Difficulty producing speech sounds correctly, making speech hard to understand.

What It Looks Like:

• Substituting sounds ("wabbit" for "rabbit")

• Omitting sounds ("ca" for "cat")

• Distorting sounds (lisping, lateralized sounds)

• Patterns of sound errors affecting multiple sounds

• Speech that's difficult for others to understand

Who We Help:

• Children: Speech sound delays, phonological disorders

• Teens: Persistent articulation difficulties affecting confidence

• Adults: Motor speech disorders (dysarthria, apraxia) following stroke or neurological conditions

How We Help:

• Play-based articulation therapy for children, motor-based approaches for apraxia, intensive therapy for motor speech disorders, and compensatory strategies when needed.

Difficulty understanding language (receptive) or expressing thoughts, ideas, and needs (expressive).

What It Looks Like:

• Expressive Language: Limited vocabulary, short sentences, difficulty finding words, grammatical errors

• Receptive Language: Trouble following directions, understanding questions, comprehending stories or conversations

• Both: Challenges with language comprehension AND expression

Who We Help:

• Children: Late talkers, language delays, language disorders, developmental language disorder (DLD)

• Teens: Language-based learning challenges, academic language difficulties, word-finding problems

• Adults: Aphasia (language disorder after stroke), cognitive-communication disorders, language difficulties following brain injury

How We Help:

• Evidence-based language therapy targeting vocabulary, grammar, comprehension, narrative skills, and functional communication in real-life contexts.

A motor speech disorder where the brain has difficulty planning and coordinating the movements needed for speech.

What It Looks Like:

• Inconsistent speech sound errors

• Difficulty imitating sounds and words

• Groping or struggling to produce sounds

• Vowel distortions

• Better automatic speech than intentional speech

• Difficulty with longer or more complex words

Who We Help:

• - Children (primarily ages 2-8): Diagnosed or suspected CAS

How We Help:

• Our SLPs use specialized, evidence-based motor-based therapy approaches for CAS, including intensive practice, multi-sensory cueing (visual, tactile, auditory), and systematic progression toward functional communication.

Disruptions in the flow of speech, including repetitions, prolongations, or blocks.

What It Looks Like:

• Repeating sounds, syllables, or words ("b-b-ball")

• Prolonging sounds ("sssssnake")

• Blocks (getting stuck, no sound comes out)

• Physical tension when speaking

• Avoidance of speaking situations

• Anxiety related to speaking

Who We Help:

• Children: Early childhood stuttering, developmental stuttering

• Teens: Stuttering affecting confidence, school participation, social interactions

• Adults: Persistent stuttering, fluency challenges affecting work or relationships

How We Help:

• Age-appropriate, evidence-based stuttering therapy. For young children, we use indirect approaches and parent coaching. For older children, teens, and adults, we teach fluency strategies, address anxiety, and support self-advocacy. You decide your goals—speaking more fluently, stuttering more comfortably, or both.

Difficulty with voice quality, pitch, loudness, or vocal endurance.

What It Looks Like:

• Chronic hoarseness or raspiness

• Breathy, weak, or strained voice

• Vocal fatigue (voice gets tired quickly)

• Pitch abnormalities (too high or too low)

• Loss of voice (aphonia)

• Pain or discomfort when speaking

• Professional voice concerns (teachers, singers, public speakers)

Who We Help:

• Children: Vocal cord nodules, chronic hoarseness, vocal strain

• Teens: Voice disorders, vocal strain from sports/activities

• Adults: Professional voice users, vocal cord dysfunction, voice problems following medical issues

How We Help:

• Voice therapy to improve vocal hygiene, breath support, resonance, and reduce vocal strain. We often collaborate with ENT specialists for comprehensive care.

Difficulty with the social use of language—conversation skills, reading social cues, understanding non-literal language.

What It Looks Like:

• Trouble taking turns in conversation or staying on topic

• Difficulty reading facial expressions, body language, or tone of voice

• Challenges understanding sarcasm, jokes, or figurative language

• Tendency to talk only about preferred topics

• Difficulty making and keeping friends

• Struggles with perspective-taking

Who We Help:

• Children: Social communication disorder, autism spectrum disorder (communication support), pragmatic language challenges

• Teens: Social skills difficulties, navigating complex peer relationships

• Adults: Social communication challenges following brain injury or associated with autism

How We Help:

• Structured social communication therapy, social stories, video modeling, role-playing, and strategies for real-world social situations.

