What are Speech / Language Delay and Occupational Therapy?

Signs and Symptoms

Speech and language delays may become evident at various developmental stages. Symptoms can range from mild to significant, affecting expressive, receptive, and social communication abilities.

Speech Delay

• Difficulty making sounds correctly for age
• Limited vocabulary for age
• Trouble forming words into sentences
• Omitting beginning or ending sounds
• Speech is difficult for unfamiliar listeners to understand

Language Delay

• Not following simple directions
• Limited understanding of spoken words
• Not pointing, gesturing, or using eye contact
• Delay in combining words into phrases or sentences
• Trouble answering questions or expressing wants/needs

Social Communication Concerns

• Limited back-and-forth interaction
• Lack of pretend play
• Avoiding peer or adult engagement

Difficulty taking turns in conversation

Causes

Multiple factors can contribute to speech and language delay, including medical, neurological, and environmental influences:

Biological Factors

• Hearing impairment
• Premature birth
• Neurological differences (e.g., cerebral palsy, autism spectrum disorder)
• Genetic conditions (e.g., Down syndrome, Fragile X syndrome)

Environmental and Developmental Factors

• Lack of verbal stimulation at home
• Speaking several languages at home could cause a brief delay. 

• Parental neglect or trauma
• Oral-motor dysfunction, or trouble synchronising the speech-related muscles

Family History

• A family history of speech or language issues can increase risk

Types

Receptive Language Delay

• Difficulty understanding spoken language
• May appear inattentive or confused during conversations

Expressive Language Delay

• Trouble expressing thoughts or forming sentences
• Vocabulary significantly below age expectations

Mixed Receptive-Expressive Language Delay

• Challenges in both understanding and expressing language

Speech Sound Disorders

• Problems with articulation, phonological processes, or motor planning

Pragmatic Language Impairment (Social Communication Disorder)

• Difficulty using language appropriately in social situations

Assessment and Diagnosis

A thorough evaluation by a certified Speech-Language Pathologist (SLP) and Occupational Therapist may include:

Clinical Observation and Developmental History

• Observing the child in structured and play settings
• Gathering milestones and family concerns

Standardized Assessments

• Receptive-Expressive Emergent Language Scale (REEL)
• Preschool Language Scale (PLS)
• Peabody Picture Vocabulary Test (PPVT)
• Goldman-Fristoe Test of Articulation

Hearing Tests

• To rule out hearing loss as the cause of speech delay 

Occupational Therapy Evaluation

• Sensory profile assessment
• Fine motor, oral-motor, and feeding evaluations
  

OT for Speech/Language Delay

Early intervention is crucial for successful outcomes. A collaborative and child-centered treatment plan may include:

1. Speech Therapy

Helps children develop age-appropriate communication skills through play, modeling, and interactive techniques.

Goals of Speech Therapy:

• Expand vocabulary and sentence structure
• Improve articulation and sound clarity
• Develop listening and comprehension skills
• Enhance social use of language
• Promote confidence in communication

Therapeutic Approaches:

• Play-based speech stimulation
• Augmentative and Alternative Communication (AAC) tools if needed
• Language modeling and expansion techniques
• Picture Exchange Communication System (PECS)

2. Occupational Therapy (OT)

Supports underlying skills necessary for communication, such as motor planning, sensory regulation, and feeding.

How OT Supports Communication Development:

• Improves fine motor skills for gesture and writing
• Strengthens oral-motor muscles for clearer speech
• Enhances sensory processing to reduce overstimulation or withdrawal
• Builds focus and attention during interactions

Evidence-Based OT Interventions:

1. Sensory Integration Therapy
   Regulates arousal levels and attention, helping children stay engaged in speech tasks
2. Oral-Motor Exercises
   Develops strength and coordination of lips, jaw, and tongue
3. Feeding Therapy
   treats low oral tone, oral aversion, and finicky eating.
4. Play Therapy Techniques
   Encourages natural language learning in social and imaginative play

Parent Involvement and Psychoeducation

Educating caregivers is key to success. At Psychowellness Center, families receive ongoing training to:

• Support communication at home
• Reinforce therapy techniques
• Monitor progress
• Reduce frustration and improve bonding
  

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