Can Speech Therapy Help School-Age Children?

Can Speech Therapy Help School-Age Children?

When we talk about speech therapy, people often look at us with a sweet, smiling face and say things like, “Oh, it is so wonderful that you help kids say their ‘r’ and ‘s’ sounds!”  Don’t get us wrong, we can definitely help your child stop calling that furry animal with long ears a “wabbit”. But did you know that speech-language pathologists work with school-age children in many other areas outside of resolving errors with speech sounds?


Here are four examples of the areas we can provide help to school-age children at TheraCare:

1 – Executive Function Skills

Executive function and self-regulation skills are crucial to a person’s ability to get things done in their daily life. You may notice that your child has difficulties planning for upcoming tests, making decisions regarding the best ways to schedule their time, or remaining focused on a conversation at the dinner table. Executive function skills help us all plan, focus attention, remember instructions, and juggle multiple tasks. If your child is having difficulty with these things, then schoolwork and social interactions may be negatively impacted.

2 – Auditory Processing Disorder

Have you noticed that your child has difficulty understanding instructions in noisy environments or continues to have difficulty with reading or spelling even given specific instruction? Sometimes children are able to hear words being said, but their brains have a hard time processing what they are hearing. Speech-Language Pathologists can help students discriminate, recognize, and comprehend auditory information to help them achieve greater success in school.

3 – Language Skills

Language skills are how we convey our thoughts and ideas to others. Adequate language skills are fundamental to academic and social success. This includes both receptive language (how we understand language) and expressive language (how we get our thoughts across). Language is such a broad area, but here are a few examples of the types of things we might work on with children of various ages:

  • Following directions (from simple, one-step directions, to multi-step, complex directions)
  • Grammar (subject-verb agreement, proper verb tense, grammatically-correct sentences, etc.)
  • Vocabulary (demonstrating understanding and using grade-level vocabulary)
  • Asking and understanding wh- questions
  • Writing a complete, grammatically-correct narrative

4 – Spelling, Reading, and Writing Skills

Is your child struggling with spelling words correctly? Maybe reading and writing has been a consistent challenge over the years? We can help with that! We focus on integrating all the functional elements necessary to help your child develop effective reading and writing skills. At TheraCare, we utilize a specific approarch that is proven to help improve skills for individuals with various levels of needs, including individuals with Dyslexia. We can help your child discover that learning these skills is fun while using our systematic, multi-sensory approach.


Whether it’s by saying that tricky /r/ sound, working on auditory discrimination skills, or helping your child succeed with reading and writing, the Speech-Language Pathologists at TheraCare would love to help your child communicate effectively and succeed in school! It is never too late to get help for your school-age child.

Check out our summer programs at for more information about upcoming learning opportunities or call us at (417) 890-4656.

We are excited to partner with you to set your child up for success!

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3 Reasons Why School-Based Therapy Is Not Enough for Your Child

reasons to continue private therapy


Your kids have spent the summer splashing in pools, eating ice cream, and staying up way past their bedtime. It’s hard to believe that in a few short weeks, they’ll be trading in those swimsuits for backpacks.

If your child has been receiving private speech, language, or occupational therapy services this summer, you may be considering cancelling these services for the school year.  After all, won’t their speech therapy services in school be enough?

Here are three important reasons to continue private therapy services during the school year:


1. One on One Setting

In the public schools, it is highly likely that your child will be paired with as many as three other children during therapy.  While school therapists are trained to make the most of therapy sessions involving several children, the simple math is that your child might only be getting ten minutes of therapy out of a 30-minute session.

In private therapy your child receives one-on-one therapy services, so every minute of a session is devoted towards working on his or her own specific goals.


2. More Collaboration with Parents

In private therapy, parents consult with the therapist directly after each session.  You are kept informed of the specific goals your child is working on, what strategies will improve their skills in these areas, and suggestions for what can be done at home to continue the progress.

More importantly, you as the parent get to know your therapist; together you prioritize what areas you want to work on first. As much as school therapists try to keep parents informed through quarterly progress updates and annual IEP meetings, they provide services for so many students that their ability to collaborate with you is limited.


3. More Therapy=More Progress

Public school therapy is free and takes place during the school day, making it a cost-effective and convenient form of therapy for your child. Unfortunately, not every child who is struggling will qualify for services in public schools. Research has shown that early intervention is a key to reducing the severity of your child’s needs and increasing the positive impact of therapy services.

