Services and Solutions

Speech-Language Pathologists provide the following services: education, diagnostics and treatment for infants, preschoolers, school aged children, adolescents, adults and seniors, collaboration with other professionals and research. Our clients may present with hearing, speech, voice, resonance, language, communication, feeding, and swallowing challenges.

We possess a unique skills set. Speech-Language Pathologists hold graduate level Master’s, Master’s equivalent or Doctorate degree designations, and are regulated by colleges, such as the College of Audiologists and Speech-Language Pathologists (SLPs) of Ontario (CASLPO). We are further governed by the Regulated Health Professions Act/RHPA, and the Audiology and Speech-Language Pathology Act (1991). 

Our diverse work settings include child development centres, preschools, school boards, rehabilitation centres, government agencies, health units, industry, hospitals, community settings, preschool programs, community care access centres, colleges, universities and research centres, complex care or long term care centres, and private practice. We may see our clients directly on an individual basis, in groups or as consultants in school boards.

Our broad scope of practice includes intervention in the following domains:

Language: This may be delayed or disordered. There may be a learning disability. Any modality or aspect of language may be involved (grammar, vocabulary, social use of language, speaking, listening, reading writing), as well as underlying behaviours including short term, long term, working memory or phonological awareness skills (precursors to spelling and reading). Therapists guide clients towards self-advocacy, targeting explicit skills for weaknesses by using their strengths. Accommodations are suggested for our sessions together, school and home.

Cognitive communication disorders are acquired and may be traumatic (i.e. head injury) or non-traumatic (i.e. stroke). Aphasia or language loss may occur as a result of a stroke.

Articulation disorders include challenges to pronounce one or more sounds.

Phonological disorders refer to ruleful error patterns such as final consonant deletion.

Motor speech disorders are challenges to organize sounds or their sequences, as a result of oral muscular differences and/or motor planning impairment (dysarthria, apraxia).

Fluency disorders (i.e., stuttering) involve disruptions in the smooth forward flow of speech.

Voice disorders are characterized by changes in quality, loudness and/or pitch, such as vocal nodules in children as a result of vocal abuse.

Resonance disorders may reflect too much airflow through the nose (i.e. in those with cleft palate) or too little airflow in the case of obstructions (enlarged tonsils), sounding nasal, as though they have a cold.

Feeding challenges reflect difficulties with chewing, sensory challenges, swallowing (dysphagia), or using inappropriate lip-face-tongue-jaw movements, for eating and drinking.

Drooling: There are numerous causes affecting this and treatment options.

Oral resting mouth posture: There are factors affecting an abnormal mouth posture when at rest. Normally the jaw is up, lips are closed and the tongue lies in the upper quadrant of the mouth, ready for speech production.

Augmentative communication systems-visual strategies: Sometimes our clients require other forms of communication as an adjunct to support speaking or to replace it.

My services include assessment, therapy, consultation, education, prevention, collaboration and assistance with resources for the following:

Speech Challenges

• mispronouncing sounds, i.e. lisp (forward tongue carriage between teeth)
• phonological disorder/ruleful error patterns, i.e. final consonant omissions(ca/cat)
• motor speech disorder: challenges to organize movements for speech due to muscle imbalance and/or motor planning issues (dysarthria, apraxia of speech)
• stuttering: disruption of smooth, forward flow of speech characterized by some or all of the following: word repetitions (‘I I’), part-word repetitions (co co coming), sound repetitions (p p party), sound prolongations (sssssnake), vowel distortions (Pi Pi Peter) or silent/audible blocks (no talking, vocal tension, sounds stuck). Secondary behaviours or more advanced stuttering may include loss of eye contact, blinking, movements of body parts, avoidance of speaking situations, and negative thoughts or beliefs about talking and stuttering

Voice Challenges

• misuse or abuse of the voice resulting in pitch, loudness or quality (hoarse, raspy) changes, such as vocal nodules commonly noted in children or adults who misuse/abuse their voice

Resonance Differences

• challenges to direct air primarily through the mouth instead of the nose, i.e. commonly noted in children with cleft lip and palate. Some children with intact oral structures may also shunt too much air through the nose through habit. Others still may have obstructed airways sounding nasal.

