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Speech-Language Pathology

Speech-Language Pathology aims to help children with communication challenges, in both expressive and receptive aspects. 

Areas Of Communication

The following are nine areas of communication that a Speech-Language Pathologist might focus on:


Intelligibility refers to the quality of a person’s speech in reference to how it is understood by others. There are many reasons a person may have reduced intelligibility, including, but not limited to, articulation errors, phonological processes, structural differences of the speech mechanism, and motor speech disorders. Therapy may address learning the correct way to make sounds in a specific hierarchical method, or it may target substituting hard to produce sounds with others which increase intelligibility and reduce frustration.

Stuttering and other fluency disorders (cluttering, atypical disfluencies, etc.)

Disfluencies alter the smoothness of a person’s speech, usually in the form of stuttering or cluttering, which can impact a person socially and emotionally. Therapy addresses both the physical and social/emotional impacts of stuttering/cluttering by focusing on effective communication and reducing the impact that stuttering/cluttering have on the person’s life and self-image.


Pragmatics refers to the social language skills that we use to communicate in our daily lives, which includes what we say, how we say it, and our non-verbal communication. People with pragmatic disorders may have difficulty from greetings to continuing a conversation and misinterpreting nonverbal social interactions such as facial expression and body language. Therapy addresses difficulties related to social interactions by using scripts, role playing, social stories, and modeling to help teach and facilitate appropriate social interactions.


Literacy refers to the ability to read, spell, and write. It is one of the most important factors contributing to academic, economic, and social-emotional success.Spoken language is the foundation for the development of reading and writing. Spoken and written language have a reciprocal relationship, in which they build upon one another, resulting in overall language competence. This begins in early childhood and continues into adulthood. When children have difficulty acquiring language, they are at increased risk for differences in learning to read write, listen and speak.

Early signs that indicate later reading, writing, and learning differences include, difficulty learning or remembering letter names and sounds, the letters of their own name, understanding simple directions, and lack of interest in shared, preferred reading. Children who have difficulty telling stories may also find writing stories challenging. SLPs are trained to assess strengths and differences at the word, sentence, and discourse levels. Their knowledge of communication processes, systems, disorders, and language acquisition allow them to provide specialized and individualized literacy instruction.

Language Development

Expressive Language refers to the ability to transform thoughts into words, gestures, writing, and other communicative acts that convey the intended meaning to others in a grammatically appropriate way, while receptive language refers to the ability to understand what is communicated by others speech or writing. At Sandbox, your therapist will work with you and your family to identify not only areas of need in language development, but as importantly, those skills that are a strength, and can be used to ease frustrations in other areas.


Feeding is the process of eating and drinking a variety of foods and liquids for nourishment. While swallowing is the complex process during which food motility (movement of food from the mouth down the throat) and mastication (chewing) occur. Therapy addresses difficulties related to these processes such as avoidant/restrictive food behaviors, helping to achieve age-appropriate eating skills to maximize quality of life.


Voice and resonance refer to the quality of phonation, loudness, pitch, and nasality. People with voice and/or resonance disorders may have anatomical and/or behavioral difficulties that make any or all of these qualities impaired, often impacting communication and quality of life. Additionally, transgender folx may experiene may experience voice disorders due to the mismatch between their true gender identify and expression and the pitch associated with their sex assigned at birth. Therapy addresses behavioral aspects of these disorders, sometimes in conjunction with medical interventions (e.g. ENT collaborations to address anatomical aspects) so that a person’s voice is healthy, affirming and allows them to fully express themselves.

Alternative and Augmentative Communication (AAC)

AAC is a term that’s used to describe various methods of communication that can help people who are unable to use verbal speech to communicate. AAC methods vary and may be personalized to meet each individual’s needs. It encompasses a wide range of nonverbal communication methods, from sign language and picture boards to mobile device apps and sophisticated, dedicated speech-generating devices (SGDs). Therapy focuses on using AAC to improve functional communication, increase language and literacy skills, improve speech production and use of multiple modalities, decrease challenging behaviors, and improve social communication.

Services & Therapies Offered

Therapy for each individual is customized and may include the following:

Individual Therapy

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Clinic-based one-on-one therapy

Communication Dyads

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Therapy with a peer present, often a sibling or good friend

Social Groups

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Therapy with one or more professionals present and at least 2 peers

School/Home Visits

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Therapy done in one of the child’s natural environments

Alternative and Augmentative Communication (AAC) Programming

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Planning and programming of a device used to communicate instead of or in addition to speech


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Meeting with parents, caretakers, educators to help determine appropriate carryover of therapy goals


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Evaluation of all appropriate areas of communication to determine if intervention is warranted and determine appropriate goals and services