Giving your child the ability to receive therapy services in public schools AND in a private setting maximizes their ability to make progress early. That means less services will be needed later on, when school coursework becomes more complex. Basically, the more therapy your child receives early on, the fewer services they will need later on!

Remember, the benefits of private therapy continue to last all year round! Public school services combined with private sessions makes for a one-two punch that tackles your child’s therapy needs early on.

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3 Red Flags Your Kindergartener Needs Speech/Language Therapy

3 red flags

Written By: Allison Slone, MS, CCC-SLP

It seems like only yesterday your child was learning to roll over, sit up, and take those first wobbly steps.  Now it’s time for them to go to Kindergarten, and you’re left wondering how time managed to slip by so quickly.  Your mind swirls with a million questions.  Will they make good friends?  Will they succeed in school?  Will they remember that you put their lunch money in the front pocket of their backpack?

You’re so proud of your child you think your heart might burst.  But at the back of your mind, the questions continue.  Is this “normal”?  Do other kids have a hard time following directions?  Your relatives have mentioned they can’t understand what your child is saying.  Should you be worried?

A child’s ability to communicate is one of the most important skills they will use as they progress through school and adulthood.  Here are three red flags that your Kindergartener might need to be evaluated by a speech-language pathologist:

  1. People are having a hard time understanding what your child is saying.

By Kindergarten, your child should be able to be easily understood by both familiar (ex: Grandma and Grandpa) and unfamiliar (ex: a stranger at the grocery store) listeners.  Your child may make errors on some speech sounds that are harder to say, like “wabbit” for “rabbit” or “yips” for “lips”, but his or her overall message should be easily understood.  You may need to rely on other people’s report for this, since parents seem to be able to “speak the language” of their child, no matter how difficult they are to understand.

  1. Your child has difficulty following multi-step directions at home or school.

As a Kindergartener, your child should easily be able to follow 3-step directions at home, like “put on your pajamas, brush your teeth, and then pick out a book.”  If he or she seems to get lost after step one or needs frequent reminders about what the next step is, this could be a sign of a receptive language issue.

Receptive language is your child’s ability to understand spoken words (since he or she most likely isn’t able to read fluently yet).  If he or she doesn’t understand what’s being asked or can’t retain the information, these issues will show up in school, too.  If your child’s teacher reports that your child has a difficult time following classroom directions, it might be time to look into an evaluation from a speech-language pathologist to determine his or her overall language skills.

  1. Your child is struggling putting his or her thoughts into words.

By the time your child is in Kindergarten, he or she should be speaking in complete sentences.  These sentences should be relatively free of grammar errors, and they should be able to convey two or more ideas.  If your child is upset, can he verbalize what happened?  If he wants to tell you about something fun that happened at school, could he do so in a way you could easily understand?  Can your daughter retell the basic elements of a story you read to her?  Could she describe what a picture looks like that you can’t see, or explain to you the basic steps of how to make a peanut butter and jelly sandwich?  Can your son use his words to tell his brother “Don’t touch my rocket ship!  It’s mine!” rather than hitting him?

If not, your child may be demonstrating difficulty with expressive language skills.  Expressive language is your child’s ability to put his or her thoughts into words in a way that makes sense.  Difficulty with expressive language can affect your child’s ability to explain what he or she knows at school, which impacts academic success.


If you’re worried about your child’s speech or language skills, you can put your mind at ease by requesting a speech and language evaluation by a qualified speech-language pathologist.  Early intervention is the key to reducing the impact of any issues that could affect your child’s ability to communicate and succeed, both at home and in school.

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A Beginner’s Guide to Augmentative & Alternative Communication

A Beginner’s Guide to

Augmentative & Alternative Communication

Written by: Rachel Ball, MS, CF-SLP


Singing along to your favorite song in the car. Ordering food at the drive-thru. Saying, “I love you” to someone special. Speech is often a concept taken for granted in our day-to-day activities. However, for many people, verbal output is not a viable option for communication.


When an individual is unable to use speech to communicate functionally, families and caregivers are often directed to seek out alternative options. It can be a daunting task when choosing what mode of communication works best for your loved one. Outlined below are terms and definitions that are useful for navigating through the confusing world of acronyms and jargon common to professionals in the field of assistive technology and alternative communication.


Assistive Technology (AT): An umbrella term that encompasses any item, equipment, software or product system that is used to increase, maintain, or improve the functional capabilities of individuals with disabilities. This information and more can be found here.


