Services

Screenings & Evaluations

We offer screenings and comprehensive evaluations for speech and language services at our office by appointment.

A full evaluation will be recommended for any area failed during the screening.

The speech-language screening is a quick 5-10 minute session that will consist of the following:

Language
Articulation
Voice
Fluency (stuttering)

If you are concerned about your child's speech and language development, a screening is the best way to put your mind at ease and to intervene if necessary. Early intervention is the key!

Please contact us to set up an appointment for your screening or to request additional information.

*Screenings do not yield a written report

**Tongue-tie screenings are available for $35 and do not yield a written report nor referral for surgery.

Articulation & Phonology (Speech Sounds)

ARTICULATION

One of the most common sounds affected by an Articulation Delay is /r/ and it is the most difficult for most SLPs to treat. At Expressions Speech, Language, & Myofunctional Center, we have a great love for this sound and created a step-by-step program, Let's Hear It For /R/!, that shows clinicians how to correct this sound quickly and effectively.

Unfortunately, most school systems will not treat one-sound errors (/r/) and often private therapy will be your only option. If you have the need for an SLP to correct your child’s /r/ sound, come to the area experts in /r/ therapy! If you are not close enough for an office visit, we may be able to utilize teletherapy, depending on your location. Research has shown that short, frequent sessions can rapidly increase progress which make teletherapy a great alternative to in-person services, plus no travel time!

The /r/ sound is not the only error sound we treat. Children often have errors commonly called a “lisp” that make affect /s/ and /z/. Or, they may have difficulty with SH or CH sounds and we can help your child correct these sounds using Traditional Articulation Therapy, an evidence-based therapy.

PHONOLOGY

Phonological Delay is different than an articulation delay in that the entire sound system is usually affected, and the child is difficult to understand because of the number of errors. This delay requires specific therapy that is different than Traditional Articulation (described above). The SLPs at Expressions Speech, Language, & Myofunctional Center specialize in Cycles for Phonology which is a holistic approach to your child's sound delays. This approach will target all of the primary error sounds in your child's speech at once creating greater progress and more generalization to conversation. A home therapy program will be utilized and its implementation will greatly reduce the amount of time your child is in therapy, sometimes by half. The best part about the home program is that it will consist of only a few target words!

If you are interested in this type of therapy or want to request a screening, please view our contact information to set up an appointment or to request additional information.

Language

RECEPTIVE

Receptive language is the language your child understands. Language tasks involving following directions, processing information, and comprehension are receptive language tasks. As a rule, children acquire receptive language at a faster rate than expressive language in the early years. For example, many one-year-old children can follow a one-step or two-step directions, but cannot expressively ask someone else to perform the same direction.

Receptive language delays affect children in many ways. The inability to follow directions will affect children in every aspect of their learning and development. For most kids, it is the inability to understand the words in the directions (before, after, next to, most, many etc.) than the direction itself.

Children with ADD/ADHD have a lot of difficulty with directions as well as processing information and comprehension. Strategies can be taught for children with receptive language delays to comprehend language in meaningful ways.

EXPRESSIVE

Expressive language is the language your child uses to express their needs and wants. Language tasks involving asking questions, commenting, conversing, and even arguing/protesting are expressive language tasks.

Expressive language delays are easier to identify than receptive delays in the early years.

If you suspect an expressive language delay, request a consult with a Speech-Language Pathologist as soon as possible! The days of “wait and see” are over as early intervention is crucial! See our RED FLAGS page here.

Expressive language delays can have a far-reaching effects on a child's overall education due to the impact on language development and use which will affect all other subject areas in school.

Autism & Autism Spectrum Disorders

Autism is considered a developmental disability characterized by marked impairment in social communication and interaction. The characteristics that define autism are typically recognized and diagnosed before a child is three years old. Autism is considered a spectrum because there can be significantly variability in symptoms between children.

Signs/Symptoms of Autism

Not babbling by 12 months
Not gesturing by 12 months
Doesn't understand or follow directions
Not using single words by 16 months
Not using two-word phrases by 24 months
Rocking, hand flapping or other repetitive movements
Problems in dealing with transitions from one activity to another
No fear of real dangers or extreme fear of some things
Crying a lot and very sensitive (or not sensitive at all) to some things in the environment
Feeding difficulties relating to wanting to eat certain textures
Problems with sleeping
Choosing to play alone
No pretend play
Limited or no eye contact
Flat affect (limited or no facial expressions)

Many people know the "common" types of characteristics associated with autism. However, not all these characteristics are exhibited by all of those with autism.

Problems in dealing with transitions from one activity to another
No fear of real dangers or extreme fear of some things
Crying a lot and very sensitive (or not sensitive at all) to some things in the environment
Feeding difficulties relating to wanting to eat certain textures
Problems with sleeping
Choosing to play alone
No pretend play
Limited or no eye contact
Flat affect (limited or no facial expressions)
Some of these characteristics describe my child, what should I do?

