What is the Difference Between Speech and Language?

Speech is the production of sounds that make up words and sentences. It involves the coordination of the jaw, lips, tongue, vocal cords, vocal tract, and respiration. There are three divisions to speech: articulation, voice, and fluency.

Articulation – This is one of the most common reasons parents contact Stephanie. Parents often report: “I am the only person who can understand my daughter” or “My son is having trouble pronouncing R.” Treating articulation disorders is one of Stephanie’s specialties.
Voice – A consistent raspy or hoarse vocal quality or history of vocal nodules is a reason to seek out a speech therapist. Here are therapists in New York City who specialize in voice.
Fluency – A disorder of fluency is stuttering. It is considered normal for young children to have some dysfluent speech. If the stuttering becomes more prevalent, it would be appropriate to consult a speech pathologist specializing in working with children who stutter. For helpful information on stuttering, check out The Stuttering Foundation.

Language refers to how we use words and sentences to communicate ideas. Speaking, gesture use, writing, understanding verbal conversation, and understanding written words are all language-related.

Parents of children with language delay often report to Stephanie, “My daughter is 18 months old, and she only babbles; she doesn’t have any words.” or “My son is 2, and he has trouble putting words together to make sentences.”

Stephanie is a pediatric speech and language pathologist (speech therapist) specializing in improving articulation (speech) and language skills.

Stephanie evaluates and treats children in their Manhattan homes. She encourages parents to learn how to ask stimulating questions, model language optimally, and follow their child’s lead to create an effective playtime.

How Can Stephanie Help My Preschooler Thrive at Kindergarten Admission Interviews?

Stephanie helps children develop confidence, build attention, and learn skills to succeed at NYC kindergarten admission interviews.

Through fun games and activities, your child will strengthen skills in various areas, including early reading and math, memory, and expressive and receptive language.

Addressing these skills in weekly sessions with Stephanie can help your child throughout the kindergarten admission interview process and beyond.

Stephanie is not directly involved in the New York City school admissions process (public or private), and preparation does not guarantee your child will perform well at interviews.

I’m Worried About My Child’s Language Development, but My Pediatrician Says Not to Be. What Should I Do?

Children develop language skills at their own pace, and there is a wide range of what is considered typical. For example, one 18-month-old may say nine words, and another may say fifty. This is similar to how children develop skills to crawl, walk, and read. Also, at 18 months, you should notice that your child is talking more than using gestures.

Two-word utterances should emerge just before age two and become consistent at age two. Children should have at least a 50-word vocabulary by this time and always be using new words.

Between 2 and 3 years old, sentence length should increase, and you should notice more of a variety of words (verbs, pronouns, adjectives, prepositions, etc.).

If you notice your child has difficulty answering questions, “finding” words, following directions, or your child repeats what others say, it is appropriate to meet with a speech therapist for a language evaluation.

How Do I Know If My Child Has an Articulation Delay?

Your child should use speech sounds accurately in conversation by the ages listed below. Prior to these age requirements, you should hear approximations of these sounds.

The ages below (years.months) have been averaged by Stephanie based on her own experiences, from articulation resources, and the Goldman-Fristoe Test of Articulation 2.

Overall, your child’s conversational speech should be understood by age 3.

M, H	2.7
N, W, -ING, P	2.9
B	3.0
F	3.2
K	3.3
Y (as in yellow), G	3.4
D	3.5
T	3.9
CH	4.2
L, S	4.5
R	4.6
V	4.8
SH	4.9
J	5
Z	5.2
TH (as in thumb)	5.4
TH (as in “this”)	5.5

If you feel your child’s articulation is delayed, an articulation and possibly an oral motor assessment should be conducted.

How Can Ear Infections Affect Language Development?

When a child consistently has ear infections or fluid in the ears, it isn’t easy to hear sounds and words accurately. If you plug your ears with your fingers, you can appreciate the muffled speech quality your child may be experiencing. Recurrent ear infections often occur before age 3, when children learn to speak. It is crucial to keep follow-up appointments with your pediatrician or pediatric ENT (Ear, Nose & Throat)/otolaryngologist to ensure the ears have been cleared of fluid after a course of antibiotics. In addition, periodically have your child’s hearing formally tested in a soundproof booth with an audiologist. More information and tips regarding communicating with your child with an ear infection can be found on Stephanie’s Ear Infections and Language Development blog.

How Can Sign Language/Gestures Help Improve Verbal Communication Skills?

Signs/gestures can facilitate language development and indicate a child understands and uses language. Gestures can also help develop listening and visual attention skills because children observe parents’ gestures while hearing corresponding words. Gestures may let you know what your child feels (e.g., hot, tired, hungry) and help avoid frustration when your child can not verbally communicate wanting a drink of water. Read more about how a child’s language may progress with gesture usage.

Are My Bilingual Child’s Language Skills Delayed Because it’s Difficult to Learn Both Languages Simultaneously?

Many NYC families are bilingual or even trilingual. Language milestones should still be met when a child is exposed to two or more languages. Sometimes children mix vocabulary and grammar from multiple languages. It is unusual for Stephanie to discourage a child’s exposure to multiple languages. However, based on the type and severity of the language delay, it may be best to focus on the primary language temporarily.

How Does Stephanie Improve Language Skills Through Reading Books?

