The following provides a brief overview of the types of communication disorders treated by Ellen Golden, M.S., C.C.C., SLP



A child’s speech is expected to be intelligible by the time they are 48 months. A speech disorder can be an articulation disorder, phonological disorder, apraxia of speech, voice disorder or fluency disorder. Early treatment for beginning and later developing sounds is more effective.

Articulation Disorder

If your child has a speech/articulation disorder, s/he has difficulty coordinating the movements of the lips, tongue, soft palate, teeth, and jaw to produce sounds. S/He may substitute /f/ for [th] or have a lisp and distort /s/ and /z/ sounds.

Phonological Disorder

Children who have a phonological disorder have not learned the rules or patterns of speech sounds. A child may mispronounce sounds in some words but not in others (e.g., they may say “du” for “duck” and omit the final /k/ sounds in words, but they can say the /k/ in the beginning of words as in “key”). Phonological disorders are seen as a language-based disorder. Children with phonology disorders are at high risk for reading and learning disabilities.


Apraxia of speech is a neurological disorder which affects a child’s ability to plan, sequence, transmit and execute oral speech movements from the brain to their mouths. The child may exhibit groping when attempting to say a difficult word or phrase.

Voice Disorder

Voice disorders involve pathologic laryngeal conditions, including inflammation of the vocal folds, chronic laryngitis, vocal nodules, vocal polyps and contact ulcers, all of which can be identified by an Ear, Nose and Throat doctor. These conditions, usually caused by vocal abuse, are normally reversible with the elimination of laryngeal overuse and tension, along with a program of vocal hygiene. Shouting is the primary way in which children or adults abuse their voices. Typically, children yell from room to room in the house and scream to each other on the playground. At times, they make funny noises or imitations of character voices. Children or adults who are excessive talkers may experience inadequate breath supply and support, causing them to push down harder on the vocal folds to complete lengthy utterances. All of these behaviors ”shouting, screaming, yelling, excessive talking” are used by children to get the attention of playmates, siblings, parents and teachers. However, these behaviors can result in serious vocal abuse problems.

LVST LOUD for Parkinson Disease

This is the first speech treatment with Level 1 evidence and established efficacy that improves the voice and speech of individuals with Parkinson Disease and other Neurological Disorders.  Treatment focuses on improving vocal loudness and immediate carryover into daily communication enabling patients to maintain and/or improve their oral communication. The LVST LOUD is administered on an intensive schedule of 16 individual, 60 minute sessions in one month's time.  90% of patients improve vocal loudness from pre to post-treatment.  More than 15 years of research funded by the National Institute of Health (NIH) has documented that LSVT LOUD Parkinson-specific speech therapy is effective.


Stuttering or dysfluency runs in families. As a result, researchers are inclined say that stuttering has genetic roots. There is a period of normal dysfluency which occur in some preschoolers and is simultaneous with the acquisition of language. Stuttering disappears as the child develops greater language competency. True stuttering occurs when a child becomes aware of his dysfluency and attempts to manage or hide it. People who stutter lack the coordination of time sequences and movement. Some common characteristics of stuttered speech may include repetitions, hesitations, or prolonged sustained speech sounds at the beginning of words or within words. There may be struggle or tension shown by excessive movement of the facial muscles. Emotional reactions that are learned can be unlearned. Techniques can be learned to reduce stuttering and make speech more manageable.

Myofunctional Therapy

A tongue thrust is a reverse swallow in which the tongue pushes forward against the front teeth upon swallowing. The tongue is a strong muscle. As the tongue moves in a forward motion it pushes against the front teeth and can create an open bite. Myofunctional therapy is necessary to teach the child or adult to swallow correctly.

Accent Reduction

Are you often asked to repeat yourself? Are you having difficulty advancing in your job because of your English pronunciation? Are people missing your message due to substituted, added or omitted sounds or incorrect grammar? Are you too shy or embarrassed to use English? If your accent interferes with your communication then you are a candidate for Accent Reduction.


Processing Disorders

Language Processing

Children with difficulties in language processing might have slow development of vocabulary concepts. They often have delayed receptive and/or expressive language development. Articulation and phonological development may be delayed. Immature grammar with persistent error patterns are demonstrated in their sentence structure. Sentences or thoughts are incomplete. Understanding and using Wh- questions are slow in development. Short term memory may be ineffective. Word retrieval problems may be significant. Children use fillers “uh” to buy time or frequently answer “I don’t know”, “what” or “I forgot”. The Development of social language skills is slow. There is a poor awareness of conversational rules. Learning is inconsistent and extensive review of previously learned material is required.

Auditory Processing Disorder

The term Central Auditory Processing (CAPD) can be defined as the ability to receive and integrate auditory information. I f your child has an Auditory Processing disorder they have normal pure-tone hearing. They may have a history of ear infections and have difficulty hearing with background noise or localizing sound. Your child may request repetitions and often ask “huh?’ or “what?’ Your child may fatigue easily and have a short auditory attention span. Following auditory directions may be difficult. Children have academic deficits (phonics, reading, spelling). CAPD is a sensory processing deficit that commonly affects listening, spoken language comprehension, and learning.

Learning Disabilities

Most learning disabilities are a result of processing deficits that interfere with the child’s verbal expression and language comprehension. Approximately, eighty percent of learning disabilities are found in children who have language processing disorders. These children have difficulty attaching meaning to an auditory stimulus even if the signal is received intactly. Children may lack the skills required for one or more of the following: Listening, speaking, reading, written expression, spelling, writing legibly, putting things in sequence, reasoning/problem solving, and mathematical ability.. Children with reading comprehension or written expression have difficulties using language to communicate. They lack verbal reasoning and problem solving skills necessary to make inferences, associations. summarize, paraphrase, see cause and effect relationships or make predictions. A learning disability is not a problem of intelligence. A child or adult with a learning disability cannot try harder, pay more attention, or improve motivation on their own. They need skills and help to learn how to do these things.

Attention Deficit Disorder

Although it is not considered a learning disability, ADD – Attention Deficit Disorder (ADD) can disrupt learning. Children, teenagers, and adults with ADD. often have problems staying focused, following instructions, sitting still, staying organized, and completing work. They may be hyperactive or hypoactive. Years of academic failure may have resulted in low self esteem, poor social skills, and low self esteem.


If you or your child has one of the issues or a combination of deficits please make an appointment for an initial assessment with Ellen Golden, M.S., C.C.C.