Language Difficulties

• challenges with understanding and/expression: listening, speaking, reading, writing
• may present with difficulties in three components of language: content (vocabulary), form (grammar within and between words, i.e. plural forms ‘boys’ or asking versus telling) plus the appropriate use in social situations (communication intentions, sharing, giving, showing, joint attention between the object of interest and the communication partner, eye contact, listening, watching, focusing, talking about the appropriate topic at the appropriate time, topic initiation-maintenance-closing and turn taking)
• Underlying behaviours of language include short term memory, working memory, long term memory and phonological awareness skills. In order to retain something learned, one must be able to focus on auditory or visual stimuli, and hold in short term memory long enough to store in long term memory. Working memory refers to the concentrated effort required to hold onto information in short term memory while working something out, i.e. ‘7×7+4’. Phonological awareness refers to the ability to manipulate the sound system of language, skills that are importnt precursors for later reading and spelling, such as blending sounds together, segmenting them, rhyme and sound detection. Decoding of SOUND-SYMBOLS (phonemes-graphemes) accurately & quickly, and teaching ADVANCED PHONEMIC AWARENESS SKILLS through deletion and substitution, are the goals for word level reading. The pillars of reading include PHONICS & PHONOLOGICAL AWARENESS, FLUENCY, VOCABULARY, READING COMPREHENSION, and OTHER EXPERTS NOTE SPELLING as a vital literacy PILLAR as well.
• Written expression, involves the greatest multitasking requirements including: sustained attention, ideation, organization and sequencing of ideas, vocabulary selection, grammar, knowledge of letter-sounds, PHONICS, conventions/mechanics (spelling, punctuation, capitalization), phonological awareness skills, various memories, fine motor skills, writing for the reader, and the abilities to self-monitor and repair errors.

I am also trained in the highly regarded Orton-Gillingham approach, comprehensive as a language approach to teaching literacy. The Orton-Gillingham approach is rooted in essential language components, necessary for learning to read and spell. These components include: phonological awareness, sound-symbol associations, syllable instruction (6 syllable types which assist with vowel pronunciation for new words), syllable division, instant word recognition (recalling words as whole units), morphology (smallest units of meaning, i.e. prefixes, suffixes, roots), grammar (within and between words, word order, sentence variation), vocabulary building, reading fluency, literacy concepts(i.e. vowels, consonants, clusters), decoding and reading comprehension strategies and the history of the English language. 

Functional Magnetic Resonance Imaging/fMRI has revealed positive brain changes using this approach. Founded in the 1930s, it was created by Dr. Samuel Orton, Anna Gillingham and Bessie Stillman, with the purpose of remediating those with literacy (reading-spelling) challenges (Dyslexia). It has set the stage for sound literacy programs in use today. Tailored to the individual, it supports a variety of learners. 

Therapy sessions are built for client success. Students are taught the code explicitly, step by step, in a highly structured fashion, working in sequence from simple to more complex code, spiralling back to consolidate prior learning. It is highly repetitive. The structure of the English language is demystified, revealing a mostly predictable and highly orderly code (approximately 86% is predictable). Exceptions to rules are revealed. 

I am also trained in SWI, which I have integrated with Orton-Gillingham, my backbone

approach. Dr. Peter Bowers changed the trajectory of my Intervention, and my own knowledge of English. You can visit his website called WordWorks Literacy Centre

www.WordWorksKingston.com SWI stands for Structured Word Inquiry. The alphabetic

principle only goes so far. The alphabetic principle means that what we see in text translates to sounds in words, but this is not always the case. We need to go beyond this. There seems to be little scientific investigation of language in schools, only for science-based subjects. It is no wonder that Ontario received a failing grade on how to teach reading and writing. Refer to the more than 150 recommendations, which came out of the Ontario Right to Read, Human Rights Inquiry report over the pandemic. The Ontario Human Rights Commission sampled various schools, and asked tutors like myself to weigh in, as well as parents about the educational system. 

