Speech & Language Therapy

Speech-language pathologists at the KCC assess, diagnose, treat, and help to prevent disorders related to speech, language, cognitive communications, voice, swallowing, and fluency. Speech and language therapy builds a child’s ability to communicate by improving and strengthening receptive and expressive language and social pragmatic skills along developmental lines.

Signs & Symptoms

Signs that could indicate the need for an evaluation

Get Started

How to begin speech and language therapy

Services

Explore treatment options available at the KCC

K-SLP Method

The heart of our speech services at the KCC

Speech Staff

Meet the staff who will be working with your child

Therapist Tips

Ideas to help your child outside the therapy room

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Signs & Symptoms

When it comes to communication issues, the sooner children receive intervention the better. For over 20 years the KCC has been a leader in early detection and treatment of speech and language disorders. If you feel that any of these signs and symptoms apply to your child and you would like to speak to one of our staff members, please feel free to contact us at (248)737-3430. We look forward to helping in any way that we can!

  • Doesn’t smile or interact with others (birth-3 months)
  • Doesn’t babble (4-7 months)
  • Makes few sounds (7-12 months)
  • Does not use gestures such as waving and pointing (7-12 months)
  • Doesn’t understand what others say (7 months-2 years)
  • Says only a few words (12-18 months)
  • Doesn’t put words together to make sentences (1 ½-3 years)
  • Has trouble playing and talking with other children (2-3 years)
  • Has problems with early reading and writing skills – for example, may not show an interest in books or drawing (2 ½-3 years)

Dysarthria (flaccid) is a speech disorder caused by dysfunctional or damaged innervation to the speech musculature (tongue, lips, soft palate, facial muscles, larynx).  Generally, oral musculature is weak.  Some children may have a functional dysarthria, due to inappropriate carriage of the tongue at rest.

 

The following are signs of dysarthria:

  • Marked difficulties with strength, speech and accuracy of articulatory movement.
  • Imprecise or weakly targeted consonants.
  • Imprecise or weakly targeted vowels, especially those which involve spreading intrinsic tongue muscles, such as /i/, /ai/, /ei/, oi/.
  • Weak vocal quality (lack of respiratory support).
  • Hypo or hypernasality.
  • Weak articulatory contacts.
  • Rapid or slow speaking rate.
  • Speech clarity disintegrates with lengthy utterances (this may be due to lack of breath support or muscle fatigue and may resemble apraxia of speech).
  • Weak targets, especially for / r, s, l / and vowels.
  • Generally weak, mushy, garbled, imprecise speech.

Many children with apraxia of speech have an accompanying oral-motor weakness. Usually, working on the apraxia inadvertently helps to strengthen weak articulatory contacts.

 

Severe dysarthria can be such a significant obstacle to motor-speech skill development in that the average listener may not be able to decode their speech. Children with severe dysarthria will require an augmentative communication system.

Social pragmatic language disorder may also be known as semantic/pragmatic language disorder, non-verbal learning disability (NLD), or even Asperger syndrome.

 

The following are symptoms of social pragmatic language disorder:

  • Excessive questioning.
  • Lack of eye contact.
  • Aggressive language.
  • Excessive talk about specific subjects in too much detail
  • Only talking about him/herself.
  • Disinterested in other children.
  • Unable to engage in conversational exchange.
  • Literal/concrete understanding of language.
  • Unable to answer open-ended questions such as “what happened?”
  • Difficulty with abstract language such as verbal problem solving (why, when, how do you know?), double meanings, innuendos, and jokes.
  • Difficulty taking the listener’s perspective.
  • Difficulty reading or interpreting body language, facial expressions.
  • Unable to express feelings.

Childhood apraxia of speech (CAS) is a neurological childhood (pediatric) speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits (abnormal reflexes, abnormal tone). CAS may occur as a result of known neurological impairment, in association with complex neurobehavioral disorders of known or unknown origin, or as an idiopathic neurogenic speech sound disorder. The core impairment in planning and/or programming spatiotemporal parameters of movement sequences results in errors in speech sound production and prosody.

