A tongue-tie, also known as ankyloglossia, is when the tongue is anchored to the bottom of the mouth restricting movement. This may mean the tip of the tongue cannot poke out past a person’s lips or when their mouth is open they may have difficulty touching the roof of their mouth.  Sometimes, when a person with a tongue-tie pokes out their tongue, the tongue will form a “w” or heart-shape.

What are the effects of a tongue-tie?

A lot of children with a tongue-tie have no speech issues.  This is because a lot of the sounds in English are made with the tongue tip (s, d, n) and can be produced with a slight movement of the tongue.  Sounds where the tongue needs to move more (l, r and th) can still be articulated clearly with reduced movement. 

Speech issues and tongue-tie are most common in children and therefore, it is not surprising that the two may co-occur.  However, this does not mean that a child’s speech delay is caused by their tongue-tie.

How can a speech pathologist help?

A speech pathologist can examine and evaluate the functional impact of a tongue-tie on individuals. 

This includes:

 When should surgery for tongue-tie be considered?

At birth, babies should be assessed to determine their ability to feed and latch.  A Speech Pathologist and/or Lactation Consultant needs to be considered first before surgery.

Unfortunately, there is no guarantee that tongue-tie surgery will make speech clearer or resolve feeding issues.

Before considering surgery, Speech Pathology Australia recommends considering the following questions:

  • What type of surgery are you doing?
  • What will be the benefits of surgery?
  • What will happen if you don’t do the surgery?
  • Are there any side effects to the surgery?
  • Will an anaesthetic be required?
  • Will pain relief be required after surgery?
  • What is the recovery period after surgery?

If you or your child are having difficulties with speech, or swallowing, speech pathology assessment and intervention is recommended before going ahead with surgery. 

To discuss further or book an appointment, please call Harrison Speech Pathology and speak directly to one of our trained speech pathologists.


The human voice is unique to everyone. Your voice can help express your personality, emotions and even your physical health. Your voice is created by the vocal cords in your voice box (larynx). Our vocal cords open and close as we inhale and exhale to let air in and out of our lungs. Our vocal cords produce sound (voice) when they come together and vibrate as we breathe out. Problems with voice can happen to anyone!

What can cause a voice problem?

Problems with your voice can be caused by one or a combination of factors, such as:

  • Overusing voice (e.g. shouting, talking over loud background noise etc.)
  • Dehydration
  • Stress/Anxiety
  • Reflux
  • Chronic Cough
  • Illness/Disease
  • Traumatic Brain Injury
  • Stroke
  • Natural Ageing
  • Smoking 
  • Significant Alcohol consumption

What can I do to help my voice?

There are several things that you can do everyday to ensure you maintain a healthy and natural voice. 

Maintain hydration. Hydration plays a large role in maintaining healthy vocal cords. Drinking plenty of water not only quenches thirst but, also keeps the vocal cords hydrated and moist for effective and efficient voice production. If you are dehydrated, then your vocal cords are dehydrated which may make it difficult to produce a clear and healthy voice. Drinking 6-8 glasses of water per day can help maintain a healthy voice.

Decrease Alcohol and Caffeine. Decreasing or eliminating the amount of substances containing alcohol and caffeine can also assist in maintaining a healthy voice. Caffeinated or alcoholic substances can dehydrate your body and vocal cords and can also cause your vocal cords to become irritated and sometimes inflamed if a lot of the substance is consumed. 

Decreasing or eliminating smoking. Substances such as tobacco can weaken or damage the respiratory system, which is needed for breathing and a clear, healthy voice. 

Speak in moderation. If you have been using your voice for a long period of time, your voice may begin to get tired and need a rest. Just like if you are running, after a while your body may begin to feel tired and need a rest. If you are required to use your voice frequently for work, try setting aside some realistic rest times throughout the day as much as you can. 

Nose breathing. Breathing through your nose instead of your mouth as much as possible can also help maintain a healthy voice with good breath support. Your nose acts like a filter when we breathe and can filter most environmental pollutants from entering our throat and lungs. 

