Melbourne Speech Pathologist

Speech sound disorders occur when children have difficulties producing certain sounds used in speech. This may involve lisps, where children misarticulate sounds like /s/, /z/, /sh/, and /ch/. There are four types of lisps:

• interdental, where the tongue protrudes between the front teeth;
• lateral, where the air escapes over the sides of the tongue;
• palatal, which occurs when the tongue rises and touches the roof of the mouth; and
• dental, where the tongue pushes against the back of the front teeth.

Speech sound disorders also include delayed speech sounds, where children struggle with phonetic sounds past the expected developmental milestones of their age, or have learned to pronounce certain sounds incorrectly, which then becomes a habit.

Childhood apraxia of speech (CAS) is a motor speech disorder where children know what they want to say but have difficulty coordinating the muscle movements needed to produce the necessary sounds. This may look like

• unclear or inconsistent speech sounds;
• pauses or gaps between syllables or words;
• difficulty with positioning their lips, tongue or jaw for articulation;
• pronouncing the same word differently each time they say it; and/or
• producing consonants with the wrong voicing such as saying “bye” instead of “pie”.

Children with phonological disorders often apply incorrect rules to groups of sounds. This may include

• deleting final consonants from sounds, such as saying “ca” instead of “cat”;
• replacing sounds made from the back of the mouth with the front of the mouth, such as saying “key” instead of “tea”; and
• reducing consonant clusters, such as saying “poon” instead of “spoon”.

Receptive language delay occurs when children have difficulties understanding written or spoken language. These difficulties include struggling to understand when provided with simple instructions or directions and struggling to respond appropriately to questions. This may look like

• not responding when their name is called;
• appearing to tune out during conversations;
• difficulty understanding spatial concepts like “in”, “on”, or “under”;
• struggling with concepts related to shapes and colors; and
• confusing different “wh” questions, such as responding to a “who” question as a “where” question.

Expressive language delay affects a child’s ability to utilise words and sentences to communicate their thoughts and ideas despite being able to understand written or spoken language. This includes experiencing difficulties with specifics during conversation, often generalising these as “stuff” or “things”. Children may also struggle with using verb tenses, excluding essential words in sentences, or struggling to find the necessary words, leaving information incomplete or difficult to understand.

Mixed receptive-expressive language disorder occurs when children struggle with both receptive language delay and expressive language delay, often affecting understanding and speaking at the same time.

Developmental language disorder (DLD) occurs when a child has persistent difficulties understanding and using spoken language that cannot be explained by other conditions such as hearing loss, autism, or intellectual disability. DLD may carry on into adulthood and may affect speaking, listening, reading, and writing, throughout a child’s development.

Pragmatic language difficulties, often related to autism spectrum disorder, affect an individual’s understanding and usage of language in social contexts. Individuals with pragmatic language difficulties may understand the literal meaning of words and can form grammatically correct sentences but may struggle with things like

• maintaining conversation topics,
• understanding what information is relevant to share in different social settings,
• interpreting figurative language like sarcasm or jokes, and/or
• when to be formal or informal.

Difficulty with turn-taking and understanding social cues involves challenges recognising when it’s appropriate to speak or act during social interactions, which relies on interpreting subtle non-verbal signals like pauses in conversation, shifts in body language, or changes in facial expressions. Individuals experiencing these difficulties may interrupt others frequently, remain silent when a response is expected, or are unable to recognise when to yield the conversational floor to others. They often struggle to identify social cues such as tone of voice, facial expressions, or body language.

Stuttering is a speech disorder where the flow of speech is interrupted by repeating sounds or words, stretching sounds out, or having speech block where no sound comes out. It can vary from mild to severe and may become more noticeable in situations like talking on the phone, speaking in class, or meeting new people.

Cluttering is when speech becomes rushed, unclear, or disorganised, often sounding too fast or jumbled to listeners. People who clutter may leave out sounds or parts of words, blend words together, or jump quickly from one idea to another, sometimes without realising that their speech is unclear.