 

The following are symptoms of CAS:

  • Limited or little babbling as an infant (void of many consonants). First words may not appear at all, pointing and “grunting” may be all that is heard.
  • The child is able to open and close mouth, lick lips, protrude, retract and lateralize tongue while eating, but may not be able to when directed to do so.
  • First word approximations occuring beyond the age of 18 months, without developing into understandable simple vocabulary words by age two.
  • Continuous grunting and pointing beyond age two.
  • Lack of a significant consonant repertoire: child may only use /b, m, p, t, d, h/
  • All phonemes (consonants and vowels) may be imitated well in isolation, but any attempts to combine phonemes are unsuccessful.
  • Prosody is unusual, there is equal stress or lengthy pauses between or within syllables or words, and sometimes a monotone quality.
  • Speech may change or disintegrate with many repetitions.
  • Words may be simplified by deleting consonants or vowels, and/or replacing difficult phonemes (consonants and vowels) with easier ones.
  • Single words may be articulated well, but attempts at further sentence length become unintelligible.
  • Receptive language (comprehension) appears to be better than attempts at expressive language (verbal output).
  • One syllable or word is favored and used to convey all or many words beyond age two.
  • The child speaks mostly in vowels.
  • Verbal perseveration: getting “stuck” on a previously uttered word, or bringing oral motor elements from a previous word into the next word uttered.
  • Oral groping may occur when attempting oral motor movements or consonant/vowel production.
  • Struggle behavior may occur when attempting to imitate or to speak (without dysfluency or stuttering).
  • Deletions or replacements of consonants, vowels or syllables may occur at the end of a word, phrase or connected word levels.
  • Vowel distortions or replacements occur which are not due to oral motor weakness.
  • The ability to blurt out clear whole words, phrases or sentences may occur though there is difficulty imitating these same words “on command” or upon imitation.
  • Difficulty with maintaining clarity with extended word length or complexity.
  • Many phonological processes are employed to simplify motor speech output.
  • Late talking with above characteristics or errors may be present.
  • Other fine motor challenges may be present.
  • Echolalic utterances (the automatic repetition of words, phrases or sentences often without comprehension) might be perfectly articulated but novel attempts at words or combinations might be more effortful.

Children with expressive language disorder have difficulty with verbal expression (putting words together to formulate thoughts).

 

The following are symptoms of expressive language disorder:

  • Word retrieval difficulties.
  • Difficulty naming objects or “talking in circles” around subjects with lack of the appropriate vocabulary.
  • Dysnomia (misnaming items).
  • Difficulty acquiring syntax (the rules of grammar).
  • Difficulties with morphology (changes in verb tense).
  • Difficulty with semantics (word meaning).

Unintelligible speech is a descriptive term used subjectively by the listener.  It can be due to a few minor consonant or vowel errors, oral-structural differences, oral-motor weakness, dysarthria or apraxia of speech.

 

However, another casual factor to unintelligible speech, which even many professionals miss, is that of the faulty perception of language.  Children who have difficulty processing and comprehending spoken language, particularly children who exhibit autism spectrum disorders, may exhibit jargon (sometime called “gibberish,” or unintelligible speech).

 

It is important to uncover whether a child has an unusual capacity to memorize dialogue, which doesn’t necessarily hold any meaning for them and are reiterating it the way they perceive it, without attaching meaning.  In this case, the more emphasis there is upon improving processing and comprehension skills, the more improvement will be seen in increased intelligibility.  Whereas, unintelligible speech rooted in the fine-motor coordination aspect of talking would require motor-speech or verbal motor work.

 

Children may have both perceptual and motor-speech difficulties.  If there are any questions regarding whether the child comprehends spoken language, attention should be given to comprehension and not necessarily motor-speech output.

The following are a few examples of an articulatory disorder:

  • Frontal and lateral lisps
  • Weak articulation of /r/
  • Substituting /j/ (the “y” sound) for /l/
  • Difficulty with blends /r, l, s/ (brake, clown, slow)

These articulatory errors are typical of pre-schoolers and are usually not cause for concern. If they persist past age five, an evaluation is necessary.

Receptive language disorders include central auditory processing disorders (CAPD), aphasia, comprehension deficit, “delayed language,” and “delayed speech.” Receptive language disorders also refer to difficulties in the ability to attend to, process, comprehend, retain, or integrate spoken language.