Some behaviours to AVOID for a clear and healthy voice:

  • Frequent throat clearing – try having a drink of water or swallowing saliva
  • Talking over loud background noise – try turning down the TV or music, walk away from air conditioners 
  • Shouting/Yelling – try waving or whistling to get someone’s attention and move closer to the person 

Signs/Symptoms of voice problems

There are several signs and symptoms to watch out for if you are concerned about your voice. Some of these include:

  • Gradual or sudden changes in the tone/pitch of your voice
  • Gradual or sudden changes in the loudness of your voice
  • Abnormal voice qualities such as, sounding:
    • Strained
    • Breathy
    • Rough
    • Shaky 
  • Having periods of or complete loss of voice
  • Noisy breathing
  • Frequent throat clearing and/or coughing
  • The sensation of having something stuck and/or tightness in your throat
  • Shortness of breath

How can a Speech Pathologist help?

A Speech Pathologist can help in many ways. The treatment approach and techniques will vary for each client. Therapy is individualised to each client depending on their presenting problems and the cause of these problems. If you are concerned about your voice, it is best to see your General Practitioner (GP) or an Ear, Nose and Throat (ENT) Specialist prior to booking a speech pathology appointment. Some voice problems may require medical management by a Specialist or Doctor prior to or in addition to Speech Pathology intervention.

Difficulties articulating speech sounds can impact a person’s confidence expressing themselves and can also impact on their ability to be understood by others. There are a number of ways to help improve and develop speech sound skills for both children and adults.

Practice in front of a mirror or using video. 

One way to help improve your speech or your child’s speech sound skills is to practice the sounds that are difficult in front of a mirror so you can see what your lips and tongue are doing. Taking short video clips of yourself or your child saying difficult sounds is a good way to identify how you are saying them. 

It is a nice interactive way to target those difficult sounds and also a bit of fun! It can also be helpful to associate a sound you or your child is finding difficult with a gesture or movement. For example, if your child is having difficulty with the ‘ch’ sound, doing a pretend sneeze can often stimulate correct production of the ‘ch’ sound (ahh-chooo).

Face to Face Modelling.

An effective method that helps children to feel comfortable, and not pressured into constantly repeating an incorrect sound; is face to face modelling. You may be having a conversation with your son or daughter and hear them say “wook at the gog”. 

Acknowledge what they have said and repeat it back to them slowly while correctly modelling the speech sounds e.g. “yes, look at the dog”. You may also expand on the sentence they said while focusing on the sounds they had difficulties with e.g. “yes, look at the dog. The dog loves running”. Doing this frequently will help your child hear the sound correctly modelled many times during your interaction.

Singing Songs.

Singing is such a great way to practice speech sounds while also building language skills. Alternating the tones in your voice while you are singing uses a different part of the brain and can help stimulate language and sound learning.

 Songs that have a lot of words with the sound your child is having difficulty with in them, are a great resource. For example, if you are targeting the ‘t’ sound, “twinkle twinkle little star” would be a good song to practice together as it contains multiple ‘t’ sounds at the start, in the middle and at the end of words.

Drawing pictures. 

Drawing pictures of items that start with the sounds that are difficult for your child can also be a fun and engaging way to help improve speech skills. It’s an interactive way to work on the sounds in the words. 

You can also use the pictures to make silly sentences or a short story. Working on the difficult sounds like this is motivating but also allows for the difficult sounds to be targeted while increasing the level of difficulty moving from single words to telling a short story.


Books are fantastic for so many things. Reading books is great for speech and language development and can spark your child’s imaginative thinking. Discussing the pictures and the finer details in the pictures can also be a great way to work on speech sounds your child has difficulty with. 

You can pick images on the page that start or end with challenging sounds. For older children or adults, reading books with a lot of alliterative sentences is a good way to practice difficult sounds. An example of an alliterative sentence may be “Peter Piper picked a peck of pickled peppers”.

How does Harrison Speech Pathology help children improve their speech skills 

The Speech Pathologists at Harrison Speech Pathology can help you identify what articulation difficulties your child is having through a full speech assessment. 

Once the areas of need are identified, the most appropriate individualised treatment approach and recommendations will be given. This will also include strategies to try outside of the clinic that will be easy to implement into daily life and routines.

Speech therapy treats a range of disorders, delays and difficulties across the lifespan. While it is often thought of in the community as a service for children, speech pathologists are trained in communication and swallowing disorders for all ages. Their role is diagnosis, treatment and management.

What may an adult need speech therapy for? 

