Speech and Language Services

• Seattle Children’s speech-language pathologists (SLPs) work with a wide range of children, including those who are bilingual or have a tracheotomy, brain injury or other complex medical needs.
• Our experts specialize in fluency, augmentative and alternative communication, autism, selective mutism and other conditions.
• When you call for an evaluation, we ask for details about your child and any test results or therapy records you have on your child. Then we will review the information and schedule you with an SLP who specializes in your child’s concern.
• For concerns about swallowing, we offer in-depth evaluation and a videofluoroscopic swallowing study. This test is done by an expert with special equipment that is not available in many places.

• To assess your child’s condition, our SLPs work closely with experts in many areas of Seattle Children’s, including Neurodevelopmental, Pulmonary and Sleep Medicine, the Craniofacial Center, the Autism Center, Otolaryngology, Audiology and the Childhood Communication Center.
• We work with providers caring for your child in our clinics, as well as inpatient teams if your child needs to stay in the hospital for care.
• We also team up with others in the community to improve speech and language services for all children. We provide education for medical providers, give lectures for other SLPs and train school teachers on communication disorders. In the summer, we partner with the UW Speech and Hearing Clinic to offer a 5-day workshop for teens who stutter.

• After your child’s evaluation, our experts connect you and your child with services in the community and at your child’s school.
• If your child needs therapy with an SLP, we can help you find one in your community. We will share with them the treatment we recommend for your child. Your Seattle Children’s SLP may call the therapy office or school to discuss what we found and what we recommend.
• We also see families who already have an SLP in the community but need a specialized evaluation. Our team connects with your community SLP to share information and recommend an approach for helping your child.

Articulation and phonology disorders affect the way a child pronounces certain sounds. They have to do with errors making individual vowel or consonant sounds (articulation disorders) and overall patterns of errors in speaking (phonological disorders).

Autism can affect the way a child behaves, thinks, communicates and interacts with others. We work with providers from the Autism Center to evaluate children with social communication disorders, including autism. Read more.

Cognitive-communication disorders involve problems with thinking processes that affect communication, such as memory, reasoning and problem solving.

Speech-language pathologists evaluate and treat problems with eating, drinking and swallowing. We provide feeding and swallowing evaluations (described below) if there are concerns about your child being able to eat and drink safely, without food or liquids going into their lungs when they swallow (aspirating).

A fluency disorder means there’s a problem with the natural flow of speech. Children with fluency disorders may stutter or stammer when they speak.

Children with motor speech disorders have problems moving their mouth for speech. Causes may include weakness of the muscles used for speech (dysarthria) or difficulty coordinating the muscle movements needed for speech (apraxia).

In this condition, the vocal cords close and limit breathing during activities such as exercise.

Speech and language disorders affect not only a child’s ability to talk, but also reading, writing and comprehension.

Children with language disorders have trouble understanding spoken and written language (receptive language disorders) or using language to communicate their ideas and questions (expressive language disorders). Some children have trouble both understanding and using language.

Velopharyngeal dysfunction (VPD) means air escapes out a child’s nose during speech. This may make it hard for the child to pronounce certain sounds. Many children with VPD also have cleft palate. Some have other differences in the structure of their face or skull. Read more about VPD and how we evaluate it (PDF).

Selective mutism is an anxiety disorder where children do not speak in certain settings or with certain people despite speaking in other settings.

This refers to any problem that profoundly impairs the ability to communicate with words (verbally). Often children with severe communication impairment have another condition, such as Down syndrome, cerebral palsy or another developmental delay. Augmentative and alternative communication (described below) may help your child.

Children with voice disorders may sound hoarse, breathy or more high pitched or low pitched than usual, or they may have lost their voices.

We do a detailed evaluation to understand your child’s condition and any forms of treatment that may help.

Your child will see a speech-language pathologist who has extensive training in the specific concerns that apply to your child. Depending on your child’s needs, we might arrange for your child to see providers from other Seattle Children’s clinics.

After the evaluation, we provide you with resources, such as: 

• A report to share with your child’s doctor and their speech-language pathologist (if they already have one at school or in the community) about what we found and what we recommend
• Activities or strategies you can use at home to improve your child’s communication or swallowing
• Aids like picture boards to help your child express themselves
• Recommendations about where to get therapy in the community based on your family’s needs, including your child’s condition and where you live 

At our South Clinic in Federal Way and our North Clinic in Everett, we can provide short-term outpatient speech-language therapy. If your child is also seeing physical or occupational therapists at the regional clinics, we work with them to make sure your child gets complete, coordinated care.

If your child is in the hospital, we work with other members of your child’s inpatient medical team to treat communication, feeding and swallowing disorders.

If your child is medically ready to leave the hospital but still needs speech and language services not available in the community, we can help with the transition. Our speech-language pathologists provide intensive therapy to help your child and family prepare to work with community or school-based speech-language pathologists.

AAC is all forms of communication except speech. For example, AAC can include facial expressions, gestures, drawings or writing. AAC aids, such as picture boards or electronic devices, can help children with serious speech or language problems express themselves. Read more about our AAC Program and frequent questions about AAC (PDF).

To understand your child’s swallowing and feeding, we often do a clinical swallowing evaluation (CSE). Your child will see a speech-language pathologist who is an expert in feeding and swallowing to tell whether your child has trouble swallowing (dysphagia).

The speech-language pathologist will: 

• Watch how your child chews and manages food in their mouth.
• Look for signs that your child is at risk of getting food or liquid in their lungs when they swallow. This is called aspirating.
• Recommend next steps, such as having more tests, trying thickeners (gel or powder you add to liquids to make them easier for your child to swallow) or having other treatment. 

Based on the results of the evaluation, your child might need a videofluoroscopic swallowing study (VFSS), also known as a modified barium swallow study. We will take an X-ray movie of your child’s mouth and throat while they eat and drink. Right after the test, we will explain what we found and what your child might need next. Your child may benefit from a Fiberoptic Endoscopic Evaluation of Swallowing (FEES).

We do these studies for children with a range of feeding and swallowing concerns, including children seen in the Pediatric Feeding Program.

Read more about: 

• Clinical feeding and swallowing evaluation (PDF) (Spanish)
• VFSS (PDF) (Russian) (Spanish)
• FEES (PDF) (Spanish)