 

The following are symptoms of a receptive language disorder:

  • Echolalia (repeating back words or phrases either immediately or at a later time).
  • Inability to follow directions (following of routine, repetitive directions may be OK).
  • Inappropriate, off-target responses to “wh” questions.
  • Re-auditorization (repeating back a question first and then responding to it).
  • Difficulty responding appropriately to yes/no questions, either/or questions, who/what/where questions, and when/why/how questions.
  • Not attending to spoken language
  • High activity level and not attending to spoken language
  • Jargon (sounds like unintelligible speech)
  • Using memorized phrases and sentences.

*Note: Children with autism spectrum disorders often have difficulty decoding spoken language and may tend to memorize rather than have a true understanding of novel language.

Stuttering affects the fluency of speech. It begins during childhood and, in some cases, lasts throughout life. The disorder is characterized by disruptions in the production of speech sounds, also called “disfluencies.” Most people produce brief disfluencies from time to time. For instance, some words are repeated and others are preceded by “um” or “uh.” Disfluencies are not necessarily a problem; however, they can impede communication when a person produces too many of them. (ASHA)

 

Speech-language pathologists at the KCC do not treat stuttering. Please contact us at (248) 737-3430 for a referral.

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Getting Started with Speech & Language Therapy

Our staff is excited to help you get started at the Kaufman Children’s Center! Here’s what to expect.

GIVE US SOME INFORMATION

If you have concerns about your child’s speech and language development, we ask that you provide some basic information by clicking HERE. We will follow up to let you know how we can help, answer any questions, and get your child scheduled for an evaluation.

COME IN FOR AN EVALUATION

Generally speaking, an evaluation by a KCC speech-language pathologist (SLP) is required before therapy can begin. This allows us to formulate goals based on first-hand knowledge of your child. The evaluating SLP will go over your child’s background with you, then the fun begins. Our therapists are entertaining and truly know how to engage children. The bulk of the evaluation will be spent one-on-one with your child, but you are welcome to watch from one of our observation rooms.

SCHEDULE THERAPY

At the end of the evaluation, the SLP will go over her findings with you. If therapy is recommended,  our front office staff will make every effort to provide a schedule that works for your family. The SLP will follow up with a formal, written report that will be mailed to your home within a few weeks.

BILLING & PAYMENT

The KCC bills directly to Blue Cross Blue Shield, Blue Care Network, and Health Alliance Plan. For all other insurance plans,  payment is the responsibility of the parent. Our front office staff is happy to provide you with the codes you will need to try to get reimbursement from your insurance company. The fee for evaluations is due the day you are here, and all other therapy is billed on a monthly basis. Payment is accepted in cash, check, Visa, or MasterCard.

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Speech & Language Services

Individual Speech & Language Therapy

One-on-one therapy with our speech-language pathologists, for local children.

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SPEAK Intensive Visits with Nancy Kaufman

Nancy Kaufman's intensive program for children visiting from long distances.

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Video Consultations with Nancy Kaufman

Send a video of your child for review. Required for families visiting from long distances.

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Social Language Skills Groups

Our groups enhance social communication, understanding, and confidence.

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The Kaufman Speech to Language Protocol (K-SLP)

The method at the heart of all of the KCC's speech and language programs

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The Kaufman Speech to Language Protocol

The heart of all we do at the KCC

The Kaufman Speech to Language Protocol (K-SLP) is the method at the heart of all of the KCC’s speech and language programs. It is a treatment approach for children with childhood apraxia of speech (CAS), other speech sound disorders, and expressive language challenges. The K-SLP focuses upon the child’s motor-speech skills, shaping the consonants, vowels and syllable shapes/gestures from what they are capable of producing toward higher levels of motor-speech coordination, giving them a functional avenue by which to become an effective vocal communicator.

Speech & Language Staff

All members of the KCC staff represent the highest standards of excellence in their field and have extensive experience in pediatric therapy. Continuing education is supported and encouraged to ensure our methods are as up-to-date as possible. Our staff members are part of the KCC team because of their expertise, outstanding clinical skills, and their warmth and insight into children.

NANCY R. KAUFMAN

KCC DIRECTOR
Speech-Language Pathologist
MA, CCC-SLP

Since 1979, Nancy R. Kaufman has dedicated herself to establishing the Kaufman Speech to Language Protocol (K-SLP), a treatment approach to help children become effective vocal communicators.