Speech pathologists are trained in the domains of speech sounds, language, social skills, fluency, voice and swallowing. There are a range of diseases, disorders and conditions that effect these skills. Common causes for adults receiving speech therapy include:

  • Stroke
  • Persistent loss of voice
  • Dyslexia
  • Vocal nodules rehabilitation
  • Traumatic brain injury
  • Progressive disease, such as Motor Neuron Disease, Parkinson’s Disease etc.
  • Normal changes associated with ageing
  • Dementia/Alzheimer’s Disease 
  • Stuttering
  • Language disorders
  • Laryngeal, facial and oral cancer
  • Aphasia
  • Dysarthria
  • Dysphagia
  • Apraxia
  • Chronic cough
  • Intellectual delay

Communication difficulties which affect adults may lead to feelings of inadequacy in social, professional, educational and personal lives. Additionally, adults may experience difficulties with their swallowing which can impact on adequate intake to support their energy needs, safe intake of food and drink, and enjoyment of eating and drinking. 

What kind of language difficulties can an adult experience?

Language includes being able to understand information and use communication. This includes all methods including speech, reading, writing, and augmentative and alternative Communication (AAC). 

Language deficits can significantly impact on independence and self-worth. A common type of language impairment following a change in brain functioning, such as stroke, is aphasia. 

There are different types of aphasia which may cause challenges thinking of the right word to use, making sentences, understanding what words mean, reading and spelling. Adults may also experience language deficits due to an ongoing developmental conditions and normal changes during ageing. 

Many speech therapy approaches require the client to do tasks outside of the appointment to achieve and maintain best results. Your therapist will work with you to make these as achievable in daily life as possible.

What should I expect as an adult client?

As a client at Harrison Speech Pathology you will receive respect and care. Our therapists are trained in countless disorders and conditions and provide a service personalised to your needs. 

Your therapist will support you in your needs and help advocate for you. This is particularly important when a client’s difficulties mean they can no longer successfully communicate for themselves. As an adult, your initial appointment will be focused on your therapist gaining information necessary for planning ongoing management. 

Your therapist’s plan will be based upon your own goals, lifestyle and area of difficulty. This can range from implementing AAC in the absence of verbal communication to being able to better communicate in the workplace. 

No matter what age group, your therapist will use evidence-based practice combined with knowledge of how to tailor therapy to your personal needs to create a specific therapy plan. If you are receiving multiple services your speech pathologist will work with all professionals to ensure you receive holistic and cooperative intervention.

What factors impact recovery?

Everyone is individual in their communication and recovery. Some people fully recovery from their difficulties while others may have management strategies put in place in the anticipation that their condition will worsen. This is dependent on several factors including:

  • Medical diagnosis and management
  • Age
  • Motivation
  • Therapy attendance
  • How early therapy is applied
  • Personal goals
  • Pre-morbid functioning
  • IQ
  • Medications

Your therapist will use best clinical judgement in addition to evidence-based practice to determine a likely prognosis. 

Contact Harrison Speech Pathology for further information about speech pathology services for adults.

The basic purpose of communication is to interact with others and therefore it is no surprise that we are constantly using social skills. Some children and adults have difficulty developing social skills in a typical way and this can cause varying challenges when interacting with others. The individual may be aware or unaware of their challenges. This can affect all areas of life including school, home, work, leisure activities and relationships. 

A social communication difficulty may mean the person seems awkward in their interactions, doesn’t seem interested in others, frequently breaks social rules, or doesn’t understand what relationships are and how they are formed. 

A few areas people with social communication difficulties may struggle with are:

  • Engaging with other people 
  • Using turn taking in play or conversation
  • Playing or participating with others
  • Using and/or understanding body language and facial expression
  • Beginning and ending a conversation 
  • Keeping a conversation going
  • Changing how they talk to match a certain situation and/or person
  • Understanding how to predict other people’s thoughts, feelings and motivations
  • Understanding figurative language
  • Following social rules

What causes social communication difficulties and who can diagnose it?

Most commonly social communication difficulties are associated with Autism Spectrum Disorder (ASD) as it effects a person’s ability to interact with the world around them. 

There are many other reasons someone may experience social communication difficulties including intellectual delay, Attention Deficit Hyperactivity Disorder (ADHD), developmental delay, brain injury, anxiety or mental health conditions and some people may experience a social communication disorder without a known underlying cause.

