations, mingling with peers, repeat questions instead of answering or utterances that were heard before and that are not relevant to the context (echolalia), difficulties in gross motor and fine motor skills, Mouthing inedible items, difficulty in adjusting to change in routine, repetitive play, smelling objects, flapping, rocking, spinning, eating limited food, auditory, tactile, visual, olfactory hypo/hypersensitivity, reading and writing difficulties, fascination about music, and advertisements. They may also exhibit temper tantrums.

Let’s have a detailed idea on the assessments and interventions of these disorders.

Stuttering – Stammering

Stuttering is a disorder of fluency characterized by excessive amounts of dysfluencies, excessive duration of dysfluencies and unusual amount of muscular effort in speaking. People wonder if there’s ever a cure for stammering.

Have you listened to any one stuttering? He/she repeats, hesitates and breaks in between. Do you call him/her fluent? No, why because his/her speech is not continuous. For example, “I am reading this material”. Normally the sentence can be said in 2-5 seconds. Now say one word in one minute. You will take 5 minutes to complete the sentence. Does your friend understand it? It is difficult to understand because the rate of speech is very slow. One should have appropriate rate of speech for others to understand. A common rate of speech that a person speaks is 80-180 words per minute. Have you ever stopped speaking because you don’t recall words? or have you seen someone speaking with pressure on his or her articulators? You don’t call it as fluent speech because it was effortful. So fluency is the continuous, effortless speech at a fast rate. Therefore, the parameters of fluency are continuity, rate and effort, knowing which helps in the stammering treatment.

Description of stuttering

Dysfluencies include the following.

1. Repetitions

Sound /syllable repetitions or part-word repetitions (“ma-ma-ma-mom”, “ye-ye-ye-yesterday”)

Word repetitions: multisyllabic or monosyllabic (“you-you-you you are welcome”: “Can I – Can I take this?”)

Phrase repetitions (“What is – What is – What is the time now?”)

2. Prolongations

Sound prolongations (“Yyyyyeeesssss I’m”; “Dddddaaady”)

Articulatory postures without voicing or Silent prolongations (a silent period with a tensed articulatory posture for the initial sound in saying a word such as “Knob”)

3. Broken words

Silent intervals within words (“g- (silent pause)-oing”)

4. Interjections

Sound/syllable interjections (“I’m um going to do it”)

Word interjections (“I can well do it”)

Phrase interjections (“He is you know- you know coming today”)

5. Pauses

Excessively long silent intervals at inappropriate loci in speech (“She will (long pause) bring it”)

6. Revisions

Productions that retain the same idea but with word changes (“I will take a cab----bus”)

7. Incomplete phrases

Productions that suggest that the speaker dropped the idea he or she was going to express (“I was going to ----but let me just say this”)

Associated motor (nonverbal) behaviors

(Mostly associated with dysfluencies or stutterings)

  • Rapid and tensed eye blink
  • Tensed and prolonged shutting of the eyelids
  • Rapid upward, downward, or lateral movement of the eyes
  • Knitting of the eyebrows
  • Nose wrinkling and nose flaring
  • Pursing or quivering of the lips
  • Tongue clicking and other noises
  • Teeth clenching, grinding and clicking
  • Tension in facial muscles
  • Wrinkling of the forehead
  • Clenched jaw or jerky or slow or tensed movement of the jaws
  • Jaw openings or closings that are unrelated to target speech production
  • Tension in chest, shoulder, and neck muscles; including twitching and extraneous movements
  • Head movements including turns, shakes, jerks, and lateral, upward, and downward movements
  • Tensed and jerky hand movements including fist clenching and hand wringing
  • Tensed and jerky arm movements including banging on the thighs or pressing against the sides of the abdomen
  • Tensed and jerky foot movements including grinding, pressing, rubbing, or circular movements on the floor
  • Generally tensed body postures

Avoidance

  • Avoidance of speaking in situations (e.g., speaking on the telephone, ordering in restaurants, buying at a counter, speaking to a group)
  • Avoidance of certain conversation with partners (e.g., strangers, authority figures, persons of the opposite gender)
  • Avoidance of certain words (because of sound- specific difficulties) as indicated by word substitutions and circumlocutions
  • Avoiding talking as much as possible (reduced verbal output)
  • Depending on others to communicate (e.g. having a spouse or a friend order at restaurants)

