Speech & Language Therapy

Evidence-based assessment and treatment for communication, language, swallowing, and voice disorders. Serving pediatric and adult clients at Medcare Royal Speciality Hospital.

ABOUT OUR SPEECH THERAPY SERVICE

Our speech-language pathology team provides comprehensive, evidence-based assessment and intervention for a wide range of communication, language, voice, and swallowing disorders affecting children from birth through school-age and adults at all stages of life. We specialize in helping individuals maximize their communication potential and quality of life through personalized, family-centered care. Our clinicians maintain current knowledge of research-based practices and maintain high standards of clinical excellence.

PEDIATRIC SPEECH THERAPY SERVICES

Language Development & Delays

What We Treat

Late language emergence (LLE) and developmental language delays affect toddlers and preschoolers who show delayed vocabulary acquisition, slower development of sentence structure, or reduced comprehension of spoken language compared to age-matched peers. Children may present with expressive language delays only, or mixed receptive and expressive delays affecting their ability to understand and use language. Late talkers may also be at risk for developing literacy difficulties as they progress to school-age.

Age Groups Served: Toddlers (18–36 months) through early school-age (ages 5–7)

Our Approach

Early intervention is critical. Research supports child-centered and parent-based language interventions beginning at age 2. We focus on vocabulary development, syntax building, and enhancing parent-child interactions to support natural language learning across home and community settings.

Speech & Articulation Disorders

What We Treat

Speech sound disorders (SSDs) refer to difficulties with the perception, motor production, or phonological representation of speech sounds. Children may substitute sounds (saying 'wabbit' for 'rabbit'), omit sounds (saying 'nana' for 'banana'), distort sounds (lisping), or add extra sounds. While most children can produce almost all sounds correctly by age 4, delayed or disordered sound development affects intelligibility and classroom participation.

Age Groups Served: Preschool through school-age (ages 3–8+)

Our Approach

We assess both articulation and phonological patterns to understand the nature of the speech problem. Research shows that children who learn early speech sounds (stops, nasals, glides) progress to later-developing sounds. We use motor-learning principles to establish correct sound production and integrate newly learned sounds into functional communication.

Fluency Disorders (Stuttering & Cluttering)

What We Treat

Stuttering is a fluency disorder characterized by repetitions (repeating sounds or syllables), prolongations (holding out sounds), or blocks (momentary stoppage of airflow). It typically emerges between ages 2.5–3 years during rapid language acquisition. Cluttering involves rapid, irregular speech rate often accompanied by excessive disfluencies, collapsed syllables, and misplaced pauses. Research indicates that approximately 2–3% of preschoolers stutter, though about 75–80% recover naturally without intervention.

Age Groups Served: Preschool through school-age (ages 3–12+)

Our Approach

Early identification is key. We assess stuttering severity and associated behaviors. Research supports both child-centered fluency-shaping approaches and family-based interventions that modify environmental factors and communication styles. We help children develop awareness of their stuttering and teach them strategies to maintain fluent speech.

Social Communication & Pragmatics

What We Treat

Social (pragmatic) communication disorder involves difficulties in the social use of verbal and nonverbal communication. Children may struggle to use language for different purposes (greeting, requesting, informing), adjust their communication based on listener or context, or follow conversational rules. Pragmatic difficulties can occur with or without autism spectrum disorder (ASD). Individuals may struggle with understanding nonliteral language (jokes, idioms, metaphors) and integrating language with nonverbal behaviors.

Age Groups Served: School-age children (age 4 and older)

Our Approach

We assess pragmatic skills including conversational competence, narrative abilities, and social interaction patterns. Treatment involves explicit instruction in social communication rules, peer-interaction coaching, and natural communication practice. We work closely with families and schools to generalize skills across environments.

THE ASSESSMENT & TREATMENT PROCESS

Step 1: Initial Consultation & Intake

We begin by gathering detailed background information including developmental, medical, and communication history. For pediatric clients, we learn about developmental milestones and family communication patterns. This initial meeting establishes rapport and clarifies the client's or family's priorities and concerns.

Step 2: Comprehensive Speech-Language Assessment

We conduct formal and informal assessment of relevant areas: language comprehension and expression; speech sound production; voice quality and vocal function; fluency; pragmatic communication skills; hearing sensitivity; swallowing function (if indicated). Assessment may include standardized tests, observations, play-based activities (for children), and oral-motor examination. Results document current abilities and identify specific areas requiring intervention.

Step 3: Collaborative Treatment Planning & Goal-Setting

Following assessment, we meet with the client and family to discuss findings, share results, and collaboratively establish meaningful, measurable treatment goals. Goals address functional communication needs and reflect what is most important to the client. We explain treatment recommendations, answer questions, and develop a plan specifying frequency, duration, and intensity of services.

Step 4: Evidence-Based Intervention

Treatment is tailored to the individual's needs and incorporates the latest research-based techniques. We use naturalistic, play-based approaches for children and functional, meaningful activities. Therapy is active and engaging, with extensive practice opportunities. We regularly involve families in therapy sessions and provide activities for home practice to maximize learning and generalization.

Step 5: Progress Monitoring & Data-Based Adjustments

We regularly measure progress toward goals using objective measures. Sessions include systematic tracking of performance. We adjust treatment based on client response, increasing or decreasing complexity as appropriate. Progress is communicated regularly to the client and family.

Step 6: Discharge Planning & Follow-Up

When treatment goals are achieved, we develop a discharge plan including strategies for maintaining skills and recommendations for future services if needed. We may schedule follow-up sessions to ensure skills are maintained. For chronic conditions, we continue providing services with periodic re-evaluation of goals and treatment effectiveness.

