Our Speech Services

Speech-Language Therapy Services

The Initial Assessment:
When services first begin with your child, the SLP will conduct both formal and informal assessments in order to determine your child’s current levels of functioning and areas of need. A comprehensive treatment plan is then developed based upon assessment results and parental input. Treatment plans utilize evidenced-based treatment practices and incorporate a wide variety of highly personalized, structured supports in order to best facilitate skill acquisition and generalization across goal areas.

Ongoing Assessments:
Approximately every 12 months or when otherwise indicated (i.e., a rapid increase in skills occurs), your child will be re-assessed by the SLP. This assessment will provide information on skills gained during the past treatment period and allow for necessary changes to be made to the treatment plan.

Assessments Used:
The SLP will utilize both formal and informal assessment measures to identify strengths and needs across a variety of domains. Frequently used assessments are listed below. Assessment measures are grouped according to speech-language service delivery areas:

Receptive & Expressive Vocabulary

Peabody Picture Vocabulary Test – Fourth Edition (PPVT – 4)
- The PPVT-4 is an individually administered norm referenced test used to quickly evaluate receptive vocabulary. For its administration, the SLP presents a series of pictures to the student. There are four pictures to a page, and each is numbered. The SLP speaks a word describing one of the pictures and asks the individual to point to or say the number of the picture that the word describes.
Expressive Vocabulary Test – Second Edition (EVT – 2)
- The EVT-2 is an individually administered norm referenced test used to quickly evaluate expressive vocabulary. For its administration, the SLP presents a single picture to the student. The SLP then asks the student to verbally label the picture (e.g., “What is this?”).

Receptive & Expressive Language Skills

Preschool Language Scales – Fifth Edition (PLS – 5)
- The PLS-5 is a comprehensive developmental language assessment, with items that range from pre-verbal, interaction-based skills to emerging language and early literacy. This interactive, play-based assessment provides information about language skills for children birth through age 7.
Comprehensive Evaluation of Language Fundamentals Preschool – Second Edition (CELF Preschool - 2)
- The CELF Preschool -2 is a comprehensive language assessment that provides in-depth information on semantics (the meaning of words and phrases in language), morphology (word structure and form), and syntax (grammar).
Comprehensive Evaluation of Language Fundamentals – Fifth Edition (CELF – 5)
- The CELF-5 is an individually administered, norm-referenced tool used for the identification, diagnosis, and follow-up evaluation of language and communication disorders in students 5-21 years old. Subtests assess receptive and expressive language skills related to following directions, formulating sentences, recalling sentences, providing word definitions, assembling sentences, identifying semantic relationships, identifying word classes, and understanding spoken paragraphs. The CELF-5 also includes a “pragmatics profile” which is used to identify verbal and nonverbal social pragmatic areas of need.

Functional Communication & Communication Milestones

Test of Early Communication and Emerging Language (TECEL)
- The Test of Early Communication and Emerging Language (TECEL) assesses the earliest communication behaviors and emerging language abilities in typically developing young children and in older individuals with moderate-to-severe language delays. The TECEL can be used to assess and chart communication and language strengths and weaknesses and subsequently design intervention plans.
Verbal Behavior Mapping and Assessment Placement Protocol (VB-MAPP)
- The Verbal Behavior Mapping and Assessment Placement Protocol (VB-MAPP) is an assessment tool based upon Applied Behavior Analysis with a focus on verbal behavior. The VB-MAPP can help identify a child’s strengths and weaknesses across a variety of critical skills. In addition to looking at the phonemes, words, phrases, and sentences that the student uses, the assessment also identifies the conditions under which he/she emits those words.

Augmentative and Alternative Communication

Test of Aided-Communication Symbol Performance (TASP)
- The Test of Aided-Communication Symbol Performance (TASP) is an augmentative and alternative communication (AAC) assessment battery designed for use by individuals with cognitive, communication, and/or speech disabilities. This test of symbolic skills provides a starting point for designing or selecting an appropriate page set for an AAC device. The test can also be used to help design communication boards. Results can also help in establishing appropriate AAC intervention goals and strategies targeting symbolic and syntactic development, and can be used to benchmark progress in aided communication performance.