Augmentative and Alternative Communication (AAC): Any mode of communication other than speech. Some examples include facial expressions, gestures, symbol systems (e.g. PECS), pictures, writing, sign language and high tech communication devices. The American Speech-Language Hearing Association explains more here.


Augmentative Communication Device (ACD): Equipment used as an alternative and/or supplement to speech for communicative purposes. ACDs help individuals overcome their inability to speak due to a disease or medical condition that interferes with participation in daily activities. Examples include communication picture books/boards, speech amplifiers/enhancers and electronic devices that produce speech or written output.


Speech-Generating Device (SGD): Electronic AAC devices that produce digital or synthesized speech as a result of selections made by the user. They are often used to supplement or replace the natural speech and/or writing for individuals who have severe speech impairments. SGDs can also be referred to as voice output communication aids (VOCA).


Dedicated: Communication devices that have hardware and software designed to be used strictly for communication purposes. In contrast to integrated devices, dedicated ACDs do not have the capability of accessing other features common to your everyday tablet (e.g. applications, internet, music, camera, etc.)


Core Vocabulary: Words that are most commonly used in a language. Usually core words consist of pronouns, simple verbs and helping verbs, articles and prepositions. Core vocabulary is typically more general and can be used across a wide range of settings with various communication partners. Much research has been done to define the “best” set of core words, leading to differences in software/programing for ACDs.


Fringe Vocabulary: A more specific set of words that lend themselves to the individual, environment or topic. Fringe words are often nouns and specific verbs. Every AAC user has a unique set of fringe vocabulary that best fits their needs, and people’s fringe expands according to their own experiences. These words are not often found at the forefront of an ACD, as they are not used with as high of frequency as the core set. In the example below, the fringe words are in bold, italicized font.


“I want to go swing at Oak Park with Bobby and Suzy, please.”


Explore some more!

Check out the links below to learn more about the wonderful world of AAC.


Contact us via social media, email, or by phone for more information about AAC!










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Orofacial Myology – Part 5: Orofacial Myology and Orthodonics

Orofacial Myology and Orthodontics


Orofacial myofunctional disorders (OMD) can cause changes in the growth and shape of the upper and lower jaws, as well as other facial bones and teeth. In some situations a narrowing of the roof of the mouth (hard palate) can occur. When this is the case, it is important to consult an orthodontist to consider the possibility of palatal expansion. Generally, optimal outcomes with orofacial myofunctional (OM) therapy are achieved when this expansion is completed.


While we may refer for an orthodontic evaluation, this does not mean that your child must wait to move forward with therapy. Orthodontic treatment can coincide with OM therapy and long term effectiveness of orthodontic treatment can in fact be enhanced by OM therapy.


At TheraCare, we work hand in hand with several local orthodontists and we would be happy to talk with you about the positive impact orofacial myofunctional therapy could have for you or your child.


Feel free to contact us via our social media links, email, or by phone to discuss any questions you have.







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Orofacial Myology – Part 4: Orofacial Habits – Thumb Sucking and More

Orofacial Habits

This will be a short introduction to orofacial habits. These habits are of concern because they can be caused by or contribute to other orofacial issues in the areas of both structure and function.

Orofacial habits include, but are not limited to:

  • Mouth Breathing
  • Thumb or Finger Sucking
  • Tongue or Cheek Sucking

Let’s briefly take a look at these.


Mouth Breathing –

There are many factors that can cause mouth breathing. If your child breaths through their mouth consistently throughout the day or during the night, an evaluation to assess the root cause of this posture should be considered. If allowed to continue this posture while breathing. a child’s tongue will sit unnaturally low in the mouth. This can cause concerns related to development of the face, upper and lower jaws, as well as possible speech articulation issues.


Thumb or Finger Sucking & Tongue or Cheek Sucking – 

Thumb sucking can be seen as early as 18 weeks in utero. Human infants lose the essential need for sucking around the age of 4 months. At that point, it can quickly become associated with comfort and pleasure; therefore, making it difficult to break the habit as the child gets older.

Thumb and finger sucking can cause inappropriate shaping of the palate and chin. In addition, it can cause changes in the tone of the tongue and facial muscles, as well as a lower resting posture of the tongue. An anterior open bite can sometimes be the result of prolonged thumb and/or finger sucking.

Tongue and cheek sucking, while similar, could stem from a number of causes. It is important to find a knowledgeable professional who can complete a thorough evaluation to diagnose and make necessary referrals for adequate treatment.


What can speech therapy do to help with orofacial habits?