Negative emotional reactions

  • Verbally expressed feelings of tension or anxiety associated with speaking
  • Verbally expressed feelings of frustration due to difficulty in expressing oneself
  • Verbally expressed feeling ( or a sense ) of loss of control over the speech mechanism or over fluent production
  • Verbally expressed feelings of helplessness
  • Negative verbal expressions about oneself
  • Negative verbal expressions about certain listeners
  • Description of lack of self confidence in speaking situations
  • Anxious or dreaded expectation of stuttering on certain words and in certain speaking situations (expectancy)

Breathing abnormalities

  • Attempts at speaking on limited or shallow inhalation
  • Attempts at speaking during exhalation
  • Running out of air at the end of phrases and sentences
  • Apparent efforts to squeeze the air out of lungs to continue talking
  • Inhalations and exhalations interrupting each other
  • Impounding of inhaled air with a sudden closure of the glottis and apparent attempts to speak while the air is impounded
  • Dysrhythmic respiration
  • Audible inhalation, exhalation, or both
  • Difficulty in maintaining an even airflow throughout an utterance.

Assessment

  • Assessing the types and frequency of dysfluencies or stuttering in conversational speech and oral reading
  • Assessing associated motor behaviors
  • Assessing variability in stuttering across speaking situations
  • Assessing avoidance and negative emotional reactions

Intervention

Assessment data is used to make a diagnosis of stuttering and suggest treatment options. The thought of cure for stammering refers to the treatment procedures for stuttering or stammering.

Stuttering has varied treatment procedures, most clinicians combine certain effective components of treatment to create somewhat personal programs; airflow management, gentle phonatory onset, and rate reduction through prolonged syllables are common elements across diverse contemporary treatment programs, these programs are empirically supported with some experimental evidence.

Articulation disorders

It is a speech disorder characterised by difficulty in producing speech sounds correctly, sounds may be omitted, distorted, substituted or difficulty in producing a few sounds with no patterns is often described as an articulation disorder.

Say (tata), observe the movements of tongue, these movements are called articulation. Tongue, teeth, lips and roof of the mouth are articulators.

Articulation is the movement of articulators to produce speech sounds. You can move the articulators in various places. Say (pa) carefully and observe the movement for saying the sounds /p/. You are moving the lips together to close the mouth. Aren’t you? This is called a bilabial place of articulation. Now say (ta) and carefully observe the placement of tongue. Where did you place the tongue? Yes, behind the teeth. This is the dental place of articulation

Try saying /a/ and /p/. Do you observe any difference? In saying /a/, the tongue is moving; but it is not completely blocking the mouth. In /p/ the lips are completely closed. These differences are referred to as manners of articulation. /a/ is vowel. /p/ is a stop consonant. So there are different manners of articulation.

Now keep your fingers on your throat. Say aaaa. Do you feel the vibrations of the vocal folds? Yes? This is called voicing./a/ is a voiced sound. Now say sssss continuously. Do you still feel the vibrations? No? This is an unvoiced sound. So you have voiced and unvoiced sounds in speech.

It is commonly seen that children learn to say the different sounds in a language with minimal effort. They develop sounds like ‘pa’, ‘ma’, ‘wa’ faster than sounds like ‘ra’, ‘fa’ etc. and clusters like ‘tr’, ‘cr’ and so on. Some children don’t develop the correct production of the speech sounds in accordance with their age. Children with articulation disorders may substitute one sound for another, may be distorting a sound, omitting a sound or adding a sound. As this makes it difficult for the listener to interpret what the child is trying to say, this would affect the communication.

Description of Articulatory Errors

  • Omissions or deletions: absence of required sound in a word is one of the most common errors of articulation
  • Substitutions: sound replacement, a wrong sound is produced instead of a right sound
  • Distortions: inaccurate production of sounds
  • Additions: intrusion of a sound that does not belong to the target word
  • Devoicing: production of voiced sounds without vocal fold vibrations or with limited vibrations
  • Frontal lisp: production of sibilant consonants with tongue tip placed too far forward (against the teeth or between the teeth); most common lisps involve /s/ and /z/
  • Lateral lisp: production of sibilant sound with air flowing over the sides of the tongue
  • Labialization: production of sounds with excessive lip rounding
  • Nasalization: inappropriate nasal resonance in the production on oral sounds, especially oral stops
  • Unaspirated: production of an aspirated sound without aspiration
  • Initial position error: error in the production of a beginning sound of a word
  • Medial position error: error in the production of a middle sound of a word
  • Final position error: error in the production of a final sound of a word.

