Nicola Haworth - Paediatric speech & language therapist

Helpful info

common difficulties explained

Sometimes, no matter how good our communications skills there are things we just don't understand. The following are some common speech and language terms and difficulties and what they mean in plain and simple language.
  • attention and listening
    This is an important foundation for speech, language and communication development. Children need to not only hear but to listen to what is being said and they need to be able to sit and attend to an activity in order to fully understand. If children have difficulties with this area it can have a knock on effect to many other areas of development.
  • receptive language and comprehension
    This is the understanding of what people say. If children struggle to understand what is said to them this can affect their learning as well as their socialisation. It is therefore important any difficulties with understanding of language are dealt with as early as possible.
  • expressive language and expression
    This is what a child says and how they put words together to talk to people. Children can struggle to develop their language e.g. show a delay in their development. Other children may struggle to develop expressive language in the right way i.e. have disordered language. Both can impact on a child and therefore require help in order for the child to reach their potential.
  • speech sounds and phonology
    This is how a child says things rather then what they say. A child may use the wrong sounds e.g. "tar" for car or "pider" for spider. They may be able to make sounds on their own but struggle to put them together and use them in their conversation.
  • verbal dyspraxia
    This is where a child has a specific difficulty with their speech and is characterised by the inability to coordinate their speech. They may know what sounds they want to say but find it difficult to produce them at the right time. This may appear as part of a wider motor coordination difficulty or may just be verbal dyspraxia on its own.
  • social communication skills
    These are the skills needed in order to communicate effectively e.g. eye contact, listening, waiting, turn taking, topic maintenance, empathy, awareness of others etc. These skills are crucial in order to be an effective communicator and are important in making and maintaining friendships and relationships with others.
  • word finding difficulties
    This is where a child struggles to use the right word at the right time. They may miss words out of their speech or replace words with another word.
  • auditory memory
    This is the ability to remember information that has been heard and remember it in the correct order. A child who cannot "hold" a sentence of 3 or 4 words in his memory long enough to work out what is means will have difficulty in understanding language. Also, a child who cannot remember which sounds he heard in a word in the correct order will have difficulty in saying a word correctly or in spelling it correctly.
  • specific language impairment (SLI)
    This is where a child is of normal intelligence but has specific difficulties with speech and language.
  • alternative and augmentative communication (AAC)
    These are different ways to communicate that can be in addition to or to replace speech. These can include sign systems, use photos or symbols or using high tech aids such as voice output communication aids.
frequently asked questions

Each child is different as are the difficulties they face so the questions you have will often be very specific but I've tried to offer some answers to some of the most common questions people have about speech and language problems and therapies.
  • why would I choose independent therapy?
    Independent and NHS therapists have the same basic training and qualifications and will offer similar therapy, however independent therapists can generally offer appointments sooner and can be more flexible in terms of what they offer and when. Independent therapists can also offer intervention in a variety of settings including your own home, schools or nurseries.
  • where will you see my child?
    I generally do assessments and therapy in your own home. I can however see you in my house if more convenient or in your child's school or nursery. This can also be done flexibly, changing venue as needs change.
  • how often will my child be seen?
    This depends on your child's needs. I will always need to do an initial assessment which generally lasts an hour and then I may see a child for regular individual sessions either weekly, fortnightly or monthly; whatever frequency meets the needs. All input will be agreed jointly and discussed fully with you as parents.
  • what will I have to do as a parent?
    At the initial assessment a case history will be taken where I will need as much background information as possible to help the assessment.

    Parental involvement is important in the therapy process. I will give you ideas of activities and ways to back up therapy at home and it is important that these are followed through in order for your child to make the most progress. I ensure that any advice or activities are practical and easy to implement into your day as well as fun!
  • my child is seeing an NHS therapist, can you still see them too?
    Yes a child can have both an NHS therapist and an independent therapist at the same time. Liaison between the two is important and I ensure that I do this with any agencies involved with your child, in particular with any other speech therapist to ensure we are all working towards the same goal.
  • my child has verbal dyspraxia what can you do to help?
    I can see children with a range of difficulties; attention and listening, interaction and non verbal communication, late to talk, delayed/disordered comprehension (understanding of language), delayed or disordered expressive language, speech sounds, verbal dyspraxia and stammering.

    With each child I will do assessment to decide on the right input and will then tailor therapy to meet their individual needs. I can work with others involved with the child e,g extended family, carers, schools nurseries etc to ensure that everyone is working together to help the child.
  • what do terms "speech", "language" and "communication" mean?
    Many professional use these terms interchangeably, however speech and language therapist define them as Speech means the sounds we use (e.g. "p" "k" "s"), Language is about the words we use and how we make sentences with words where as Communication refers to the use of language and their interaction between people.
  • speech or language delay / disorder, what's the difference?

    A delay means that a child is learning to talk in the right order but at a slower rate then average whereas a disorder means that speech or language is developing in an abnormal or unusual way.

  • Got another question?
    Any other questions? Please feel free to contact me.
useful links

There are lots of sites out there providing help and information about speech and language problems. Here are a few which I think are particularly useful.

Royal College of Speech & Language Therapists
is the professional body for all speech and language therapists

Association of Speech and Language Therapists in Independent Practice
have information about independent therapy

Talking Point
have information on children's communication as well as developmental norms and information on how to help. They also has downloadable resources and tips for talking.

I Can
is a children's communication charity that has information and resources for parents and carers on communication and support.

Afasic England
has information about specific speech and langauge impairments as well as publications and resources. It has a parents forum so parents can talk to each other.

The Hanen Centre
provides parents and professionals with programs workshops and resources for early childhood language difficulties

British Stammering Association
has advice and support for parents and carers and young stammerers themselves.