Cultivating GROWTH in your child's speech and language development.
Abby Kraayeveld, M.A., CCC-SLP
Abby Kraayeveld holds her Certificate of Clinical Competence (CCC) from the American Speech Language and Hearing Association (ASHA) and is licensed by the Washington State Department of Health. She has been practicing for over 13 years with experience working in a variety of settings including schools, clinics, and hospitals.
Abby evaluates and provides treatment for toddlers, children, and adolescents with a variety of speech, language, and communication needs. She has a special interest and expertise in working with children with autism spectrum disorders, traumatic brain injury, stuttering, speech sound production disorders, language-based disorders, and selective mutism.
Abby has advanced training, provides evidenced-based treatment, and prioritizes child-
centered intervention that involves parent/family education and training.
Abby's professional experience includes providing pediatric outpatient therapy services at Legacy Salmon Creek Children's Center, serving on the Oregon Traumatic Brain Injury team, working in public school systems providing direct therapy services, providing rehabilitative therapy to adults in an inpatient hospital program, and consulting for a public school district. Abby is also PROMPT trained.
Abby enjoys spending time with her family including her two young children and husband, as well as running, cycling, cooking, reading, and traveling.
Speech Sound Disorders
Speech production is quite a complex process that involves planning and coordinating the articulators (i.e., tongue, teeth, lips, jaw, palate) to form a sound or word. Correct movement and organization produces clear speech, or intelligibility. Errors in speech production are referred to as articulation errors. When a child produces articulation errors beyond a developmentally appropriate age speech therapy may be appropriate.
Patterns of speech sound errors that typically developing children use to simplify their speech as they are learning to talk are called phonological processes. However, as a child’s speech develops these phonological processes are naturally eliminated. When a child continues to demonstrate patterns of error or phonological errors in his/her speech beyond a developmentally appropriate age speech therapy may be appropriate.
A Speech-Language Pathologist can teach the child how to move his/her articulators to correctly produce the target sound or target the phonological processes as an error pattern to improve overall speech intelligibility.
Social Communication Disorder
& Autism Spectrum Disorder
Social communication refers to the way in which we use language in social contexts. Social communication skills include varying ones speaking style, taking the perspective of others, following rules for conversation exchanges, and understanding nonliteral or ambiguous language. A social communication disorder is characterized by difficulties with understanding and using verbal and nonverbal communication rules appropriately. A social communication disorder can impact a child’s ability to participate in social settings appropriately, develop positive peer relationships, and achieving academic success.
Children with autism have difficulties with communication and social interaction skills, including engaging in conversations and understanding social cues. Autism ranges on a spectrum from mild to severe. Some children with autism may be nonverbal while others may talk very well. Children with autism may have a restricted interest or repetitive behavior, including hyper-focus on one topic or toy/activity, and may not handle change in their schedule or transitions between activities well. A child with autism may demonstrate difficulty with sharing in and engaging in shared attention, joining in play with others, understanding how others feel, and taking turns in play or conversation.
A Speech-Language Pathologist can evaluate a child’s receptive, expressive, and pragmatic (social) language or communication skills as a member of an evaluation team. However, the Speech-Language Pathologist does not diagnose a child with Autism Spectrum Disorder. A Speech-Language Pathologist does provide therapy services targeting communication and social skills across settings.
Fluency refers to the smoothness, rate, and effort associated with speech production. All speakers experience disfluencies at times, including hesitations, interjections or fillers, repetitions of words or phrases, and revisions. These are generally considered typical disfluencies (non-stuttered).
Less typical, however, is a fluency disorder called stuttering. Stuttering is an interruption in the flow of a person’s verbal message. It may be characterized by repetitions (of sounds, syllables, words, and/or phrases), prolongations (of sounds), blocks (i.e., inability to initiate sounds), and/or revisions. These disfluencies affect the rate and rhythm of a person’s spoken message, and may be accompanied by physical tension and struggle.
A Speech-Language Pathologist plays a critical role in assessment and treatment of fluency disorders in children.
Traumatic Brain Injury & Executive Functioning
Traumatic Brain Injury (TBI) causes damage to the brain that can affect a child’s speech, language, and thinking skills. A TBI can affect a child’s performance in school, as well as in everyday activities. The brain controls all that a person does, so a TBI can impact many areas of function depending on what part of the brain was injured and how severely the brain was injured. The problems a child may experience following a traumatic brain injury may include physical, sensory, behavior, thinking, reasoning, attention, speech, language, social communication, or swallowing problems.
The brain injury itself is treated by medical professionals, but a Speech-Language Pathologist can provide treatment targeting skill deficits that result from the TBI. A Speech-Language Pathologist can work on the following targets improving: speech clarity, expressive language, receptive understanding of spoken language and/or written language, attention, memory, problem-solving and organizational skills, as well as social skills. Therapy may be impairment-based in which the Speech-Language Pathologist is working on rebuilding or rehabilitating lost skills, or it may be activity or participation-based in which strategies are employed to help support an individual in the execution or involvement in a daily task.
Children start communicating and expressing themselves long before he/she says their first word. Children develop at their own rate, but most children who speak only one language reach developmental milestones within defined age ranges. Reaching a milestone outside of these typical age ranges does not necessarily mean your child has a language delay or disorder.
However, some children do have difficulties understanding language (e.g., following directions, answering questions, pointing to named objects and pictures, understanding gestures) and may be diagnosed with a receptive language disorder. Some children have difficulties talking or expressing themselves (e.g., asking questions, naming/labeling objects, putting words together into sentences, using correct pronouns, starting conversations) and may be diagnosed with an expressive language disorder. Some children may demonstrate both a receptive and an expressive language disorder.
A Speech-Language Pathologist can work with your child to improve his/her understanding and speaking. Language skills help your child learn, follow directions, express his/her needs and thoughts, make friends, and feel positive about himself/herself.
Some children are shy or don’t like to talk to people they don’t know, but they usually start talking once they feel comfortable. However, some children won’t talk at certain times, no matter what. Selective mutism is a complex childhood anxiety disorder. A child’s ability to speak in select social settings, such as school, is impacted. A child’s pattern of mutism can vary, insomuch that the child selects the situations and people with whom they verbally communicate. Not speaking to others gets in the way of school, social situations, and friendships.
A Speech-Language Pathologist can evaluate your child’s speech and language skills and collaborate with your child’s pediatrician and behavioral health professional (psychologist or psychiatrist), as well classroom teacher and family. This collaboration and communication about assessment, treatment planning and implementation is important and necessary because of the nature of selective mutism. A Speech-Language Pathologist does not diagnose selective mutism but can work closely with the child’s team of professionals and family to coordinate efforts.
Note that the service areas listed above are not an exhaustive list of therapeutic areas addressed at Grassroots Therapy Solutions.