At TheraCare, we offer evaluations that can help to pinpoint the root cause of these concerns. Through our treatment programs, we address these concerns and work with your family to devise a program tailored specifically to you or your child. We utilize a multimodal approach that has seen proven results – utilizing proprioceptive techniques and a hierarchy of exercises as needed, along with positive reinforcers.


Feel free to contact us via our social media links, email, or by phone to discuss any concerns you have.






thumb sucking

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Orofacial Myology – Part 3: Tongue Tie

This is a very basic overview of tongue tie and possible concerns related to speech production. Please call our office for more information if you have any concerns or questions.

What is a tongue tie?

The lingual frenum (or lingual frenulum) is the cord that stretches from under the tongue to the floor of the mouth.

‘Tongue tie’, ‘Ankyloglossia’ or ‘short frenum’ are the terms used when the lingual frenum is short and restricts the mobility of the tongue.

Tongue tie can be defined as a structural abnormality of the lingual frenum.  When the frenum is normal, it is elastic and does not interfere with the movements of the tongue in sucking, eating, clearing food off the teeth in preparation for swallowing and, of course, in speech. When it is short, thick, tight or broad it has an adverse effect on oromuscular function, feeding and speech. 1

Often dismissed by professionals as unnecessary to treat, tongue tie can cause many issues that, at the time, may seem unrelated or unimportant. However, when viewing the body as a whole and assessing the parts of your system that a tongue tie can impact, it is highly important that you consider having this assessed if you have any concerns.

Symptoms that may be seen when a tongue tie is present include:

  • Heart shape of tongue when raised or protruded (see pictures below)
  • Cannot extend tongue out to a point
  • Tongue curves down when extended
  • Difficulty licking an ice cream cone or kissing
  • Extended time period in orthodontics
  • Possible speech problems
  • Possible digestive problems
  • Swallowing deficits, difficulty swallowing pills
  • Cannot suction the tongue to the roof of the mouth

Included here are a couple of images of my own child’s tongue prior to his tongue tie release. You can clearly see the heart shape of his tongue. We had been noticing symptoms which included frequent choking and gagging with solid foods, speech articulation delays, inability to click his tongue, downward curve of the tongue when extended and the heart shape. Once his tongue was released (via laser at a local orthodontic clinic), we noticed immediate improvements in his swallowing function and ability to click his tongue, as well as increased imitation of speech sounds. After approximately 2.5 months, his speech articulation skills were gaining and were considered within normal limits.

Tongue Tie - heart shape image from front


Tongue Tie - heart shape image from side


While it is important to note that some of the symptoms listed above could be caused by other factors, a quick check of the tongue by a knowledgeable professional can ensure that treatment is targeting the root cause of these concerns.

The specialty of orofacial myology is something gained outside of traditional schooling for most speech-language pathologists. Be sure to ask your speech-language pathologist if they have training in this area and if they are confident in their skills to treat deficits related to tongue tie.

What can speech therapy do to help with tongue tie?

When we identify a tongue tie is present, we refer to a provider who can complete a tongue tie release/revision, also known as a frenectomy. Once the procedure is completed, speech therapy can assist with:

  • providing gentle stretches post surgery
  • addressing jaw stability
  • developing suction to the roof of the mouth
  • addressing any speech concerns, if present


Here are a few links that give great information related to tongue tie.


Feel free to contact us via our social media links, email, or by phone to discuss any concerns you have.







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Orofacial Myology – Part 2

Part 2

What Causes an Orofacial Myofunctional Disorder?


1. Airway Changes

Could you check yes to any of the following for your child?

  • Snoring
  • Chronic middle ear infections
  • Asthma
  • Lack of core trunk strength
  • Velopharyngeal Insufficiency
  • Pediatric Obstructive Sleep Apnea
  • Enlarged adenoids or tonsils

All of these things could cause airway changes or be the result of an airway change. These may increase the amount of time your child spends breathing through their mouth. When a child is consistently breathing through their mouth instead of their nose, it may cause a resting tongue posture to present lower in the bottom of the mouth instead of resting the tip against the roof of the mouth. When this occurs for an extended period of time, the tone, strength, and function of the tongue can be impacted resulting in an orofacial myofunctional disorder.


2. Tongue Tie (Ankyloglossia)

Our next blog post will specifically target this concern but here is a quick overview.