• Voice disorders are conditions that affect an individual’s ability to produce sound and can appear as changes in pitch, volume, tone, or quality of voice. People with voice disorders may experience hoarseness, roughness, loss of voice, and discomfort when using voice. Voice disorders can impact daily communication, work, and social interactions, and may be associated with discomfort or pain when talking.

• Reading and spelling delays in children can affect their ability to learn to read words, understand what they read, or spell accurately. It may often appear as effortful reading, guessing words based on the first letter, needing to sound out the same words repeatedly, difficulty matching letters to sounds, as well as frequent spelling errors. All of these can affect a child’s ability to learn, which can affect confidence and enjoyment of learning.

Phonological awareness deficit affects a person’s ability to break down words into individual sounds, causing them to struggle with rhymes, words with similar sounds, and identifying syllables. This can lead to increased difficulty in reading, spelling, comprehension and using expressive language.

Dyslexia is a neurological disorder that can affect both children and adults and can affect a person’s ability to read or spell accurately, leading to difficulties in school and work. Dyslexia is often identified during childhood and is a lifelong condition. However, speech therapists can offer support to help individuals develop skills and manage symptoms so that they are able to reach their potential for learning or work. Sessions will often look at and develop skills in phonemic awareness, phonics, and reading.

Autism spectrum disorder (ASD) affects how a person understands and uses social communication, relates to others, and processes information like language and sensory input. There is a wide range of challenges and strengths that individuals with autism have, and no two individuals are the same.

Some children and adults with autism use spoken language, while others communicate mainly through gestures, behaviour, key word signs, picture systems, or other forms of alternative communication. Therapy aims to build on these strengths rather than replace them. Speech therapy sessions often involve

• developing functional communication (being able to ask for help, say no, make choices, and share interests),
• expanding vocabulary and sentence structure, and
• working on speech sounds or clarity.

Children with global developmental delay (GDD) may require extra time and support to develop skills like speech, movement, play, learning, and self-care. GDD is often identified during a child’s early stages of development, where the delay is noticeable for more than six months. Some children with GDD can often move towards the expected developmental milestones for their age, while some children may require ongoing therapy and support. Speech therapy can help identify delays in speech at an early stage and help children develop skills according to their specific needs.

Down syndrome is a genetic condition caused by an extra copy of chromosome 21, which is associated with a characteristic profile of strengths and challenges in communication. Children with down syndrome often have good social interest and a strong desire to connect with others, but may experience differences in hearing, oral‑motor skills, and language development that affect how clearly and easily they can communicate. They often possess stronger receptive language than expressive language. Through speech therapy, children benefit from visual supports, key word signs, or other augmentative strategies alongside spoken language to help them express themselves while their speech is still developing.

In speech therapy, support typically focuses on several areas:

• building early communication (such as joint attention, turn‑taking, and imitation);
• expanding vocabulary and sentence length;
• improving speech sound production and clarity; and
• supporting social communication skills across home, school, and community settings.

Motor planning, low muscle tone, and structural differences (for example, in the jaw, tongue, or palate) can also contribute to challenges in articulation, so therapy may also include targeted practice of specific sounds, syllable shapes, and word patterns in functional, play‑based activities.

Cerebral palsy is a condition that affects a person’s muscle tone, movement, coordination, and posture. The condition can affect the whole body or certain parts and is a lifelong condition. Cerebral palsy can also impact how a person eats, drinks, makes sounds, and speaks, caused by muscle stiffness, weakness, or poor coordination in the face. Therapy may involve breathing exercises, jaw and tongue exercises, practising specific sounds or using assistive communication devices.

A stroke occurs when the blood supply to the brain is suddenly interrupted or reduced, which can damage brain cells and can affect movement, sensation, thinking, communication or swallowing, depending on which parts are involved. Speech therapy after a stroke focuses on understanding which aspects of language, speech, and swallowing have been affected and supporting the person to communicate as effectively and safely as possible in everyday life. At our clinic we offer support in the following areas:

• aphasia (difficulties understanding or using language),
• apraxia of speech (difficulty planning and coordinating the movements needed for speech), and
• dysarthria (slurred or weak speech due to changes in muscle control).

