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Speech Language Pathology

At Chitter Chatter we provide comprehensive evaluations, assessments, diagnoses, and evidence based treatment services for speech and language, including targeting specific areas of need such as articulation/phonology, fluency/stuttering, voice, expressive language, receptive language, social communication, feeding, and other communication difficulties unique to a child's special needs. Our SLPs frequently reference the American Speech Language Hearing Association and the Michigan Speech Language Hearing Association to provide the best possible care for our clients. We also offer specialized services for children with Autism Spectrum Disorder, including early intervention to improve their verbal, nonverbal, and social communication skills.


Chitter Chatter PC offers translation services for individuals whose primary language is not English for caregiver engagement sessions as well as documentation. Please inform your supervising clinician if you would prefer an interpreter or would like documents translated into your preferred language. Chitter Chatter PC offers translation services through various placements including internal staff, translation services through the Detroit Wayne Mental Health Authority (DWMHA), or third party translation services as necessary. All requests for translation services for any language will be accommodated.


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Signs and symptoms

Some sounds (phonemes) are acquired at different age stages. Roughly, the phoneme acquisition are as follows per the development chart

Pragmatic Language

Pragmatic language is the social aspect of communication and non communication tasks. Difficulties within social language may include: inconsistent eye contact, not responding to his/her name, not using gestures (hello/goodbye), interacting alone rather than with peers, making automatic comments, making jokes/idioms/abstract concepts that are more literal

Receptive and Expressive Language

Expressive and receptive language includes words that are expressed and understood. Difficulties with understanding and expressing language may be the first sign to talk to your child’s pediatrician for a request to see a speech language pathologist. Difficulties within language may include: delayed play skills, decreased use of facial expressions, word retrieval difficulties, decreased production of sounds, decreased babbling, not understanding simple directions/commands, saying only a few words, misnaming items, difficulties answering “wh” questions (who, what, where, why) or yes/no questions, or repeating words/phrases immediately or later in the day.


Voice includes how our voice sounds or is perceived. Difficulties in this area may include a hoarse, breathy, or scratchy voice. The voice may also sound nasally as the sound is coming from the individual’s nose. The sounds /m/, /n/, and /ing/ are the only speech sounds that should come from the nose


Fluency is also known as “stuttering”. It is how well the speech process flows. Some disfluencies are typical, however disruption in the flow of speech can impact communication. If you feel like your child’s fluency is impacting their communication or if your child has negative feelings towards speaking/communicating due to their disfluencies, an evaluation with a speech language pathologist is recommended

Feeding & Swallowing

Coughing or being a picky eater is not always a sign of a fussy meal time. The position of feeding, being able to self feed, as well as handling fluids and solids differ for each age. Possible signs of a feeding/swallowing difficulties may include: refusing to eat, eating only a little bit for a certain period of time, constant or excessive drooling and/or coughing, sensitivity to textures (how the food feels) and/or temperatures (how hot or cold the food is).

Procedural skills

The procedures used in speech therapy are guided by the child’s needs based on diagnosis, age, and personal factors for success. The treatment may be modified as the clinician sees fit. More treatment procedures and resources are referenced as needed through the American Speech Language Hearing Association and other sources. Evidence based practice leads the way to know what is best for the child and how to increase and decrease the difficulty for growth and development

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  • Enhanced milieu approach:  this is a naturalistic approach that uses your child’s communication attempts to provide the caregiver and/or SLP an opportunity to model words and language in daily routines and play

  • Child led/directed play: having the child lead play routines creates a naturalistic environment to support language development 

  •  Dialogic Reading: this approach involves an adult and the child having a discussion or dialogue around what is being read. This therapy approach involves asking questions and building upon answers. Dialogic reading supports developing new vocabulary, introducing story structure, improving verbal fluency, and developing story telling skills 

  • Augmentative and Alternative Communication (AAC): AAC includes using gestures, signs, low tech communication boards (pictures/symbol systems), or high tech devices to communicate. AAC is utilized to supplement verbal speech as well. AAC does not replace verbal speech.  


Cycles Approach, Minimal Pairs, Maximal Oppositions, Melodic Intonation Approach, Rapid Syllable Transition Treatment (ReST): these are research based approaches that are utilized to help improve your child’s speech intelligibility/articulation. These approaches also help increase intelligibility between sounds and syllables. The speech language pathologist will determine which approach is most appropriate to utilize based upon your child’s needs


  • Desensitization Therapy: addresses the emotional components of stuttering.

  • Fluency Shaping & Modification Therapy: addresses the mechanics,
    tension, movement, and flow of speech

& Tips

Collaborative efforts to propose synopsis information was brought by the American Speech Hearing Association (ASHA) as well as the Chitter Chatter P.C. team. Please reference the links below for more information in regards to speech and language for your child. However, please reach out to Chitter Chatter P.C. for any other comments or concerns.

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