Stephanie uses books in speech therapy and teaches parents how to choose appropriate, fun children’s books that may improve vocabulary, grammar, and cognitive skills (e.g., attention, thinking, memory). Stephanie educates parents on asking their children appropriate questions while reading together and encouraging verbal participation with familiar books.

Did you know that a great way to encourage speech and language skills while reading with your child is to do so face-to-face? When you face your child while holding the book next to your face (not in front of your mouth), your child can observe your facial expressions and watch how you move your mouth when you speak. Stephanie provides book recommendations on her blog.

What is Oral Motor Therapy? What is Oral Placement Therapy?

Oral motor therapy/oral placement therapy uses various child-friendly exercises to develop awareness, strength, coordination, and mobility of the jaw, lips, and tongue.

Stephanie uses oral motor therapy to address problems such as drooling and open-mouth posture and when traditional articulation activities are not enough to help a child learn how to say specific speech sounds. For example, if a child has difficulty saying the sounds /p/ and /t/ and can easily bring the lips together for /p/ but cannot elevate the tip of the tongue for /t/, we would work on the sound /p/ in words (articulation therapy) while we strengthened the tongue using oral motor therapy for /t/.

Oral motor therapy can also help resolve issues with thumbsucking and pacifier use.

How Can a Speech Therapist Help Resolve Drooling and Thumbsucking?

Drooling can often be eliminated through improving awareness and oral motor exercises.

Click to learn more:

What is PROMPT?

PROMPT = Prompts for Restructuring Oral Muscular Phonetic Targets.

PROMPT therapy uses tactile, verbal, and visual cues to stimulate articulation skills. When therapists are “PROMPT trained,” they have taken beginner PROMPT courses.

A “PROMPT certified” therapist has taken the introductory and bridging course, a technique practicum, and has completed a self-study project. PROMPT-certified therapists are most qualified to help children diagnosed with motor-speech disorders such as developmental/Childhood Apraxia of Speech.

When Stephanie begins working with a toddler who is not speaking or has few words, she often incorporates PROMPT techniques, traditional language development play therapy, and oral motor therapy. It can be difficult to rule out Childhood Apraxia of Speech. Combining PROMPT, oral motor therapy, and a strong language program can facilitate development.

What is Developmental/Childhood Apraxia of Speech?

In Childhood Apraxia of Speech (CAS), the brain has difficulty communicating with the mouth and effectively moving the jaw, lips, and tongue to say speech sounds. Apraxia is a movement disorder. PROMPT therapy is one effective way to address apraxia, but with a toddler, the key is to target communication development.

Common characteristics of Childhood Apraxia of Speech or Suspected Motor Speech (SMS) difficulties may include:

Use of only a few sounds
Unintelligible and/or inconsistent speech (e.g., difficulty placing sounds in the correct order, deleting sounds)
Difficulty with imitation of sounds and words
Family history
Difficulty planning movement sequences/limited variety of speech motor movements
Limited vocabulary (mostly nouns)
Slow rate of progress
Use of non-speech sounds to communicate
Drooling

Childhood Apraxia of Speech can be difficult to diagnose in toddlers because children who are late talkers may exhibit the same symptoms. Also, a severe articulation delay can be confused with apraxia. An experienced speech therapist will use a comprehensive treatment approach.

What Are Typical Feeding Concerns and How Are They Addressed?

Feeding issues may include “picky” eating, refusing to eat, choking, gagging, food pocketing, drooling, difficulty transitioning to different textures, and difficulty with cup drinking. Feeding issues often require oral motor therapy. A feeding technique often used with babies is a spoon-feeding method that helps achieve lip closure, which diminishes tongue thrusting. Later, when a child is ready to talk and can now close the lips, it should be easier to articulate sounds such as m, b, and p.

What is a Tongue Thrust?

A tongue thrust occurs when the tongue moves horizontally (instead of vertically) and pushes against the teeth during a swallow.

A tongue thrust may cause dental issues such as an overbite or an open bite and may be associated with thumbsucking, mouth breathing, and ear infections. Children with upper respiratory problems and chronic ear infections may exhibit an open-mouth posture. An open-mouth posture may lead to a forward tongue position.

Tongue thrust may affect the production of sounds such as /s/ and /z/. A speech therapist may combine traditional articulation therapy with oral motor therapy to improve the production of these sounds and eliminate tongue thrust.

What is Floortime/D.I.R. Approach for Language?

Floortime or the D.I.R. (Developmental, Individual, Relationship-Based) Model is a technique that helps children learn language and social skills in a more related and logical way than traditional language therapy. Traditional language therapy typically promotes specific skills (vocabulary, grammar, etc.) that may leave a child with rote responses.

For more information or to find a Floortime therapist, please visit The Interdisciplinary Council on Developmental and Learning Disorders.

How Do I Make an Appointment With Stephanie?

Stephanie Sigal, M.A. CCC-SLP, provides speech and language evaluations, treatment, and consultations in the comfort of your Upper East Side Manhattan home or via Zoom. Stephanie does not have an office or accept insurance. She provides services between 60th and 95th Street on Manhattan’s Upper East Side.

The best way to schedule an appointment with Stephanie is via email. Please email your name, your child’s name and age, your cross streets, and phone number. A brief description of your concerns for your child would be most appreciated.

All communication is kept confidential. Stephanie looks forward to hearing from you!

phone: 646-295-4473
email: sayandplay@yahoo.com