A speech pathologist can use a series of formal and informal assessments to identify if a social communication difficulty is present and to what extent. A psychologist will typically diagnose conditions such as Autism Spectrum Disorder. Other people involved in the care and treatment can include an Occupational Therapist, doctor and psychiatrist.

How can a speech pathologist help?

Speech pathologists are experts in all areas of communication, and this includes social skills. Your therapist is trained in social development norms, disordered social development, a range and therapy and methods to monitor progress. 

The first step for improving social skills is attending a detailed assessment session where your therapist will identify what specific areas of social functioning are affected. This is then used to tailor therapy to the individual’s needs, learning style and personal goals. The chosen activities to facilitate learning will depend on the age, skill level, and preference of the individual and their families. 

Examples of methods used to improve social skills are social stories, social scripts, role play, technology-based instruction, direct teaching, problem solving scenarios, spotlighting during interactions, practice in play and parent training. Therapies are aimed to be interesting, engaging and encourage the client to discover new skills that will help them with their daily needs.

How do I book in for social therapy?

You do not need a referral or diagnosis to start therapy for social skills. As therapy is personalised to the individual’s presentation it is not necessary to have a formal diagnosis before attending. Your therapist will discuss with you if they feel a diagnosis would assist the therapy process. 

You can phone our clinic on (02) 4953 6128 to speak directly with one of our therapists regarding your concerns. All our therapists are trained and experienced in implementing therapy targeting social skills.

Stuttering is a speech fluency disorder where the flow of speech is interrupted. It can impact both adults and children and can be treated at all ages. Treatment for stuttering requires specialist input from a speech pathologist who is trained in a variety of stuttering therapies. The specific therapy used will depend on the individual, their family, and the stutter type.

The Lidcombe Program is commonly used for younger stutters. In this therapy a parent or caregiver is trained to give specific feedback for smooth and stuttered speech. This therapy does not change the speaking pattern of the child. Syllable Timed Speech and Smooth Speech are also common therapies and are more frequently utilized for adolescents and adults. These programs change the person’s speaking pattern to assist them to manage their stutter. Other options include individualised strategies to manage stuttered moments, assistance and alternative technology (AAC), and a combination of approaches.

How to recognise a stutter in a toddler or small child

Stuttering behaviours interrupt the flow of speech even though the person knows exactly what they want to say. There are different types of stutter behaviours such as:

  • Repetition: when someone repeats a sound or syllable of a word e.g. “w-w-we went to the park”, “we-we-we went to the park”
  • Prolongations: when a sound is lengthened e.g. “sssssssee the ducks”
  • Blocks: when no sound comes up e.g. “the (pause) ball is over there”
  • These may be accompanied by excessive blinking, the mouth and face looking stuck in a position, twitching of facial features or lots of fillers such as ‘um’ and ‘ah’.

A mild stutter may occur between ages 2 and 3 as the child has a large increase in their language. At times this goes away without therapy, however in some children it gets worse or does not go away. Stutters most commonly occur without a known cause, however they can be acquired due to a brain injury. They may vary in their severity on a daily basis and tend to worsen when the person is tired or upset.

What do I do if my child has a stutter?

If your child develops a stutter that persists from more than 3 months, please contact a speech pathologist. They will provide you with information and strategies specific to the individual. It is best not to comment on the stutter until you have gained individualised advice from a speech pathologist. Commenting can bring unwanted attention on the child causing them to withdraw and reduce their communication. It can also negatively affect therapy. This includes avoiding telling the child to slow down or think about what they want to say.

If your child is frustrated by their stutter you can say “It’s okay. I’m still listening. Keep going”. Getting down to your child’s eye level is a great way to show them that you are interested in their communication message. Always allow your child the time to say their message and avoid finishing off words or sentences for them. You can also reduce background noise, such as turning off televisions, to help them be understood. 

How does Harrison Speech Pathology treat children with a stuttering issue?

All therapists at Harrison Speech Pathology are trained and experienced in stuttering. The therapist will first see the parent and child for an initial appointment. During this time the therapist will get an in-depth case history and observe the child during play to determine the stutter type and most appropriate treatment approach. Therapy will then be tailored to the child and family’s lifestyle. The therapist will work directly with the family to train them in the selected therapy approach.

