Before Andrew Clarke turned 3, his mother knew he needed speech therapy.
“I was the only one who could understand him,” said Glenna Griffiths of Tinley Park. “He would try to say a word like `pig’ and it would come out `g’–just the last sound. Andrew has a grandmother in Ireland and he couldn’t talk on the phone to her because she couldn’t understand anything he said.”
Today 6-year-old Andrew races Griffiths to answer the phone. His Irish grandmother and he carry on conversations regularly.
“Anyone can understand him now,” his mother said. “If he’s tired or excited about something, the words don’t always come out right. But he’s come a long, long way.”
What has made the difference, Griffiths said, is the speech therapy Andrew has received through Kirby School District 140 in Tinley Park in the last three years.
Speech therapy is considered a special education service and is provided in Illinois public schools primarily by a speech pathologist, a professional who has earned a master’s degree in speech and language pathology and holds at least a Type 10 special education certificate issued by the Illinois State Board of Education. In addition, the speech therapist must hold a current state license. In some large school districts, such as Chicago, speech assistants may provide therapy services. However, these assistants–who must have bachelor’s degrees in speech pathology–cannot assess or diagnose speech disabilities.
For Andrew Clarke, the road to speech therapy began with a preschool screening offered by his public school district.
These screenings, which test children beginning at age 3, are mandated in Illinois to identify problems in such areas as motor development, learning concepts and speech and language development. Revisions of the federal Individuals with Disabilities Education Act of 1974 in the last decade require schools throughout the U.S. to offer screenings for preschoolers and provide early interventions in the form of therapy and/or specialized classroom settings.
The services must also be provided by public schools for children enrolled in private or parochial schools, said Elizabeth Dailey, administrator for the Chicago Public Schools’ services for children with communications disorders. These children must be brought to the public schools for the therapy.
(In addition, under federal rules, public school districts must provide specialized services for any child with a diagnosed disability from birth through age 21. Children with cerebral palsy and Down syndrome, for example, usually participate in these early intervention programs soon after birth. In the Chicago Public Schools, the early intervention program for those birth to age 3 is located at Skinner Elementary School, 111 S. Throop St. Other school districts are part of special education cooperatives, pooling their resources with other districts to provide these services.)
For many children, problems are first discovered during the preschool screenings. In the speech and language portion of those evaluations, “the children are screened for articulation, how they say words, if they can answer questions, their memory, the sentences they produce–a myriad of things,” said Beth Pfrommer, a licensed speech pathologist at Keller School, 7846 W. 163rd St., Tinley Park.
Pfrommer tested Andrew when he was 3 and discovered he has apraxia, a motor difficulty that prevents him from automatically knowing where to place his tongue and lips to form sounds. Griffiths began bringing Andrew to Keller School for half-hour speech therapy sessions three times a week. This year that therapy has been reduced to two half-hour sessions weekly, which Pfrommer provides near the end of Andrew’s half-day in kindergarten. In the next school year, Griffiths said, her son will be part of the pull-out program for speech therapy when he goes all day to 1st grade.
Apraxia is just one of the many speech and language disabilities that speech pathologists work with in Illinois public schools.
Human speech includes “receptive” and “expressive” language, said Keri Gold, a licensed speech pathologist at Adams Elementary School, 555 Old Mill Grove Rd. in Lake Zurich.
“Receptive means how we understand, and expressive is how we use language,” Gold said.
Children who need speech therapy may have fluency disorders, also known as stuttering, she said. Others are hearing impaired or have congenital anomalies such as a cleft palate.
Some children are aphasic, which means either a partial or total inability to articulate sounds, usually the result of neurological disabilities. Others, including those children with Down syndrome or cerebral palsy, have difficulty producing speech sounds because of structural problems in the mouth or because of spastic motor difficulties.
Children with pervasive developmental disorder, of which autism is one category, have trouble processing language and producing useful speech. Some children have auditory processing problems that hamper their ability to understand and decode the language they hear around them.
“They’re all so different. They’re unique,” Pfrommer said of the 43 pupils, from age 4 through 5th grade, for whom she provides speech and language therapy at Keller School.
In addition to the preschool screenings, children may be referred for speech therapy by a parent or by a classroom teacher, Dailey said. The Chicago Public Schools provide some form of speech therapy for 19,000 students.
“We rely on parents or guardians to pick up any delays in development,” Dailey said.
Speech pathologists in the Chicago Public Schools also provide in-service training for classroom teachers so they can spot children who have speech or language difficulties, Dailey said.
Whether the children are preschoolers or pupils in a regular or special education classroom, all children receiving speech therapy have a written set of goals called an Individual Education Plan, or IEP. This document, written with input from teachers, therapists and parents, outlines what the child should accomplish in speech therapy that school year.
“What we’re working for is to help the child be as successful academically as possible,” Pfrommer said. To that end, the speech therapists often work with classroom teachers, using class lessons in therapy sessions.
“We do lessons and therapy keyed into those IEP goals,” said Gold, who works with 65 students from age 3 through 12th grade in School District 95.
Most children receive half-hour speech therapy sessions one to three times a week. If their goals are reached during a school year, the child may be dismissed from speech therapy. Evaluations are performed regularly to determine if children currently in speech programs should continue the following school year. School districts offer speech therapy throughout high school and can provide this therapy to children up to age 21.
“Some children with severe and profound problems may need speech therapy almost every day,” Dailey said.
The speech therapy provided by public schools is as varied as the children who receive it, the speech pathologists said.
For those pupils with fluency disorders, Gold said, she works first to get the child to identify his disfluencies–those sounds on which he stutters–then helps the child modify those sounds.
“We talk about feelings, about how he feels when he stutters. We go over his rate of speech. He’ll need to slow down,” Gold said.
Another child who has a medical problem that affects the voice, such as vocal abuse or prolonged screaming, may require lessons on how to use his or her voice, how to keep the throat moist and what foods to eat and which ones to avoid.
A child with learning disabilities who has problems decoding words may first be taught to “tap” out the sounds using a stick, Pfrommer said. For those with very severe language problems, she added, “the goal is to give them functional language like `My name is . . . I need help. I need to go to the bathroom.’ “
Apraxic children, such as Andrew Clarke, begin learning one sound at a time using pictures of a pig or pie for the “p” sound. Later, tongue strengthening exercises help a child with apraxia learn where the tongue needs to be placed.
“Beth (Pfrommer) gave us sticks with a sponge on them. I place the sticks on Andrew’s tongue and he has to tell me where it’s at,” Griffiths said. “I rub the inside of his checks with a dry wash cloth to stimulate his mouth. We also do tongue exercises such as having him scrape icing off the roof of his mouth with his whole tongue, not just the tip.”
The kind of “homework” that Griffiths does with Andrew is vital to successful speech therapy provided by schools, Pfrommer and Gold said.
“Parents are an important part of the team,” Pfrommer said. “What parents can do is be interested in speech work, reinforce what we do in therapy sessions. That could be working for five to 10 minutes nightly to promote a new sound.”
Gold said District 95 in Lake Zurich has “high parent involvement. They do homework and get the kids motivated to do speech.
“The ultimate goal for all of us is to carry speech goals into conversation in various settings, in home and classroom and the community.”