Nancy lectures nationally and internationally on the subject of childhood apraxia of speech (CAS) and other speech sound disorders. Families from around the world are able to experience video consultations with her and many travel to the KCC to participate in intensive, specialized therapy programs.

Since opening in 1993, the KCC has grown from a one-woman operation to a full-service, award-winning pediatric center for children with special needs. Nancy now leads a team of over 75 professionals known for their enthusiasm and clinical excellence. The center continues to grow and has earned a reputation for excellence, warmth, and successful outcomes.

Nancy was a member of the Apraxia Kids Professional Advisory Council for 10 years and currently serves on the board of visitors of the Merrill Palmer Skillman Institute for Child and Family Development at Wayne State University. She is also a speech-language consultant for the Parish School and Carruth Center in Houston, Texas, and Suburban Speech Center in Short Hills, New Jersey.

Nancy earned her undergraduate degree at Michigan State University and her master’s at Wayne State University. She has been honored by both alma maters, receiving the Outstanding Alumni Award from MSU in 2010 and the Distinguished Alumni Award from WSU in 2015.

Both Nancy and the clinic have been honored by the Michigan Speech-Language-Hearing Association (MSHA). She was named Community Excellence Business Person of the Year Award by the West Bloomfield Township Chamber of Commerce in 2015.

Nancy and her husband reside in West Bloomfield, Michigan. They have three grown children and one granddaughter.

ALBIONA RAKIPI

KCC ASST. DIRECTOR
Speech-Language Pathologist
MA, CCC-SLP

Albiona earned her bachelor’s degree in early childhood education from the University of Michigan and her master’s in speech and language pathology from Wayne State University.

Prior to coming to the KCC, she was a preschool teacher and director for 12 years.

Albiona and her husband have two children. She enjoys bike riding, traveling, and soccer.

JENNIFER HILL

CLINICAL DIRECTOR
Speech-Language Pathologist
MA, CCC-SLP

Jennifer earned a bachelor’s degree in communication arts and sciences from Michigan State University with high honors. She completed her master’s in speech-language pathology at Wayne State.

Jennifer’s experience includes evaluation and treatment in public schools, hospitals, rehabilitation centers, and skilled nursing facilities. She has worked exclusively at the KCC since 1999.

Jennifer lives in West Bloomfield with her husband and three children. She enjoys time with her family, yoga, and being outdoors.

ERIN BEEKER

Speech-Language Pathologist
MA, CCC-SLP

Erin earned her undergrad degree from Purdue University with a major in speech-language hearing sciences and minors in linguistics and psychology.

She went on to Eastern Kentucky University, graduating with a master’s in communicative disorders in May 2016.

Prior to joining the KCC, Erin was a speech-language pathologist in the pediatric outpatient unit at Indiana University Health. She and her husband Ryan moved to Michigan in the summer of 2018.

Erin enjoys reading, traveling, and spending time with her family.

AMANDA DUNN

Speech-Language Pathologist
MA, CCC-SLP

Amanda earned her bachelor’s degree in psychology and her master’s in communicative sciences and disorders at Michigan State University.

She has worked as an SLP in both pediatric inpatient and outpatient settings as well as acute care settings.

Amanda is a new mom to a baby girl. She also has a mini goldendoodle named Copper.

LARA ELMBLAD

Speech-Language Pathologist
MS, CCC-SLP

Lara earned her bachelor’s degree in communicative sciences and disorders from Eastern Michigan University and a master’s in the same subject from New York University.

Lara loves reading and kayaking in her free time. She has two dogs (Laney and Teddy) and they enjoy going for walks to the lake together.

KATIE FENSKE

Speech-Language Pathologist
MA, CCC-SLP

Katie graduated from Central Michigan with a BS in communication disorders, then earned a master’s in speech-language pathology from Eastern Michigan.

She has previous experience in public school districts and as an ABA behavior technician.

Katie and her husband, Jonny, have a dog named Louie, and love to be outdoors with him, hiking and boating in the summer.

SIMONE FRAME

Speech-Language Pathologist
MS, CCC-SLP

Simone earned her undergrad degree at Calvin College and her master’s in speech-language pathology from Saint Mary’s College.

In addition to speech, she is also certified in behavior management.

Simone loves to crochet and garden.