A team approach is needed for children suspected of having autism. This team may include your doctor, a speech-language pathologist, a neurologist, occupational therapist, physical therapist (possibly), and a developmental specialist, as well as others. In some cases, SLPs are the first professional to identify characteristics of autism. A detailed case history must be completed with extensive parent input and a variety of assessments will be used to make the diagnosis.

If you have concerns about your child, do not wait to seek help. Early intervention is key and the "wait and see" approach may cause you and your child to lose valuable time. Trust your instincts. Even if your child doesn't have autism, it is always to better to rule it out than to wait. In addition, you may find ways to help your child communicate better by consulting a professional.

Apraxia of Speech

Apraxia of Speech is a motor speech disorder. Children with apraxia of speech have difficulty with motor planning. For them, producing the precise, highly refined series of movements of the lips, tongue, jaw, and palate that are necessary for intelligible speech is very difficult.

Apraxia of speech has many names and is often called childhood apraxia of speech (CAS), verbal apraxia, developmental apraxia of speech, or verbal dyspraxia.

Apraxia's motor impairment makes a child's speech unintelligible. For each sound we make, there are a specific sequence of steps our brains and articulators must make, in order and in perfect timing, to produce the sound. For those with apraxia, these steps do not happen in order due to issues with motor planning and timing. It is like following a path from one point to another, but you cannot quite finish each step correctly. Apraxia of speech requires specialized diagnosis and intervention from a qualified Speech-Language Pathologist.

For more information regarding Apraxia, please visit the following excellent links:

http://www.asha.org/public/speech/disorders/ChildhoodApraxia/

http://www.apraxia-kids.org/

Fluency (Stuttering)

Stuttering is a speech disorder which affects the flow of speech. For most people, it begins during childhood and can last throughout life.

Stuttering is characterized by disruptions in the production of speech sounds, commonly called "dysfluencies." Most people produce brief dysfluencies from time to time that do not affect overall communication. However, they can affect communication when a person produces too many of them. Many children go through a normal period of dysfluency as they are acquiring language and this stage is considered a part of normal development from the age of 2-4 years.

Signs/Symptoms of Stuttering

Stuttered speech is characterized of repetitions of words or parts of words: "ba-ba-ba baby" and/or prolongations of speech sounds as in "sssssnake". Some people exhibit blocking where speech is completely interrupted and may exhibit secondary characteristics such as eye blinking, foot stomping, head jerking, etc.

If you are concerned about your own or your child's fluency please contact our office to schedule an appointment. For additional resources on stuttering, please visit the following websites.

Auditory Processing Disorders

APD or CAPD

Auditory Processing Disorders (APD), sometimes referred to as Central Auditory Processing Disorder (CAPD), have recently come to the forefront of many educational and professional debate in recent years regarding its existence or a symptom of another issue like language delay. Because of this, there has been a lot of confusion as to what qualifies as APD and what does not.

Our office will complete a speech-language evaluation and investigate sleeping and breathing as part of as assessment where CAPD is a concern. Often poor breathing leads to low quality sleep that affect how we function during the day.

Voice Disorders

Your voice and the ability to talk is a lot like breathing in that most of us take it for granted. However, for many people, talking can be problematic.

Symptoms of a voice problem can range from simple hoarseness to a chronic dry and scratchy throat, to a pitch/tone that is not pleasing causing limitations in the ability to speak clearly, or periods of voice loss.

If you have concerns about your voice, the first step is to visit and ENT to determine if there is a medical cause for your voice disorder.

Once an ENT clears you or your child for voice therapy, contact us for a free consultation. We can serve both children and adults for voice therapy.

Telepractice

Do you need speech-language pathology services, but cannot find a local SLP close enough to your home? Would you like to have the convenience of therapy in YOUR home without the hassle of traveling to an office even if you are in the same area? Why not consider telepractice, sometimes called teletherapy?

With advances in technology and the pandemic of 2020, telepractice quickly became the new way to access speech-language services anywhere in the world! All you need is a high-speed internet connection and a web camera. We provide the link for the meeting place on our secure conference connection. Therapy sessions take place in real-time in a face-to-face interaction.

Teletherapy, for most children, can be a great alternative to traditional therapy, but can require more involvement on the part of the parent/caregiver. While this can be thought to be a negative aspect of this therapy type, parent/caregiver involvement can enhance therapy generalization/carryover resulting in better implementation at home and a shorter number of therapy sessions required by the SLP.

We specialize in Articulation Therapy to correct sounds like R, S, Ch, Sh etc. We can also work on phonological delays, which are entire sound system delays focusing on multiple sounds. Sessions are 15 minutes in length allowing you to save money over traditional 1/2 hour session cost!