Assessment

The child’s structure and function of oral structures like the lips, jaw, teeth, tongue is checked for any abnormalities. For the misarticulations that occur, in order to rule out the chance if hearing loss exists, a detailed audiological evaluation is also recommended. Different kinds of speech sounds produced by the child in isolation, words, sentences and connected speech are assessed. The type of errors (whether substitutions, distortions, omissions, additions etc.) and the position of occurrence of these errors (beginning of the word, middle, or end or in all positions) is also documented.

Intervention

The Speech Language Pathologists (SLPs) can teach the child how to produce the error sounds correctly by teaching them how to position the different oral structures for a particular sound and the manner in which they can be produced correctly. A systematic approach of teaching the sounds in syllables, words, sentences and connected speech is used. Feedback is provided through multisensory means like auditory, visual and tactile modes.

Aphasia or Stoke/brain injury

Aphasia is a neurological condition that highly affects the individual’s ability to communicate, i.e., to speak, to write and to understand the language, both verbal and written. Aphasia can be very mild or can be so severe. In severe cases the communication with the patient is almost impossible. It may affect mainly single aspects of language use, such as the ability to retrieve the names of objects, or the ability to put words together into sentences, or the ability to read. The other channels of communication are sometimes remains accessible.

Early symptoms of stroke

It has typically sudden, rarely slow progressive onset. The symptoms include the following.

  • Headaches in most cases and coma in some cases
  • Vomiting in some cases
  • Convulsions in some cases
  • Paralysis in certain cases or flaccidity on one side of the body
  • Sensory loss and memory impairment
  • Confusion
  • Respiratory problems
  • Falling to the ground
  • Communication impairments, sometimes severe
  • Transient ischemic attacks (TIA) those last less than 24 hours

General symptoms of aphasia

  • Impaired repetition
  • Word finding or naming problems
  • Agrammatism
  • unintended word or sound substitutions ( Paraphasias)
  • Most aphasic patients have problem of auditory comprehension of spoken language
  • Possibly impaired use or understanding of gestures in some patients ( a controversial deficits)
  • Reading problems
  • Writing problems
  • Difficulty communicating in social situations
  • Potential impairments in automatic speech and singing

Most bilingual patients show roughly equal kinds of impairment in both the languages. The degree of impairment however may be different. Better performance or recovery is associate with the native language, the language used most often, and the language of the surroundings.

Assessment

A thorough assessment of client’s speech, language, reading, writing, cognitive skills etc. was done through observation, informal conversation, standardized tests, interviewing client and family and plan individualized therapy program for each client depending on the type, severity, etc. of the problem

Assessment of specific communication skills

The following are observed and assessed while a speech therapist or a speech pathologist has to design a therapy treatment for this particular speech disorder.

  • Obtaining a language sample of conversation, narration of experience and by evoking longer, grammatically more complete utterances
  • Assessing auditory comprehension deficits which include commands, single words, abstract and logical sentences and paragraph-length material
  • Assessing fluency
  • Assessing repetition skills
  • Assessing word finding and name skills
  • Assessing the client’s use of grammatical structures
  • Assessing understanding of usage of gestures
  • Assessing reading and writing problems
  • Conducting oral motor examination

Also consider the results of medical neuro-diagnostic techniques, psychological, cognitive, physical therapy and related assessment information. The client’s current medical condition and progress are further considered.

Intervention

The basic objectives of management in aphasia are dictated by the nature, severity and extent of impairment and their impact on a patient‘s daily life. The main goal in the treatment of aphasia is to repair or restore language processes that are affected. These objectives follow the spirit of repairing what is broken or reviving what seems to be lost. Speech language pathologists have become an integral and active member of the rehabilitation team. Rehabilitation of aphasia is supported by the close relationship between a patient and speech language pathologist. Several days to several months of rapport, trust, motivation and confidentiality are the important aspects in the management of aphasia. Developing a comprehensive approach to rehabilitation is of utmost importance to improve overall communicative, cognitive and psychosocial abilities of aphasics.

Cerebral palsy

A congenital, non-progressive neuro-motor disorder resulting from damage to a child’s brain before, during, or shortly after the birth, causes speech disorders in many like respiratory control problem, laryngeal dysfunction resulting in voice problems, possible velopharyngeal inadequacy, and difficulty in talking, communicating and articulation. In some children disorders such as seizures and mental impairments are also developed. Other children might also suffer from the problems such as difficulty learning to chew and swallow. Poor eyesight and hearing difficulties, perception, growth problems, dental problems, constipation, sleep problems, slow learning, and challenging behavior. It also produces affects to the body that impair movement, coordination, balance and posture.

