Speech Disorders, Language Disorders, and Feeding Disorders
A speech disorder refers to a problem with the actual production of sounds. A language disorder refers to a problem understanding or putting words together to communicate ideas.

Speech disorders include:

Articulation disorders: difficulties producing sounds in syllables or saying words incorrectly to the point that listeners can't understand what's being said.
Fluency disorders: problems such as stuttering, in which the flow of speech is interrupted by abnormal stoppages, partial-word repetitions ("b-b-boy"), or prolonging sounds and syllables (sssssnake).
Resonance or voice disorders: problems with the pitch, volume, or quality of the voice that distract listeners from what's being said. These types of disorders may also cause pain or discomfort for a child when speaking.

Language disorders can be either receptive or expressive:

• Receptive disorders: difficulties understanding or processing language.
• Expressive disorders: difficulty putting words together, limited vocabulary, or inability to use language in a socially appropriate way.
• Cognitive-communication disorders: difficulty with communication skills that involve memory, attention, perception, organization, regulation, and problem solving.
• Dysphagia/oral feeding disorders are disorders in the way someone eats or drinks, including problems with chewing, swallowing, coughing, gagging, and refusing foods.

Remediation

In speech-language therapy, an SLP (Speech-language pathologists) will work with a child one-on-one, in a small group, or directly in a classroom to overcome difficulties involved with a specific disorder.

Therapists use a variety of strategies, including:

• Language intervention activities:
• The SLP will interact with a child by playing and talking, using pictures, books, objects, or ongoing events to stimulate language development. The therapist may also model correct vocabulary and grammar and use repetition exercises to build language skills.
• Articulation therapy: 
  Articulation, or sound production, exercises involve having the therapist model correct sounds and syllables in words and sentences for a child, often during play activities. The level of play is age-appropriate and related to the child's specific needs. The SLP will physically show the child how to make certain sounds, such as the "r" sound, and may demonstrate how to move the tongue to produce specific sounds.
• Oral-motor/feeding and swallowing therapy: 
  The SLP may use a variety of oral exercises — including facial massage and various tongue, lip, and jaw exercises — to strengthen the muscles of the mouth for eating, drinking, and swallowing. The SLP may also introduce different food textures and temperatures to increase a child's oral awareness during eating and swallowing.

When Is Therapy Needed?

Kids might need speech-language therapy for a variety of reasons, including, but not limited to:

• hearing impairments
• cognitive (intellectual, thinking) or other developmental delays
• weak oral muscles
• chronic hoarseness
• birth defects such as cleft lip or cleft palate
• autism
• motor planning problems
• articulation problems
• fluency disorders
• respiratory problems (breathing disorders)
• feeding and swallowing disorders
• traumatic brain injury

Therapy should begin as soon as possible. Children enrolled in therapy early (before they're 5 years old) tend to have better outcomes than those who begin therapy later.
This does not mean that older kids can't make progress in therapy; they may progress at a slower rate because they often have learned patterns that need to be changed.

Helping Your Child

Speech-language experts agree that parental involvement is crucial to the success of a child's progress in speech or language therapy.

Parents are an extremely important part of their child's therapy program and help determine whether it is a success. Kids who complete the program quickest and with the longest-lasting results are those whose parents have been involved.
Ask our therapist for suggestions on how you can help your child. For instance, it's important to help your child do the at-home stimulation activities that the SLP suggests to ensure continued progress and carry-over of newly learned skills.

The process of overcoming a speech or language disorder can take some time and effort, so it's important that all family members be patient and understanding with the child.

What is DIR®?

DIR is the Developmental, Individual-differences, & Relationship-based model (pronounced saying each letter as an initialism: D.I.R.).  It was developed by Dr. Stanley Greenspan to provide a foundational framework for understanding human development.  It explains the critical role of social-emotional development starting at birth and continuing throughout the lifespan.  It also provides a framework for understanding how each person individually perceives and interacts with the world differently.  The model highlights the power of relationships and emotional connections to fuel development.  Through a deep understanding of the "D" and the "I" we can use the "R" to promote healthy development and to help every child and person reach their fullest potential. 

DIR® is rooted in the science of human development and can sound very technical at times.  However, it is also very simple.  It is a pathway to promote healthy development in a respectful manner that builds connections, understanding, love, communication, and engagement. 

DIRFloortime® (Floortime) is the application of the DIR model into practice. 

While the DIR model helps us understand and promote the positive development of all children, DIR and DIRFloortime are most commonly utilized with children with educational, social-emotional, mental health, and/or developmental challenges.  DIRFloortime has become most widely known as an approach to support children with with Autism Spectrum Disorders (ASD).  You can read more about DIR and ASD in many books including "Engaging Autism" and "The Child with Special Needs" by Drs Greenspan and Wieder. 

The objectives of the DIR® Model are to build healthy foundations for social, emotional, and intellectual capacities rather than focusing exclusively on skills and isolated behaviors. 
The “D” describes development from the perspective of the individual, where they are and where they are headed. Understanding the unique developmental process means allowing space for each person to be respected and guided in his or her own personal developmental journey.
The "I" describes the unique ways each person takes in, regulates, responds to, and comprehends the world around them.  
The “R” describes how relationships fuel our development.  Humans are social beings and relationships are a key to our human development.  DIR harnesses the key affective (emotional) aspect of these relationships to promote development.  
Understanding DIR can help us promote healthy development in all children, but it is especially powerful in helping children on the autism spectrum or with other developmental or emotional challenges

ABA therapy is effective for a variety of conditions related to autism

The autism therapists at ITTA Center provide customized therapy for individuals with autism and related disorders in Tirana and Durres in Albania. 
Getting the right diagnosis can assist in achieving the most progress.

When parents or support providers become concerned that their child is not following a typical developmental course, they turn to experts, including psychologists, educators and medical professionals, for a diagnosis.
At first glance, some people with autism may appear to have an intellectual disability, sensory processing issues, or problems with hearing or vision. To complicate matters further, these conditions can co-occur with autism. However, it is important to distinguish autism from other conditions, as an accurate and early autism diagnosis can provide the basis for an appropriate educational and treatment program.

Other medical conditions or syndromes, such as sensory processing disorder, can present symptoms that are confusingly similar to autism’s. This is known as differential diagnosis.
There are many differences between a medical diagnosis and an educational determination, or school evaluation, of a disability. A medical diagnosis is made by a physician based on an assessment of symptoms and diagnostic tests. A medical diagnosis of autism spectrum disorder, for instance, is most frequently made by a physician according to the Diagnostic and Statistical Manual (DSM-5, released 2013) of the American Psychological Association. This manual guides physicians in diagnosing autism spectrum disorder according to a specific number of symptoms.

A brief observation in a single setting cannot present a true picture of someone’s abilities and behaviors. The person’s developmental history and input from parents, caregivers and/or teachers are important components of an accurate diagnosis.

An educational determination is made by a multidisciplinary evaluation team of various school professionals. The evaluation results are reviewed by a team of qualified professionals and the parents to determine whether a student qualifies for special education and related services under the Individuals with Disabilities Education Act (IDEA) (Hawkins, 2009).