Schools

School systems across the country have started to utilize this amazing technology to provide much-needed services to their students in rural areas while saving a great deal of money at the same time. If your school system is interested in telepractice, please contact us!

Our office has been providing teletherapy services for over 10 years! Dr. Moore, the owner, is licensed in NC, IL, GA, MO, and AZ.

Orofacial Myology

Orofacial Myology is a highly specialized field within the disciplines of speech-language pathology and dentistry/dental hygiene.

As shown in the graphic above, orofacial myology is the study of the muscles of the mouth and face and HOW they rest and function.

What is an Orofacial Myologist?

Orofacial Myologists (or myofunctional therapists) treat what are known as Orofacial Myofunctional Disorders or OMDs

Orofacial Myofunctional Disorders (OMDs)

Orofacial Myofunctional Disorders (OMDs) are compensations we have adopted due to some kind of disruption within the development of the face, airway, and eruption of the teeth. These may include:

Thumb and finger sucking habits
A habit of resting with the lips apart
Mouth breathing due to enlarged tonsils and adenoids or other condition
The tongue resting forward and low between or against the teeth
Tongue Thrust
Airway problems
Allergies
Other harmful oral habits

Orofacial Myofunctional Disorders are often related to or can contribute to:

Low tongue resting posture or Tongue Thrust
Disruptions in eruption and development of the teeth
Problems with speech and language development, especially speech articulation
Feeding problems or picky eating
Gagging
Abnormal facial growth and development including long, narrow faces
Improper development of sinuses, nasal passages, and the airway
Orthodontic relapse
Ear infections
Poor sleep/snoring
MOUTH OPEN BREATHING
Sleep apnea ~ Lack of oxygen to the brain!

Myofunctional Therapy

The treatment of the dysfunctions of the muscles of the face and tongue to correct oral rest posture, chewing, as swallowing, while promoting nasal breathing.

Our goal is to normalize resting postures of the lips, tongue, and jaws so that healthy facial and dental development can occur naturally which in turn creates healthy airways and great sleep!

Call our office 336.350.9263 for more information or to set up an appointment.

Tongue Tie (Ankylogossia)

Tongue tie is where the tongue is tethered to the floor of the mouth or to the gum line by the frenulum (string of tissue that anchors the tongue in the mouth). If you lift up your tongue and look in the mirror, you will see the frenulum.

There are two different types of Tongue Tie:

Anterior
Posterior

In addition, many children with tongue-tie also have a lip tie, usually in the upper lip. For examples of the different types of ties, please visit:

Dr. Ghaheri's Website and Resources

For some people, tongue tie does not cause any issues and there are varying ranges of severity of tongue tie. Some babies are tongue tied at birth and have a lot of difficulty latching during breast feeding. Some children have speech difficulties that may or may not be associated with a short or restricted frenulum.

If you suspect you or your child is tongue tied, you may also want to visit the site www.tonguetie.net to learn more information about this rarely talked about ramifications of this condition.

Here is a list of symptoms possibly related to Tongue Tie. For many, these symptoms can be life long and affect quality of life!

Tongue Tie Symptoms

It is important to remember that your child's tongue/frenulum may not match the pictures on the above websites, but it does not necessarily mean he/she isn't tongue-tied. A short frenulum, that is hard to detect, can hinder correct speech production by not allowing the tongue to travel from articulator to articulator efficiently. An evaluation would determine if the range of motion is adequate. Please call our office to schedule an appointment.

What does the child sound like after this surgery?

If you are considering this surgery for a client, your child (or yourself) and you have wondered if it will really make a difference, please listen to the following files.

(Parent permission for posting here has been granted.)

Where can I find a doctor that performs this type of surgery?

Not all doctors are trained to assess and treat tongue-tie and before you consider surgery, a myofunctional evaluation is STRONGLY recommended for pre-release and post-release therapy.

Sample of speech before surgery

00:00 / 00:19

Sample of reading after surgery

00:00 / 04:34

Another reading after surgery

00:00 / 01:04

Sample 3 months after surgery

00:00 / 00:11

Teen & Adult Speech Therapy

Are you a teen or adult struggling with articulation, stuttering, or other speech difficulty?

Maybe you received therapy in school, but were unable to fully commit to the process and would like a second chance?

Expressions Speech and Language Center specializes in remediating:

Long-standing articulation disorders such as problems with the /r/ sound and lisps
Stuttering
Expressive Language disorders that may hinder vocabulary and writing
Receptive language disorders affecting memory and processing of information

In addition, we are trained to work with clients on Myofunctional Disorders through Orofacial Myology. You can find out more about that area here: Orofacial Myology

Are you not sure if you need therapy?

We will complete a screening free of charge and recommend services if necessary.

There is no obligation.