Classification of cerebral palsy

Topographic or orthopedic classification

  • Diplegia: bilateral paralysis of like parts
  • Monoplegia: paralysis of one extremity
  • Hemiplegia: paralysis of one side of the body
  • Paraplegia: paralysis of the two lower extremities
  • Triplegia: paralysis of three extremities
  • Quadriplegia: paralysis of four extremities.

Classification based on the affected neurological system

  • Spastic Cerebral Palsy: Increased tone or rigidity of muscles is the distinguishing feature, the most common type, injury to the Pyramidal motor pathways and the higher cortical centers of motor control.
  • Athetoid cerebral palsy: Athetosis, characterized by slow, involuntary , writhing movements is the distinguishing feature; injury to the extra pyramidal motor pathways especially to the basal ganglia.
  • Ataxic cerebral palsy : Ataxia, disturbed balance and movement is the main characteristic, injury to the cerebellum
  • Mixed type (lesions in both pyramidal and extra-pyramidal regions although lesion in one of the structures may be dominant)

Assessment

During the assessment the information is obtained on neuro-motor functions by obtaining reports from the child’s physician or neurologist

  • Observing and obtain information on motor development
  • Obtaining information on mental development
  • Assessing oromotor dysfunctions
  • Assessing speech disorders and speech intelligibility
  • Assessing language disorders and fluency problems
  • Assessing prosody problems like taking a note of the stress patterns, intonation, rate of speech and pauses.
  • Also assessing other problems like voice, respiratory, presence of hyper nasality, hypo nasality and reduced oral resonance
  • Assessing the need for augmentative and alternative methods of communication
  • Also obtaining information on other areas like perceptual and attention problems, child’s emotional stability and reactivity, child’s educational performance and problems
  • Gathering further information on hearing, visual problems and any other physical problems.

Intervention of cerebral palsy

Speech therapists work closely with the team of specialists serving children with cerebral palsy.

Speech therapists or speech language pathologists, initially counsel parents about the effects of cerebral palsy on communication and their role in stimulating language at home. Therapists work closely with parents throughout the training duration and also make a thorough assessment of communication problems and design a training program to suit the child’s problems, needs and strengths. Further consider educational demands made or to be made on the child in planning training program by working closely with the special educators.

Suitable techniques of language, articulation and phonological disorders, dysarthria and voice disorders are used for training and overcoming the problem.

Training procedures

Training of language disorders

  • To train parents to stimulate language at home.
  • To assess the child’s language development periodically to determine the need for formal clinical training and implement formal language training if necessary.

Training of voice disorders

  • Speech therapist diagnoses the specific voice disorder and when appropriate, uses one or more voice disorders training techniques.
  • Works on associated respiratory problems and prescribes exercises to improve breath support for speech.

Training of articulation and phonological disorders

  • Speech therapist assesses the child’s specific sounds errors and error patterns.
  • Further assesses compensatory articulatory postures the child uses and then modifies them or eliminates those inappropriate and ineffective compensatory postures through some methods.
  • Speech therapists also provide articulation therapy for the target sounds to improve clarity of speech and communication.

Speech and language assessment

Speech and language assessments are the tests performed to understand the speaking abilities, the fluency of the speech, the verbal and non-verbal communication, and also the child’s oral structure and its function. The sensory abilities, pre-linguistic skills, cognitive prerequisites, and the reading and writing skills are also assessed.

How Speech and Language assessment is done?

Speech and language assessment are done in a step-wise procedure. Initially the below information is collected from the parents or caregivers and also by observing the child.

  • Collection of Speech and language developmental history
  • Procurement of information on speech development
  • Procurement of information on language development
  • Procurement of information on language background and stimulating environment
  • Conducting language evaluation and gathering information on child’s receptive and expressive language
  • Assessing child’s current level of vocabulary, phrases, sentences, and conversation
  • Getting information of his verbal and non verbal communication
  • Oral peripheral examination to assess child's oral structures and their function
  • Assessing sensory abilities
  • Assessing pre-linguistic skills and cognitive prerequisites that are required to learn any skill and behavior
  • Assessing reading and writing skills, that give information of his metal capabilities and these skills become an asset to the child and can aid in training program.

Scales and tests used in speech and language assessment include,

  • Speech intelligibility rating scale gives information on clarity of speech
  • Attention rating scale for rating attention levels of the child
  • REELS and extended REELS, Receptive Expressive Emergent Language Skills.