Traumatic brain injury (TBI) happens during a sudden blow, jolt, or penetrating injury to the head, disrupting how the brain works. After a TBI, some people experience changes in attention, memory, and problem‑solving, as well as difficulties with understanding language, finding words, organising their thoughts, speaking clearly, or following conversations in busy or noisy environments. Social communication can also be affected, with difficulties around reading social cues, staying on topic, understanding humour or sarcasm, and judging what is appropriate to say in different situations. Our speech pathologist works with each client to assess areas such as language, speech clarity, social communication, and cognitive‑communication skills in order to provide support specific to each individual.

Dementia is a term used to describe a group of conditions that cause gradual changes in memory, thinking, and everyday functioning, beyond what is expected with typical ageing. As dementia progresses, people often experience changes in language and communication, such as finding it harder to think of the right word, naming familiar objects, or keeping track of what they want to say. They may repeat questions or stories, lose the thread of a conversation, or switch topics unexpectedly, especially when they are tired or in busy, noisy environments. Understanding what others say can also become more challenging, particularly when information is complex. Speech pathology looks to support individuals in these areas using a range of evidence-based techniques.

Parkinson’s disease is a progressive neurological condition that affects how the brain controls movement, leading to symptoms such as tremor, stiffness, slowed movements, and changes in facial expression and posture. These motor changes can also affect the muscles used for speaking and swallowing, causing a softer voice, reduced facial expression, a monotonous voice, and rushed or mumbled speech. In session, our focus is on helping clients communicate as clearly and confidently as possible in everyday situations and on supporting safe swallowing where needed.

Motor neurone disease is a group of progressive neurological conditions that affect the nerve cells responsible for sending signals from the brain and spinal cord to the muscles of the body. As these motor neurons deteriorate over time, muscles gradually weaken, which can affect thinking, emotions, movement, breathing, and the muscles used for speaking and swallowing. Our speech pathologists aim to work with clients and their families or caregivers on identifying the best strategies for them as well as learning to use alternative communication.

Vocal nodules and polyps are non‑cancerous growths that can form on the vocal folds, often as a result of ongoing voice strain or misuse. They can cause symptoms like hoarseness, a breathy voice, reduced pitch range, vocal fatigue, and a feeling of strain or discomfort when speaking or singing. During sessions, our speech pathologist will help clients through building habits and techniques that aim to improve vocal quality and comfort while reducing the load on the vocal folds so that swelling or lesions can stabilise and improve.

Muscle tension dysphonia is a voice disorder where excessive or imbalanced muscle activity in and around the voice box affects how the vocal folds vibrate, leading to a voice that may sound tight, strained, rough, weak, or easily fatigued. It can occur on its own or develop after an illness, vocal overuse, or another voice problem, and is often influenced by a mix of voice use patterns, posture, breathing, and psychological factors such as stress or anxiety. Sessions for muscle tension dysphonia focus on reducing unnecessary muscle tension and restoring more efficient, comfortable voice production.

Vocal fatigue occurs when the voice becomes tired, weak, or harder to use after talking or singing, especially over the course of the day or after heavy voice use. This is particularly common in professional voice users such as teachers, singers, fitness instructors, and call‑centre staff, whose voices are under high demand and may not get enough rest or support. Our aim is to help clients in reducing strain and improving the efficiency of voice production so that their voice can cope better with daily demands.

Stuttering is a speech disorder where the flow of speech is interrupted by repeating sounds or words, stretching sounds out, or having speech block where no sound comes out. It can vary from mild to severe and may become more noticeable in situations like talking on the phone or meeting new people. Speech pathology for adults focuses on helping clients learn techniques for smoother speech and build confidence when speaking.

After a stroke or other neurological injury, the parts of the brain and nervous system that control the muscles for chewing and swallowing can be affected, which may make eating and drinking slower, more effortful, or less safe. Our speech pathologist will work with clients to assess areas of concern and develop strategies and techniques to reduce any risks, such as

• choking on food or fluids, and/or
• infections from food or fluids entering the airway.