Tongue tie or Ankyloglossia can be defined as “a structural abnormality of the lingual frenum (membrane extending from the floor of the mouth to the underside of the tongue). When the frenum is normal, it is elastic and does not interfere with the movements of the tongue in sucking, eating, clearing food off the teeth in preparation for swallowing and, of course, in speech. When it is short, thick, tight or broad it has an adverse effect on oromuscular function, feeding and speech. It can also cause problems when it extends from the margin of the tongue and across the floor of the mouth to finish at the base of the teeth.” 1

A tongue tie can impact the range of motion for sticking the tongue straight out, moving the tongue back and to the molars, and lifting the tongue up to the roof of the mouth. When considering these restrictions, depending on the severity, it is easy to see why a tongue tie could cause many issues for the orofacial musculature.

We look forward to exploring this area in a more in depth manner in our upcoming blog post. Stay tuned!


3. Habits

These include the following:

  • Thumb or finger sucking
  • Nail biting
  • Tongue and Cheek sucking
  • Clenching and Grinding

As mentioned previously, the change in function of the tongue, in this case due to a habit, may result in changes of the tone, strength, and function of the tongue, as well as other muscles of the orofacial musculature.

Our clinic specializes in presenting clients with feasible and intentional ways to remove these habits.


4. Lack of Necessary Palatal Space

A high, narrow palate may be due to many different reasons but can also be caused by an orofacial myofunctional disorder. If the roof of the mouth is considered to be narrow, palatal expansion may need to be considered for optimal outcomes with orofacial myofunctional therapy.


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Orofacial Myology – Part 1

Part 1

What is Orofacial Myology?

Q: Has your dentist or orthodontist mentioned that you or your child has a tongue thrust?

You may need to consider seeking treatment by an individual trained to address this concern.

Q: Have you always thought that being tongue tied was just an expression used for a person who couldn’t get their words out?

It is possible for a person to truly be tongue tied. This occurs when the lingual frenulum (tissue that connects the floor of the mouth to the under side of the tongue) is connected to far forward or is too short/tight.

You may be asking: How does that answer the question? What is Orofacial Myology and how can it help myself or my family member? Let’s go over the basics.

Orofacial myology is the study of facial muscles and oropharyngeal complex, their associated movements and how those movements word together. These movements can affect the functions of:

1. Respiration

2. Chewing

3. Gathering and movement of food and liquid in the mouth

4. Speech production

5. Oral resting posture

When a change in patterning occurs, a resulting change in muscular function and/or structure may occur. Changes can be attributed, but are not limited to genetics, birth trauma and anomalies, lack of patent airway, surgical intervention affecting the head and neck, inappropriate development of the swallow, or noxious habit patterns. (1)

In addition to the above mentioned concerns, orofacial myologists also evaluate and treat

1. Jaw Stability/Dissociation

2. Lip Seal/Competence

3. Tongue Tie (Ankyloglossia)

4. Drooling/Saliva Control


Q: I thought TheraCare Outpatient Services offered speech therapy. How does speech therapy fit into this?

Any speech language pathologist (SLP) can gain additional training to become skilled in orofacial myology. Our lead SLP, Melanie Stinnett, MS, CCC-SLP,  has completed this extensive training and is currently providing therapy to clients in the Greater Springfield Area. If you have questions about this type of therapy you can contact us through our Contact Form on the website or call our office at 417-890-4656.

Make sure to stay tuned for more discussions in Part 2: Causes of Orofacial Myofunctional Disorders, Part 3: Tongue Tie, Part 4: Bad Habits, and Part 5: Orofacial Myology and Orthodontics.


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1. Mary Billings, MS, CCC-SLP, COM (2013) – President Elect – IAOM

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Come Welcome Us to the Neighborhood!

Open House


We are prepared for a wonderful day of fun!


Local authors of the book Stars in Her Eyes: Navigating the Maze of Childhood Autism will be here signing books. They are also giving away one paperback copy and one ebook copy of their book, as well as a handmade necklace created by one of the authors. You don’t want to miss meeting these wonderful women!


Local Christian radio station 88.3 the WIND will be broadcasting live from the parking lot and collecting clothes for their annual Harvest of Clothing to benefit Victory Mission.


Giveaways throughout the day will include:

2 – LeapPad2 Custom Edition – one pink and one green

2 – $20 LeapFrog digital download cards

5 – $10 gift cards for various local businesses


In addition to all these fun activities, we will also have cupcakes from TwentyOne Cakes. We love this company for their wonderful cupcakes but also because they donate 10% of all their sales to the Down Syndrome Group of the Ozarks. If you haven’t ever had one of their cakes, you’ll want to stop just to get a little taste!


We look forward to meeting you and showing you around our beautiful clinic!

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