Social Pragmatics

CELF-P & CELF-5 pragmatics profiles
The CELF-P Descriptive Pragmatics Profile is a rating-scale that assists in the evaluation of pragmatic behaviors in relation to the social expectations for communication at home, in the community, and in early school settings.
The CELF-5 Pragmatics Profile is a checklist that is used to identify verbal and nonverbal pragmatic deficits that may negatively influence social and academic communication. The skills evaluated are common daily skills observed across ages, genders and classroom situations and are necessary for obtaining to and giving information.
Social Skills Checklists (Pre-K/Elementary and Secondary)
- The Social Skills Checklist (Pre-K/Elementary) is designed to assess an individual’s social skills related to play behaviors, understanding emotions, self-regulation, flexibility, conversational skills (verbal and nonverbal) and compliments. The evaluator rates each skill as occurring “almost always,” “often,” “sometimes,” or “almost never.”
- The Social Skills Checklist (Secondary) is designed to assess an individual’s social skills related to conversation (verbal and nonverbal), problem-solving, understanding emotions, compliments, and flexibility. The evaluator rates each skill as occurring “almost always,” “often,” “sometimes,” or “almost never.”
VB-MAPP
- Portions of the VB-MAPP addressing social skills and social play will provide additional information regarding your child’s strengths and needs in these areas.
Assessment of Functional Living Skills (AFLS)
- The AFLS is comprised of 6 individual assessment protocols that assess functional, practical, and essential skills of everyday life. Protocols include Basic Living Skills, Home Skills and Community Participation Skills, School Skills, Independent Living Skills, and Vocational Skills.
- These protocols are broken down into subcomponents. Relevant subcomponents in the area of social pragmatics are as follows: “Social Awareness and Manners” (Community Participation protocol); “Social Skills” (School Skills Protocol); “Social Interaction,” “Living with Others,” and “Interpersonal Relationships” (Independent Living Skills protocol); and “Coworker Relations” (Vocational Skills protocol).
The Informal Social Thinking Dynamic Assessment Protocol (ISTDAP)
- The ISTDAP, developed by Michelle Garcia Winner, is a means of identifying and quantifying a student’s social competencies in “real-time.” The protocol also helps to connect the dots between a student’s social learning abilities and related academic strengths and weaknesses. The ISTDAP is not a diagnostic tool but is intended to be used with individuals who have already been identified as having a social skills deficit. The ISTDAP provides information relating to the student’s ability to interpret and respond to social stimuli in the moment of interaction. The assessment tasks also explore Theory of Mind, Executive Functioning, and concepts related to Central Coherence.

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One-to-One Speech-Language Therapy

The SLP works individually with your child on the treatment goals developed during the initial assessment. The SLP incorporates treatment principles and strategies from a variety of methodologies and treatment approaches. Goals are often addressed within meaningful and highly motivating activities. Speech-language therapy goals can vary greatly depending on your child’s areas of need. Potential goal areas and target skills are listed below:

Functional Communication Skills

Making requests
- Requesting preferred items/activities (via verbal language, sign, and/or AAC support/device)
- Requesting actions needed to enjoy desired activity (i.e., “push swing,” “open box,” etc.)
Protesting/rejecting nonpreferred or unwanted items or activities
- Appropriately protesting nonpreferred items or activities (via verbal language, sign, and/or AAC support device); e.g., “All done,” “I don’t want that,” “No thank you,” etc.
Indicating acceptance/refusal
- Appropriately indicating acceptance or refusal by responding with “yes” or “no” when asked, “Do you want _____.” Responses may include verbal language, conventional gestures (e.g., head nod or shake), and/or AAC supports/devices.
Learning to wait
Asking for help
- Requesting assistance across a variety of functional tasks, situations, and communication partners
Requesting a break
- Learning how to appropriately request a break when tired, frustrated, or upset
Following directions
- Following simple 1-step directions or complex multi-step directions within functional activities
Augmentative and Alternative Communication
- Evaluation
  - Determining which AAC system/device is appropriate based on child’s unique set of strengths and needs
- Device programming
  - Programming and personalizing the device to incorporate critical vocabulary (i.e., as identified through parent completed “Vocabulary Questionnaires” and “Communication Breakdown Diaries”)
- Device training
  - Providing device training and instruction to family members, team members, and other relevant personnel.
  - Consulting with family and team members regarding the facilitation of spontaneous and meaningful communication
- Speech-Language Therapy
  - Providing aided language stimulation (i.e., direct modeling) within meaningful activities and situations
  - Structuring activities in a way that encourages spontaneous communication
  - Teaching critical AAC skills such as categorization, core vocabulary, and syntax (e.g., constructing multi-word utterances)
- Total communication
  - Encouraging, acknowledging, and respecting ALL forms of communication (i.e., low- mid- high-tech AAC, sign, vocalizations, gestures, and verbal language)
- Low-tech systems/supports
  - Picture Exchange Communication System (PECS)
  - Pragmatically Organized Dynamic Display (PODD)
  - Communication boards
- Mid-tech systems/supports
  - Go Talk communication devices
Receptive and Expressive Language Skills
- Basic concepts (e.g., positional, temporal, qualitative, quantitative, etc.)
- Sequencing
- Increasing receptive and expressive vocabulary
- Answering questions
  - Learning to discriminate between “wh” question words (i.e., who, what doing, what, where, when, why) in order to provide accurate and appropriate answers to a variety of questions.
Social Pragmatics
- Initiating and responding to greetings, social phrases, social questions, and farewells
- Making polite conversation (i.e., “small talk”) with others
- Learning about nonverbal communication (e.g., body language, body positioning, eye contact, etc.)
- Learning a variety of socially appropriate phrases and responses and generalizing these skills across multiple communication partners and contexts
- Participating in conversations by generating relevant and appropriate questions, making relevant and appropriate comments, and appropriately answering questions.
  - Learning higher-level conversation skills including conversational transitions (initiating and ending a conversation appropriately), topic maintenance, and topic shifts
Communication Skills for Daily Living
- Self-advocacy
  - Appropriately protesting the actions of others by verbalizing an appropriate message (e.g., “No,” “Stop that,” “Please leave me alone,” etc.)
- Community specific interventions pertaining to communication and social pragmatics
  - Learning to place one’s order at a fast-food restaurant
  - Learning to exhibit appropriate or “expected” behaviors in the community
- Learning to answer questions pertaining to biographical / personal information
- Learning safety skills such as identifying community helpers and verbalizing or providing relevant information if lost or in need of assistance.

Lee Silverman Voice Treatment (LSVT) – LOUD
Children with Down Syndrome have important things to say! However, several factors may impact their ability to successfully communicate spoken messages. These factors include imprecise articulation, breathy voice quality, hypernasality, monotone voice, reduced vocal loudness, and uncontrolled rate and rhythm.1 As a result, peers and adults often have difficulty understanding their spoken messages, resulting in frustration, failed communication attempts, and/or maladaptive behaviors.

Lee-Silverman Voice Treatment (LSVT)-LOUD is acknowledged as an effective, evidence-based speech treatment for individuals with Parkinson’s disease that is effectively being applied to children with Down Syndrome. The LSVT-LOUD approach focuses on a single therapeutic target: increased vocal loudness. This simple, single focus acts as a trigger to increase effort and communication across the entire speech production system while limiting the cognitive load—which is beneficial for children with cognitive impairments. The effects of LSVT-LOUD have been shown to generalize to other systems, including articulation, speaking rate, swallowing, and respiratory mechanisms. Functional gains related to speech and communicative success have been observed with LSVT-LOUD treatment. Treatment requires one month of intensive therapy (4 one-hour sessions per week for 4 weeks) and daily homework (approximately 5-10 minutes per day). LSVT-LOUD must be delivered by a certified LSVT-LOUD clinician. Learn more about LSVT-LOUD by visiting www.lsvtglobal.com.

Lauryn Olson is a certified LSVT-LOUD clinician employed at Positive Synergy. Lauryn has over five years of experience working as a speech-language pathologist with children with developmental disabilities, including Down Syndrome. She has successfully implemented LSVT-LOUD with individuals with acquired and developmental disabilities during graduate school as well as during her post-graduate career. Please contact Lauryn by email at Lolson@psaba.org or by telephone at (774) 901-4888 to request more information or to schedule an initial LSVT-LOUD assessment for your child!

1Clement & Twitchell, 1959; Heltman & Peacher, 1943; Hixon & Hardy, 1964; Keesee, 1976; Kent & Vorperian, 2013; Kumin, 1994; Mahler & Jones, 2012; Roberts, Price, and Malkin, 2007; Solomon & Charron, 1998; Venail, Gardiner, and Momdain, 2004; Wolf, 1950; Workinger & Kent, 1994

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