Age-related swallowing issues refer to changes in how older adults chew, move, and safely swallow food and fluids, which become more common as people age. Normal ageing can lead to

• reduced muscle strength and coordination in the tongue, throat, and voice box;
• changes in the structure and sensitivity of the swallowing tract;
• drier mouth and throat; and/or
• dental problems such as missing teeth or poorly fitting dentures.

            These changes can make swallowing more effortful, and they can increase the risk of choking or food entering the airway. Aside from normal age-related changes, swallowing issues can also stem from age-related conditions such as

• stroke,
• Parkinson’s disease,
• Alzheimer’s disease and dementia (Lewy body, frontotemporal),
• amyotrophic lateral sclerosis (ALS),
• myasthenia gravis,
• peripheral neuropathies, and
• cerebellar and brainstem disorders.

Head and neck cancers are cancers that develop in areas such as the mouth, tongue, throat, larynx, nose, sinuses, or salivary glands, and both the condition and its treatments (surgery, radiotherapy, chemotherapy) can significantly affect speaking, swallowing, and sometimes breathing. Speech pathology plays an important role in managing these difficulties and can support clients throughout their recover journey.

Accent reduction or accent modification in speech therapy focuses on helping individuals communicate more clearly and confidently, without viewing their original accent as defective. This includes practising recreating the desired accent to appear clearer during conversation.

Voice training for gender affirmation focuses on helping individuals develop their vocal pitch, resonance, intonation, and communication style. This is an important part of gender affirmation that helps individuals develop a voice that helps them feel comfortable, authentic and aligned with their identity.

Attention, memory, and problem‑solving skills can be affected after a brain injury (such as a stroke or traumatic brain injury) or as part of conditions like dementia, and these changes can have a big impact on day‑to‑day communication and independence. Individuals may experience difficulties in areas such as

• concentration,
• following conversations,
• memory,
• planning and organising, and
• social communication.

Speech therapy aims to support individuals through the use of evidence-based strategies and activities to utilise their strengths and maximise participation in everyday life.

Autism spectrum disorder (ASD) affects how a person understands and uses social communication, relates to others, and processes information like language and sensory input, where there is a wide range of challenges and strengths that individuals with autism have, and no two individuals are the same.

Some children and adults with autism use spoken language, while others communicate mainly through gestures, behaviour, key word signs, picture systems, or other forms of alternative communication. Therapy aims to build on these strengths rather than replace them. Speech therapy sessions often involve

• developing functional communication (being able to ask for help, say no, make choices, and share interests),
• expanding vocabulary and sentence structure, and
• working on speech sounds or clarity

Attention‑deficit-hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects how a person regulates attention, activity level, and impulses across different settings such as home, school, work, and social situations. People with ADHD may find it harder to sustain attention on tasks that are repetitive or not immediately interesting, may become easily distracted, or may struggle with organisation and time management. For some, ADHD also involves higher levels of physical restlessness and impulsivity, while others experience daydreaming, drifting off, or being slow to get started. Individuals with ADHD can also experience difficulties in communication, such as in

• social communication,
• language,
• dysfluency/stuttering, and
• voice disorders.

Our speech pathologist can help diagnose and manage communication difficulties and collaborate with clients and their family to develop evidence-based strategies to help clients achieve their goals.    

Intellectual disability (ID) is a lifelong neurodevelopmental condition characterised by differences in intellectual functioning (such as reasoning, problem‑solving, and learning) and adaptive skills (everyday practical, social, and communication skills). Individuals with an ID have the same feelings and rights as everyone else. Individuals can be born with ID or can acquire it later in life (e.g., in brain injuries, illnesses). Our speech pathologist will assess how clients understand and use language, how they interact socially, and what evidence-based supports they can use to develop a plan tailored to their needs. Throughout sessions, our speech pathologist will work alongside clients and their support network towards achieving meaningful goals such as building vocabulary and sentence skills, supporting social communication, and supporting the use of augmentative and alternative communication (AAC).