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Care for children with communication differences and disorders

The Speech-Language Pathology Program at Boston Children’s Hospital provides diagnostic evaluation services for children with communication differences. As part of the Department of Otolaryngology and Communication Enhancement, we help parents find answers if their children have difficulties with language, fluency, resonance (nasality), voice quality, speech sound production, or social communication.

Language development is critical for success in school and social situations. A variety of factors, such as developmental delays, cognitive delays, and hearing loss, can interfere with a child’s ability to communicate. Differences in speech production, resonance (hypernasality), and voice can also lead to social and academic challenges.

To effectively help a child develop language skills, it’s essential to first understand the underlying issues involved.

One of our specialists will evaluate your child and help you better understand their communication strengths and needs. This includes how language and speech fit into the larger picture of your child’s development. Based on what we find, we’ll recommend treatments and let you know what the long-term outcomes may be.

We support children and families with a wide range of communication challenges, including:

  • Developmental language disorder
  • Language learning disability
  • Fluency disorders (stuttering/cluttering)
  • Articulation disorder
  • Phonological disorder
  • Childhood apraxia of speech
  • Childhood dysarthria
  • Social communication disorders

How we approach communication differences and disorders in children and adolescents

Some families seek our diagnostic services as a first stop in their journey. Others come to us for a second opinion when their child is not progressing despite therapy. In all cases, the in-depth evaluation services we offer, which include monitoring a child’s growth and needs over time, can lead to a more complete understanding of their communication issues and how to best address them.

The speech-language pathologists on our team have several areas of specialty, including: early language development, language disorders in school-age children, language and auditory processing, adolescent language, fluency, resonance, voice, speech sound disorders, and social communication.

We provide family-centered services that take into account every aspect of the children we see and their needs. To ensure the children and adolescents we evaluate receive optimal care, we work collaboratively with other professionals at Boston Children’s and in the community.

Innovative procedures

Our assessments go beyond traditional standardized test measures to include language sampling, input from parents and treating providers, and — in very young children — assessment of pretend-play development.

As part of a qualitative analysis, we will evaluate your child thoroughly and integrate our findings with other aspects of your child’s development to get a more comprehensive picture of their skills and needs.

Evaluation services

We provide in-depth evaluations of receptive and expressive language, speech production, fluency, resonance, voice, and social communication for children of all ages.

  • Language and auditory processing evaluations: A diagnostic evaluation conducted jointly by a speech-language pathologist and audiologist to assess a child’s peripheral hearing status as well as the integrity of their central auditory pathways. We compare each child’s performance to norms for children of the same age as their auditory system continues to mature through adolescence.
  • Social-pragmatic evaluations: For children who have already had an assessment of their foundational language and speech skills, we can provide an evaluation of social-communication skills, including their understanding and use of nonverbal communication, the perspectives of others, and conversation.
  • Voice and velopharyngeal dysfunction evaluations: Specialists in our Voice and Velopharyngeal Dysfunction Center evaluate children with issues related to voice quality, resonance, or upper-airway breathing disorders. These evaluations are available after or in conjunction with a medical evaluation. Depending on the patient’s age and presenting concerns, evaluations may include perceptual ratings of voice and resonance, acoustic measurements, evaluation of breathing patterns, and assessment of speech production.

Therapy services

While we are primarily a diagnostic center, we offer limited and short-term therapy services for some children.

  • Speech and language therapy: Short-term intervention and resources to support children’s communication development and help families understand their child’s needs. 
  • Parent-mediated language intervention: For some young children, we provide parent-mediated language intervention (PMLI), which consists of eight to 12 total weekly sessions conducted via telehealth.
  • Voice therapy: We offer voice therapy for patients who have had a medical examination and completed a voice evaluation. Children enrolled in voice therapy are generally seen on a weekly basis for six to eight weeks. We also recommend patient-specific activities families can do at home to support improved voice use.