ELLE GALLAGHER

Speech-Language Pathologist
MS, CCC-SLP

Elle received her bachelor’s degree in speech and hearing sciences at Northern Michigan University. She went on to earn her master’s in speech-language pathologist at St. Ambrose University.

Elle worked as a clinical intern at University Center for Literacy and Language and was a lead speech therapy practice associate at Chicago Speech Therapy.

She enjoys playing pickleball, reading, being outside, traveling, and spending time with her family and friends.

BRIANNA MORALES

Speech-Language Pathologist (ABA)
MA, CCC-SLP

Brianna earned her bachelor’s degrees in Spanish and linguistics from the University of Michigan, where she was also a student athlete. She completed her master’s in speech-language pathology at Eastern Michigan.

Brianna did her student teaching at Skyline High School in Ann Arbor. She interned at two elementary schools and in the craniofacial anomalies program at CS Mott Children’s Hospital. She has prior experience as an ABA technician.

Brianna presented on interprofessional collaboration at the American Speech-Language-Hearing Association’s (ASHA) national convention in 2016.

Brianna enjoys sporting events, traveling, coaching track and field, and being a mom. She and her husband welcomed a baby girl in December 2021!

SHANNON NELSON

Speech-Language Pathologist
MA, CCC-SLP

Shannon did her undergraduate work at Eastern Michigan University and earned her master’s in speech-language pathology from the University of Toledo.

As a graduate student intern for Early On, she worked in an early childhood special education classroom and with those with traumatic brain injuries.

Shannon’s experience also includes work as a behavior technician in an applied behavior analysis program.

MELANIE PIERCE

Speech-Language Pathologist
MA, CCC-SLP

Melanie earned both her bachelor’s and master’s degrees in communicative sciences and disorders from Michigan State University.

She has worked as a pediatric SLP in school-based, outpatient hospital, and private practice settings.

CHRISTINA ROCHON

Speech-Language Pathologist
MA, CCC-SLP

Christina earned her bachelor’s degree in communication disorders at Northern Michigan University in 1999 and followed up with a master’s in speech pathology from NMU in 2001.

Before coming to the KCC, she worked for many years at a school for children with autism in Illinois.

Christina was named a “Mom-Approved Doc”  by the readers of Metro Parent magazine in 2014. She has two children.

KRISTI SHEARER

Speech-Language Pathologist
MS, CCC-SLP

Coming soon

ALANNA VOTRUBA

Speech-Language Pathologist
MS, CF-SLP

Alanna attended Michigan State for her undergrad degree, where she earned high honors. She earned her master’s in speech-language pathology at Grand Valley.

Alanna loves to travel and spends her summers at her family’s cottage in northern Michigan.

MARLA ZERBIB

Speech-Language Pathologist
MA, CCC-SLP

Marla earned her bachelor’s degree in psychology from the University of Windsor and her master’s in speech-language pathology from Wayne State.

In addition to her regular individual speech sessions at the KCC, Marla is our clinical director and evaluates children ages 6 and up.

She enjoys spending time with her family, being outdoors (especially in or on the water), and curling up with a good book.

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Therapist Tips for Speech & Language Development

Great information from our staff and other contributors on helping your child to better communicate at home, school, and in the community.

Best Practices for Your Child’s Speech & Language Therapy

Nancy Kaufman's top tips for helping children who struggle to speak

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Toss the Sippy Cup for Best Speech Development

The type of cup your young child drinks from can have a big impact on their development

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Helping Kids Share About Their School Day

How to get your questions answered with more than just, "I don't know"

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How to Improve Social Skills in Kids with Special Needs

Feeling accepted socially makes children feel happy and secure, and improves academic skills

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Parent Tips for Successful Speech Sessions

Seven ways parents can help get the best speech and language results for their kids

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When to Have Your Child’s Speech & Language Evaluated

Deciding to initiate an evaluation can be difficult, but it’s often the best decision

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The Importance of Receptive Language Skills

Language can be a big hurdle for young kids - and often lead to additional challenges

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Teach Real-World Skills with Board Games

Dust off those old games and remember the benefits of playing together as a family!

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How to Practice Speech & Language Skills at Home

Some fun and simple activities to try at home to keep your child’s skills in top form

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How to Help Motivate Kids in Therapy Sessions

Discovering what a child loves can be used to encourage them to give their all

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