The Speech Language Pathologists (SLPs) can teach the child how to produce the error sounds correctly by teaching them how to position different oral structures for a particular sound to be produced and the manner in which they can produce them correctly. The strategies to reduce the dysfluencies and other avoidance behaviours are also designed. This procedure is called as Speech therapy. When this is done online, you may understand it as online speech therapy.

Let’s have a look at the kinds of speech therapies that are offered to the individuals.

Types of Speech therapies

Depending upon the kind of disorder, different kinds of therapies are designed by the SLPs (Speech- Language Pathologists) or therapists, to treat the individuals.

Different types of Speech therapies may include the following

  • Speech therapy for late talkers
  • Speech therapy for those with language and expression problems
  • Speech therapy for those having Voice-related issues
  • Speech therapy for Apraxia
  • Speech therapy for Aphasia
  • Speech therapy for Disarthria
  • Speech therapy for ASD and Autism
  • Speech therapy for Stuttering
  • Speech therapy for those with Learning disabilities
  • Speech therapy for swallowing difficulty

At ExpertEase, Speech-Language pathologists design a separate program for the individuals depending upon their conditions and capabilities.

Therapies for Both Children and Adults

Speech therapy helps for both children and adults who have speech and language related problems. For those who have severe disabilities, AAC systems are used to develop communication and language skills. Consulting a speech therapist or a SLP (Speech Language Pathologist) lets you understand if the person really needs a speech therapy.

Children Speech Therapy

Children having speech and language related issues should be attended as early as possible for their betterment. Early diagnosis and early intervention helps the children cope better and be as normal as any other kid. The children with below problems require speech therapy.

  • Children with delayed speech and language disorders
  • Children having disorders with understanding the language and have problem expressing
  • Communication difficulties of Autism spectrum disorders
  • Children having ADHD
  • Articulation difficulties like difficulty producing speech sound
  • For the Children with Apraxia
  • Children having Learning disabilities
  • Children with Stammering/stuttering problems
  • Who have repaired cleft lip and palate
  • Voice related problems like reduced loudness, hoarseness , breathy voice

Adult Speech Therapy

Speech therapy helps even adults who have speech related problems and face a lot of hurdles in making their careers and going on with their daily life. The adults having below problems can seek speech therapy to get better.

  • For those having adult language disorders like Aphasia
  • Motor speech disorders like Dysarthria.
  • Problems like Stammering/Stuttering
  • Hoarseness in voice or other voice problems

Online Speech therapy

Using the web-based video conferencing system, our speech therapists interact with the patients in the real time, to provide online speech therapy sessions. Our interactive live video sessions are as promising as the traditional face-to-face sessions that allow you to contact the SLP remotely at the comfort of being at home, with no commutation, and absolutely no waiting. Our expert therapists can provide services for both children and adults via interactive therapy software. After thorough assessment and diagnosis of the problem, a customized therapy program will be designed for the individual. The mutually agreed time slots for conducting these interactive sessions will not let you wait for your turn.

Benefits of Online Speech Therapy

Online speech therapy offer you certain benefits like the below ones.

  • Time-saving – Unlike traditional meetings with SLPs, these virtual meetings can save time both for you and your therapist. Both of you can join the meeting, just by staying at home. There won’t be any waiting and no extra-time schedules
  • Secure – As the video calls, messages and the documents are all encrypted at both ends, the data security is guaranteed.
  • Convenient – You can book an appointment during your break timings or whenever the need arises irrespective of the place.
  • Money Saving – In the hassle of going to meet your therapist in-person, there need not be any work off or baby-sitter needed to save your appointment.
  • No wait times – Due to the scheduled appointments, there is no need to wait for the turn.
  • Easy to use – The practice software is so user-friendly that anyone can use it without trouble.

The problem of travelling all the way with the patient can be avoided through telemedicine. Wellness Hub provides this online speech therapy enabling you a better consulting experience. Our Speech Language Pathologists or Speech therapists possess great assessment skills and hence use profound therapy procedures to help their clients in improving the speech and language problems.

Testimonials

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I have stuttering issues. Public speaking was never my cup of tea. Though I had many thoughts in mind, I couldn’t express properly even with my friends because of stammering problem. People used to laugh behind me. Being at home during last year has given me a chance to experiment on myself and to come up afresh. I took speech therapy sessions online. My speech therapist suggested great techniques that worked really well. Now, I can speak fluent than before. Thanks to Wellness Hub

Kalyan Choksey, Madhya Pradesh (An Employee who took Online Speech therapy sessions)

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