ADULT SPEECH THERAPY SERVICES

Post-Stroke & Neurological Rehabilitation — Aphasia

Aphasia is an acquired language disorder affecting the ability to understand, express, read, or write language. It is most common following stroke, affecting approximately 25–50% of stroke survivors. Additionally, 15% of individuals under age 65 experience aphasia after their first stroke, increasing to 43% in those age 85+. Aphasia can also result from traumatic brain injury, brain tumor, or other neurological conditions. Language impairment is most severe acutely, with greatest recovery occurring within the first three months post-onset. Evidence supports speech-language therapy to improve functional communication, reading comprehension, auditory comprehension, expressive language, and written language.

Treatment includes language interventions and evidence-based techniques such as constraint-induced aphasia therapy (CIAT) and melodic intonation therapy (MIT). Research indicates that increased intensity of language therapy may be associated with larger improvements in language measures.

Dysarthria

Dysarthria is a motor speech disorder caused by impaired neuromuscular control of the muscles used for speech. Approximately 22–60% of stroke patients experience dysarthria within the first week post-stroke, with about 35% continuing to exhibit dysarthria even 6 months post-event. Dysarthria affects speech clarity, coordination, strength, speed, and breath support, significantly impacting speech intelligibility and quality of life.

Treatment involves individually tailored interventions targeting connected speech production, speaking rate control, articulatory placement, and loudness. Intensive, repetitive motor-learning-based practice is essential for recovery.

Voice & Vocal Health

What We Treat

Voice disorders are vocal deficits affecting functional communication. Common symptoms include hoarseness, breathiness, vocal fatigue, pitch breaks, reduced vocal range, and sensation of something in the throat. Voice disorders can result from organic causes (vocal nodules, polyps, paralysis) or functional causes (vocal abuse, hyperfunctional use). Voice disorders can significantly impact professional performance and quality of life.

Our Approach

We conduct comprehensive voice assessment including perceptual evaluation of vocal quality, acoustic analysis, and aerodynamic measurements. Voice therapy may be the preferred treatment to resolve voice disorders and includes voice function exercises (VFEs) targeting laryngeal muscle strength and coordination. Treatment often includes behavioral modification and lifestyle changes including vocal hygiene education.

Swallowing Disorders (Dysphagia)

What We Treat

Dysphagia involves difficulty swallowing that can affect safety, nutrition, hydration, and quality of life. Swallowing problems are common following stroke, affecting 37–78% of stroke survivors (depending on assessment method). Dysphagia can also result from neurological diseases, head and neck disorders, and age-related changes. The disorder can involve the oral cavity, pharynx, esophagus, or gastroesophageal junction.

Our Approach

Management is based on comprehensive assessment including both clinical and instrumental assessments as appropriate. We assess swallowing function, identify aspiration risk, and develop individualized treatment plans addressing nutrition, hydration, and safety. Treatment may include compensatory strategies (posture modifications, swallow maneuvers) or rehabilitative exercises targeting swallowing physiology.

THE ASSESSMENT & TREATMENT PROCESS

Initial Consultation & Intake

We begin by gathering detailed background information including medical, and communication history, we understand the onset and progression of concerns. This initial meeting establishes rapport and clarifies the client's or family's priorities and concerns.

Comprehensive Speech-Language Assessment

We conduct formal and informal assessment of relevant areas: language comprehension and expression; speech sound production; voice quality and vocal function; fluency; pragmatic communication skills; hearing sensitivity; swallowing function (if indicated). Assessment may include standardized tests, observations, and oral-motor examination. Results document current abilities and identify specific areas requiring intervention.

Collaborative Treatment Planning & Goal-Setting

Following assessment, we meet with the client and family to discuss findings, share results, and collaboratively establish meaningful, measurable treatment goals. Goals address functional communication needs and reflect what is most important to the client. We explain treatment recommendations, answer questions, and develop a plan specifying frequency, duration, and intensity of services.

Evidence-Based Intervention

Treatment is tailored to the individual's needs and incorporates the latest research-based techniques. We use functional, meaningful activities for adults. Therapy is active and engaging, with extensive practice opportunities. We regularly involve families in therapy sessions and provide activities for home practice to maximize learning and generalization.

Progress Monitoring & Data-Based Adjustments

We regularly measure progress toward goals using objective measures. Sessions include systematic tracking of performance. We adjust treatment based on client response, increasing or decreasing complexity as appropriate. Progress is communicated regularly to the client and family.

Discharge Planning & Follow-Up

When treatment goals are achieved, we develop a discharge plan including strategies for maintaining skills and recommendations for future services if needed. We may schedule follow-up sessions to ensure skills are maintained. For chronic conditions, we continue providing services with periodic re-evaluation of goals and treatment effectiveness.

OUR EVIDENCE-BASED CLINICAL APPROACH

Evidence-Based Practice

All interventions are grounded in current research and clinical evidence from ASHA guidelines and peer-reviewed literature.

Family-Centered Care

We recognize that families are central to a child's development and adult clients' support systems. We prioritize parent/caregiver collaboration, education, and involvement in all aspects of assessment and treatment.

Comprehensive Assessment

We conduct thorough evaluation of communication, language, voice, and swallowing function to accurately identify strengths and challenges, determine underlying causes, and establish appropriate treatment targets.

Individualized Treatment Plans

Each client receives a personalized intervention plan reflecting their specific needs, goals, and functional communication priorities as determined in collaboration with the client and family.

Intensive Practice

Research supports intensive, repetitive practice for motor learning and speech-language skill development. We maximize opportunities for meaningful practice in therapy and home settings.

Progress Monitoring

We regularly measure progress using objective measures and adjust treatment based on client response. Data guides clinical decision-making.

Holistic Perspective

We consider how communication and swallowing disorders affect overall quality of life, participation in meaningful activities, relationships, and psychosocial well-being.