OGA & SWI: Research has shown that for decades, all the rules lie in written language, not our oral language. So, we cannot rely solely on oral language for our answers. When students read every letter as though its sole job is to make sound, they will be challenged, since it is untrue. What about our irregular words(spellings) like ‘two?’ Children can learn that the meaning of ‘tw’ is to represent the concept of 2(twin, between, twinkle, twilight, twelve, twenty). So, let’s call them words with explanations. English is only hard if you do not use teaching methods based on science, such as Orton-Gillingham, a structured literacy approach(SL), as recommended by the Ontario Right to Read report. If only taught spellings by sounding out, students will miss other important jobs of letters like the nine or so jobs of final single silent<-e>! English is about 86% predictable if it is taught only from an oral language perspective. However, if the code is taught by weaving in SWI/structured/scientific word investigation/inquiry, a student makes almost total sense of their written language, which is also evidence-based (see Peter Bowers, Ph.D.’ website WordWorks Literacy Centre). Students are finally able to learn the tools to investigate any word scientifically in English. Children learn that the purpose of spelling is to represent meaning, and the job of letters is not solely for sounding out. Written language or spelling also provides links to etymology, phonology and morphology. They also learn to investigate meaning of a whole

word plus its meaningful parts or morphemes (prefix, base, suffix). Meaning is the most

motivating way to learn, as shown by scientific research. First, investigate the word meaning. Then identify the etymology or history of a word, which is usually of Old English, Latin, or Greek origin. The story of a word can help with spelling too. They are often interesting tales. Students are taught common morphemes, the glue which holds language together, using SL & SWI. They can create word families or webs, make word sums, analyze from whole to parts, and synthesize from parts to whole, and build matrices of word families, made up of word relatives with the same base. Lastly, students are taught to identify how letters-phonemes-graphemes, fit within the morphemes. Coupled together, the reading-spelling code is unlocked and ceases to be a mystery. When SWI is integrated with the Orton-Gillingham approach, the reading code knowledge will far exceed 86% and may even be close to 100%. Dr. Marcia Henry, author of the book, Unlocking Literacy, 2010, was a well-respected, professor, teacher, researcher, and past president of the IDA, an expert in the field of reading and dyslexia. Though she is now retired, she declared in 2019, at the annual, virtual Dyslexia conference (DTI), that if she were to begin her work again, she would integrate the Orton-Gillingham approach with SWI, both based on scientific research. Both these approaches will improve reading and spelling, along with vocabulary growth, reading comprehension, and critical thinking. They can live together. It is our

responsibility as clinicians to follow the research. Once you make sense of written language, you must do better. Though writing is the hardest, most complex, and last frontier of language, it is critically important. If you can read but not spell, you are half literate. However, if you can spell, you can usually read the code. Spelling is the more important skill, since it is part of written language. Those who are challenged to spell, will usually resort to substituting words while writing, rather than using their million dollar words during speech. Pete Bowers has used SWI in kindergarten classes with success, while the O-G approach has been used in children as young as 4-5. His research revealed that SWI aided all students, but in particular the youngest and most severe. Thanks to both the OGA, and SWI, I am more curious about language today myself, and have improved my own vocabulary, reading of complex words, spelling, reading comprehension, and critical thinking. Most importantly, it has fostered my own word curiosity. I am proud to call my self a word wizard or Geek. Wouldn’t it be wonderful if more students were curious about their language? Teachers could lift up more students, expanding their language skills to include richer vocabulary, critical thinking, reading comprehension, reading, and spelling.

SWI & High Frequency Words: I trained in administering The hfw Project-created by Rebecca Loveless and Fiona Hamilton in May of 2022, which provided me with a license for teaching the 100 most common, high frequency, oldest words of our language, mostly Old English. www.THEHFWPROJECT.COM This project teaches using the tools of Peter Bowers’ SWI, as well as structured literacy (SL) or the Orton-Gillingham Approach. Rather than teaching students all the Dolch & Fry words, they chose something more practical, the 100 most common words in English, some of which are regular for sound-symbol, while others have explanations, such as ‘two’. Students encounter these words in text, once for every two words read or written! Just think about that. In other words, they are 50% of all written words, so highly frequent. It is also SWI based. We don’t teach every Old English word, but imagine if we taught the 100 most common ones, deeply and explicitly using all the language layers, a student could devote more resources in their brain to learning more complex words, such as Latin and Greek, as well as those with more than one base. Latin begins to be embedded at about grade four, while Greek comes later. Old English, Latin and Greek word study, is normally complete by entry into high school for neurotypical learners. However, for those who are struggling with language, it will vary with each individual student, and will include: their motivation, age of onset of treatment, their severity, their brain wiring(strengths & challenges), diagnoses, home practice, and frequency of service. The earlier you start, the better it is for the student, but the good news is, that it is never too late!