Stuttering therapy is tailored to the individual and most commonly completed within play to ensure the child is engaged and enjoys practicing. Home practice is common, and the therapist will guide the family in activities which are suited to their individual routines and easily implemented at home. 

Sometimes it is hard to find time to do homework while working around other commitments with your kids.

In the car is a perfect time for busy families. We spend a lot of time in the car and it is a great opportunity to use that time to work on their speech and language while encouraging positive and motivating interactions.

Below are some ideas to try in the car to maximise your time


I-Spy is often a favourite road trip game to play in the car. It is also a fantastic game that helps promote speech and language skills as it can be adapted to suit both young and older children. It is a great game for developing vocabulary, describing skills, categorisation, sentence structure, understanding and use of prepositions and many more.

For younger children, labelling items outside the car is a great way to build vocabulary and identifying features of the item such as colour, shape and size.

For older children, describing items outside the car is a great way to build sentence structure, use of appropriate grammar and describing skills.

Creative Stories

Another favourite is creating stories. It is fantastic for turn-taking skills, creative and flexible thinking, sentence structure, use of grammar and sequencing events. It can be adapted for younger and older children and it a great way to engage and motivate children in speech and language-based activities.

Playing an adapted game of Chinese Whispers is a great way to get everyone involved without too much pressure to create a whole story. Someone can start the story with a sentence, then the next person can add another sentence onto that one until you end up creating an imaginative story.

Younger children may need some prompts and cues. It can also be fun to audio record the story so you can go back and listen to it later for a laugh and to provide feedback on your child’s speech and language use.


Singing is beneficial in so many ways. It is a great way of encouraging changes in tone of voice, engagement, language use and articulation of speech sounds. Alternating the tones in voice helps adults and children remember certain words and their meanings.

For younger children, singing nursery rhymes and ABC’s is a great way for developing and remembering knowledge of words and concepts.

For older children, singing a family favourite song is great for encouraging participation, sentence structure, grammar and vocabulary development.

What types of exercises do Harrison Speech Path provide for at home? 

The therapists at Harrison Speech Pathology will give specific exercises for your child based on their needs. Exercises will always be individualised for engagement and motivation. Exercises are kept simple and fun for you and your child to ensure the exercises are not seen as an effort to complete.

For example, if your child is having difficulty with sentence structure and describing skills, playing games such as charades (using pictures of familiar items/objects) is a fun and engaging way to encourage the development of these skills and can be fun for the whole family.


Image: Pexel

If your child has a speech or language delay, contact a Speech Pathologist as soon as you can. It is important to begin intervention as soon as possible to gain better results from therapy and allow children to fully participate in daily interactions and experiences.

What is a speech and language delay?

Children acquire sounds in a specific order at certain ages, and they also substitute sounds for other sounds until certain ages. For example, pronounce ‘ring’ and ‘wing’ until around 5 years of age. A speech delay is when the sounds that a child is producing are not as expected for their age.

Language is separated into two components. Receptive language is the comprehension of written and oral information. Expressive language is the use of language, for example writing or talking. A language delay may involve either receptive language, expressive language or both. A language delay is when the child’s skills are not at the expected level for their age, but are following the usual pattern of development.

Should I contact my child’s doctor or a speech pathologist first?

If you suspect your child has a speech or language delay, you may choose to discuss it with your doctor prior to seeking a Speech Pathologist. However, it is not necessary to acquire a referral from your Doctor to make an appointment to see a Speech Pathologist.

Should I be worried if my child has a speech delay?

Speech delays can affect a child’s communication in many environments, their confidence, and interactions with peers, teachers and family. As children reach school-age, speech delays can impact their ability to learn to read and write.

It is important to seek advice from a Speech Pathologist if you are concerned about your child’s speech as is essential to begin intervention as soon as possible.

How do I prevent speech and language delays in my toddler?

Reading books and singing with your child from an early age will allow them to be exposed to language. Research suggests reading books to children from as young as 4 months old.

Playing with your child and talking about their environment and what they are doing during routines (for example, brushing teeth, having a bath) is also a fundamental step to developing speech and language.

Model the correct pronunciations of all words so as the child develops, they hear the correct sounds to use. Give your child time to think about what you have said and to respond.

Praise any attempt that your child makes to communicate.

If you are concerned about your child’s speech or language development, get in touch with our team today.

Harrison Speech Pathology helps children in the Newcastle region with speech and language delays

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