Karin Sudlow is licensed by the state of Illinois, and is an accredited member of the American Speech-Language Hearing Association (ASHA). Karin is also an Early Intervention specialist.
Suburban Pediatric Speech and Feeding Consulting specializes in treating children with the following diagnoses:
Childhood Apraxia of Speech
Cognitive, Problem Solving and Reasoning Deficits
Neurological /Genetic Disorders and associated speech-language challenges
Traumatic Brain Injury and associated speech-language challenges
Children who are recommended for feeding therapy usually have difficulty consuming enough calories to adequately sustain nutrition. Some children, especially those with more complex feeding disorders, may choke, gag, cough, or vomit before, during or after eating. Food and liquid refusals are common. Children with feeding disorders are treated using various approaches.
How will a speech-language pathologist diagnose and help my child with a feeding difficulty?
A Feeding Evaluation is the first step for diagnosing/differentiating a feeding disorder (dysphagia) from a “picky eating” challenge. A feeding evaluation consists of a complete developmental, medical and behavioral history, a structural and functional assessment of face, jaw, lips, tongue, hard and soft palates, oral pharynx, and oral mucosa, observation of head-neck control, impression of airway adequacy and coordination of respiration and swallowing, assessment of secretion management, along with evaluating your child while he/she eats preferred and non-preferred foods.
As delineated by the American Speech-Language-Hearing Association (ASHA), the purpose of a pediatric swallowing/feeding assessment is to:
Diagnose a swallowing and/or feeding disorder,
Determine which phase (s) of swallowing may be involved in the disorder,
Provide a profile of contributing causes that will enable the clinician to
Determine if the infant or child should be referred to an interdisciplinary team for comprehensive clinical assessment of feeding skills,
Determine whether additional instrumental assessment is needed (for example: videofluoroscopic swallow study,
Determine if collaborative medical or allied health evaluations are needed,
Select and recommend appropriate, symptom-specific interventions and a program plan.
There are many causes of swallowing and feeding deficits. The therapy approach chosen by the SLP and/or team of professionals is determined by the nature of the disorder. Team members might include:
An SLP who specializes in swallowing and feeding,
o One or more physicians (e.g., a pediatrician, neonatologist, physiatrist, otolaryngologist, pulmonologist, endocrinologist, allergist, neurologist, neurosurgeon, cardiac surgeon, and gastroenterologist,
A registered dietitician,
A nurse or nurse practitioner,
An occupational therapist,
A social worker,
A board certified lactation consultant,
A physical therapist
One key therapy approach utilized by Suburban Pediatric Speech and Feeding Consulting for sensory-based feeding disorders is the Sequential Oral-Sensory (SOS) Approach, which was developed by Dr. Kay Toomey. Our goal is to address medical, behavioral, oral-motor and sensory aspects of feeding which may be disrupting your child’s ability to eat normally and to gain weight.
Visual supports and behavior management aids are often used in conjunction with the SOS approach for children with Autism and others who benefit from visual, positive reinforcement.
Articulation and Phonological Disorders
An articulation disorder means a child has trouble making particular speech sounds that should be correctly produced for the child’s age. Every sound has a different range of ages when the child should make the sound correctly. Sounds may be left off, substituted, added or changed. The term “articulation disorder” is intended to emphasize that speech is a motor activity.
A phonological disorder refers to patterns of sound errors. For example, leaving off the final consonants of words like “t” and “m” (e.g., saying “si” for sit or “ha” for ham), or reducing consonant clusters to one sound (e.g., “fog” for frog, “top” for stop and “gape” for grape). The term “phonological disorder” emphasizes that speech requires knowledge of language.
How will a speech-language pathologist diagnose and help my child with an articulation or phonological processing disorder?
A speech-language pathologist looks at four criteria when diagnosing a speech problem:
• The speech is not directly attributable to physical damage to the speech mechanism, sensory systems, peripheral nervous system, or central nervous system.
• The speech is similar to that of children without articulation and phonological disorders.
• The speech is not the result of a dialect.
• The speech is considered disordered either by the child and/or members of the child’s family and community.
For diagnosing a speech disorder, the SLP will obtain a case history, administer an established, norm-referenced diagnostic test and delineate whether your child’s challenges are motor- based, language based or the result of difficulties with speech motor planning (or a combination), perform an oral-motor exam, ask about your child’s hearing, and screen or administer a language test. Further evaluations may also be necessary. If your child cannot be formally tested, a play based evaluation can be conducted.
Articulation and Phonological Treatment
At Suburban Pediatric Speech and Feeding Consulting, a variety of articulation and phonological approaches are used. A sample of these are: The Van Riper approach (also called the Traditional Approach), Paired-Stimuli approach, Paired Stimuli (Key Word) Program, Sensory-motor Program, Distinctive Features, Cycles Program, Metaphon Therapy, and Easy Does It For Phonology. The approach chosen for your child is generally based on your child’s type of speech disorder, age, and ability to participate and sustain attention to a particular approach.
Childhood Apraxia of Speech (CAS) Disorder
CAS refers to a speech disorder that presents as disrupted speech motor control. There is no weakness, paralysis or paresis of the speech mechanism. A speech-language pathologist who is trained and experienced with CAS can diagnose and treat children with this speech motor programming/planning deficit. The Childhood Apraxia of Speech Association of North America (CASANA) lists these top 3 key characteristics of CAS, as reported by the American Speech-Language-Hearing Association (ASHA) Technical Report on Childhood Apraxia of Speech:
• Inconsistent errors with consonants and vowels on repeated productions of syllables and words (your child says the same words in different ways when asked to repeat it several times).
• Difficulty moving from sound to sound or syllable to syllable, resulting in lengthened pauses between sounds and/or syllables.
• Inappropriate stress on syllables or words.