Since about 60% of English originated from Latin, 1 of the 5 Romance languages, after my studies in the Orton-Gillingham certified level course, at the recommendation of my Fellow, I took ten Latin courses from Cambridge Senior Scholar, King’s College, Cambridge University Michel Mira-Rameau, associated with Real Spelling on the workings of written language in Latin. This a scholarly course which continues virtually today. This deepened my understanding of Latin’s orthography, and consequently English. My teacher, Michel, sadly passed away, but left a wonderful legacy. He deepened my understanding of the English language, as did my Fellows, Evelyn Reiss, Dr. Dee LaFrance, Liisa Freure, and many others such as Peter Bowers, David Kilpatrick Ph.D., Rebecca Loveless and Fiona Hamilton (The hfw Project), just to name a few. I studied Latin, French, German and of course English, in high school. Yet, little did I know that all these roads would lead me to the path I continue to walk on today.

Multisensory teaching is used involving the senses of sight, hearing, movement and touch, with the purpose of enhancing all brain pathways for recall. The code is strictly controlled, and remediated through careful diagnostic teaching, guiding students towards self-discovery, through thinking, making logical choices, and self-monitoring. Nothing is assumed and teaching is flexible. For further information about the Academy of Orton-Gillingham Practitioners and Educators visit www.ortonacademy.org.

As an experienced practitioner, I can provide continuity of service, as a child’s needs change with age, from oral to written language. My academic background as a Speech-Language Pathologist has afforded me an advantage in teaching literacy.

Stuttering – Preschool to school age with a whole child-centered slant (both the fluency and the emotional aspects of stuttering): Lidcombe Program, Michael Palin, Kristen Chmela, Scott Yarruss, Nina Reardon as well as the young school-aged child (ages 5-9) and older students (Fluency Plus), both through the Speech and Stuttering Institute.

Preschool Language – basic and advanced Hanen programs (‘Involving Parents as Language Facilitators’ & ‘Target Word for Parents of Children with Late Talkers’).

Articulation, Phonological, & Motor Speech Disorders – training in P.R.O.M.PT. technique (prompts for restructuring oral muscular phonetic targets). The therapist guides, inhibits or stabilizes speech movements, through various touch cues for each English sound. Auditory-visual support is also provided.

Literacy – I have my Associate level in the highly regarded Orton-Gillingham approach. Additionally, I have completed the Certified level coursework, and worked with three Fellows of the Academy. I have also completed the Fundations program based on Wilson Reading System principles, add ‘another structured literacy approach.’ Additionally, I consult with other practitioners in this field.

I am trained to administer The hfw Project, www.thehfwproject.com

Additionally, I have taken workshops with Peter Bowers, Ph.D., see WordWorks Literacy Centre, www.WordWorksKingston.com including a 20 hour course.

For my most recent training in PHONOLOGICAL AWARENESS, I took two workshops with David A Kilpatrick, Ph.D. and Psychologist. I have had opportunities to speak with him on-line and in-person. I have read his manual, Equipped for Reading Success, A Comprehensive, Step-by-Step Program for Developing Phonemic Awareness and Fluent Word Recognition, am able to administer the PAST (Phonological Awareness Screening

Test), administer his 1-minute activities, and train parents to do so at home with their child. 