Individuals with autism often experience challenges with communication, social interaction, and language development.

What It Looks Like:

• Delayed language development or lack of spoken language

• Echolalia (repeating words or phrases)

• Difficulty with social communication and interaction

• Challenges with non-verbal communication (eye contact, gestures)

• Narrow or intense interests

• Preference for routine and predictability

Who We Help:

• Children: Early intervention for language and communication development

• Teens: Social communication skills, functional communication, academic language

• Adults: Augmentative and alternative communication (AAC), social communication

How We Help:

• We use neurodiversity-affirming, evidence-based approaches to support communication development. We work on functional communication, social skills, language comprehension, and expressive language in ways that honor each individual's unique strengths and needs.

Stroke is a leading cause of communication difficulties in adults, including aphasia (language disorder), apraxia of speech (motor planning disorder), and dysarthria (motor speech disorder).

What It Looks Like:

• Aphasia: Difficulty finding words, forming sentences, understanding language, reading, or writing

• Apraxia of Speech: Difficulty coordinating speech movements, inconsistent errors, effortful speech

• Dysarthria: Slurred speech, weak articulation, changes in voice quality, difficulty controlling volume or rate

Who We Help:

• Adults recovering from stroke

How We Help:

• Intensive, evidence-based aphasia therapy, motor speech therapy, and compensatory strategies to help regain functional communication. We focus on real-life communication goals and work on speaking, understanding, reading, writing, and alternative communication methods as needed.

Brain injuries can affect communication, thinking, memory, and social interaction.

What It Looks Like:

• Difficulty with memory or attention

• Trouble organizing thoughts or following conversations

• Word-finding difficulties

• Slower processing speed

• Challenges with problem-solving or decision-making

• Social communication difficulties

• Speech or language changes

Who We Help:

• Teens: Concussion recovery, return to school support

• Adults: TBI rehabilitation, cognitive-communication therapy

How We Help:

• Cognitive-communication therapy targeting attention, memory, executive functioning, language, and social communication. We teach compensatory strategies and provide training in the use of memory aids and organizational tools.

Progressive conditions like Parkinson's disease, ALS, Multiple Sclerosis, and dementia can affect speech, voice, swallowing, and cognitive-communication.

What It Looks Like:

• Parkinson's Disease: Soft, monotone voice; slurred speech; difficulty swallowing

• ALS: Progressive weakness affecting speech and swallowing

• Multiple Sclerosis: Communication and cognitive changes

- Dementia: Language difficulties, word-finding problems, challenges with comprehension

Who We Help:

• Adults managing progressive neurological conditions

How We Help:

• We provide therapy to maintain communication and swallowing function as long as possible, teach compensatory strategies, and introduce augmentative and alternative communication (AAC) when appropriate. Our goal is to maximize quality of life and functional communication.

Difficulty learning to read, spell, or write despite appropriate instruction, often rooted in underlying language and phonological awareness challenges.

What It Looks Like:

• Difficulty learning letter-sound relationships

• Trouble blending sounds to read words

• Poor phonological awareness (rhyming, sound manipulation)

• Reading comprehension difficulties

• Spelling challenges

• Difficulty with written expression

Who We Help:

• Children: Early literacy difficulties, dyslexia, language-based learning disabilities

• Teens: Persistent reading and writing challenges affecting academic success

How We Help:

• Our SLPs with specialized literacy training use evidence-based structured literacy approaches to address the underlying language skills needed for reading and writing success. We work on phonological awareness, phonics, fluency, vocabulary, and comprehension.

An anxiety-based condition where a child or teen consistently does not speak in specific social situations (like school) despite speaking comfortably in other settings (like home).

What It Looks Like:

• Speaking freely at home but silent at school or in public

• Anxiety in social or performance situations

• "Freezing" when expected to speak

• Communicating through gestures, nodding, or writing instead of speaking

Who We Help:

• Children & Teens with selective mutism

How We Help:

• We use gradual exposure techniques, anxiety reduction strategies, and collaboration with families and schools to help children and teens become comfortable speaking in all settings.