I also have competencies in administering his screening test, the PAST, or Phonological Awareness Screening Test. Both have become part of my foundational testing and teaching. His area of interest and research is word level reading, and phoneme-grapheme knowledge (letter-sounds), not just with respect to accuracy, but also automaticity, at the basic syllable, onset-rime, and phonemes, both basic and advanced. We must go beyond just segmentation or separation of sounds. It is the advanced phoneme levels (deletion and substitution of phonemes), and focus on both speed and accuracy with phonemes and letter-sounds, that improve word level reading further, and moreover reading comprehension. It helps students remember words, also called ‘Orthographic Mapping’. His manual includes one-minute activities finely graded for success, which can be administered and taught to parents for home practice as well. His test measures accuracy and efficiency/speed/proficiency. Test levels on this screen inform the teacher as to starting levels for intervention in phonological awareness skill building, a necessary component for both reading and spelling. Additionally, phonemic awareness is built into the Orton Gillingham Approach.

I first learned about Dr. Carol Dweck’s book, Mindset, and the neuroscience that supported her research, back in 2017, when I took the Certified Level OGA Academy course with my present Fellow, Liisa Freure. Mental health professionals have often told me that the social-emotional aspect of our students with learning challenges or suspect challenges, and ADHD, are the most neglected part of the children we treat. I believe it. I read her small, user friendly paperback book years ago, and realized it is a useful book for everyone. Neuroscience has shown, that our smartness is not determined at birth, as once thought. We can become smarter by working our brain, like we do when we exercise. As long as we are embracing tasks which are hard, and not avoiding them, or always staying within our comfort zone with easy tasks(growth or fixed mindset), our brains can continue to grow. It has implications for checking our own mindset at the door, aside from our students, such as parents, teachers, and others within the circle of care of the child. It is a useful and interesting read for everyone. Apparently, when applying for jobs, many companies look for this type of mindset in prospective workers now, and I believe it has made its way into the school system. As the OGA states, treatment must also be emotionally sound. I introduce the mindset research into my classes, presented in a way, that children of different ages can process. Dr. Dweck ultimately proved that one can alter their mindset.

Additionally, I have read Tera Sumpter’s first book, SLP and author of Seeds of Learning, in which she presents the overriding importance of assessment and teaching to executive

functioning, which many call the CEO of the brain. It is needed for all tasks involving these skills: attention, engagement, initiating a task, executing it, self-monitoring and modifying, being efficient of time, pacing, sequencing, remembering (holding in memory, manipulating information, storing and retrieving/accessing), inquiring, prioritizing, organizing and more. This is particularly important for anyone diagnosed with ADHD, a dis-regulatory disorder, which impacts on all aspects of a person’s life. Both organizations in Canada for ADHD, CADDAC for parents & professionals, as well as CADDRA for professionals only, and my special go-to magazine, ADDitude Magazine are top on my list for ADHD resources, as well as books read for the OGA. Most of the students I treat also have ADHD. Speech-Language Pathologists have a unique role to play here, as they study the development, content(vocabulary), form(grammar) and use (appropriateness for the social context) during their postgraduate program. Speech-Language Pathology encompasses mostly science; we are taught about speech, language, voice, linguistics, statistics, testing, audiology, the physics of sound, word retrieval, phonetics, phonemes-graphemes, morphemes, anatomy, neurology, psychiatry, and much more in our schooling. Even with that, I continue to expand my  learning.

When to begin? As soon as a child experiences challenges in auditory-verbal language in the preschool years, this in itself is an inherent risk factor for written language, reading and writing, along with any family history, diagnosed or suspect. Preschoolers are developing pre-literacy skills based on listening and speaking. Language delay can impact on reading and writing at school age. Auditory-verbal language skills map onto reading and writing, which must be taught on school entry. It is no longer advisable to ‘wait and see,’ given what we now know about early intervention. We need to monitor and screen ‘at-risk’ children and do our best to help them early, but using sound teaching methods, based on evidence-based research. It is a known fact that the most important factor for teaching struggling readers and spellers, are the competencies of the teacher. ‘Reading is Rocket Science,’ and must be treated as such, according to the science of reading, SoR. I encourage those wishing to learn more about all of this to read the Ontario Human Right to Read report online. Over 150 recommendations were made, and sadly, the Ontario school system, received a failing grade. The language-literacy curriculum will need to be revised, however we are not alone here. This is a systemic, and global problem. It is through no fault of teachers who care for their students, but rather, a systemic issue. There is a gap between science-based professions, and the educational system, which must be closed to include SoR, and benefit all students. We all grew up being taught the same way. On a positive note, since the report was published, there is a positive change afoot.