Secondary to:

  • Unknown etiology
  • Apraxia of speech
  • Dysarthria
  • Hearing loss
  • Cleft lip or palate
  • Craniofacial Disorders
  • Other


  • Refusal of age-appropriate foods and liquids
  • Aspiration/penetration of foods or liquids
  • Safe swallow techniques
  • Decreased cup and straw-drinking/coordination with swallowing
  • Decreased labial movement and strength (drooling/ food falling out of the mouth)
  • Poor oral intake
  • Babies/children with gastrostomy tubes (G-Tubes)
  • Coughing/ choking when eating or drinking

What do we treat? 

  • Oral phase impairments including:
    • Decreased bite strength/ inability to chew age-appropriate consistencies
    • Limited tongue mobility/strength
    • Increased oral transit time
    • Decreased suck strength/loud swallows
    • Low tone/ cheek strength

What do we treat:

  • Detection of sound
  • Discrimination
  • Identification
  • Comprehension
  • Following instructions
  • Understanding complex information
  • Conversational repair strategies


Secondary to:

  • Underlying medical conditions
  • Sensory issues
  • Syndromes
  • Developmental disabilities
  • Behavioral issues
  • Social-emotional factors
  • Structural abnormalities
  • Factors affecting neuromuscular conditions
    • Prematurity
    • Low birth weight
    • hypotonia
    • hypertonia


Secondary to:

  • Unknown etiology
  • Hearing loss
  • Autism
  • Cleft palate
  • Down syndrome
  • Chemotherapy
  • Seizure Disorder
  • Cerebrovascular accident
  • Cerebral Palsy

What do we treat? 

  • Use of a resonant voice
  • Proper vocal hygiene
  • Tension release for muscles surrounding the vocal folds
  • Breathing exercises for PVFD

Pediatric Therapy Center

Shenandoah SOUNDstart, LLC

Call Us:  +1.5405148486

What do we treat?

  • Use of age-appropriate speech sounds
  • Use of age-appropriate phonological skills
  • Factors impairing fluency/stuttering and working toward forward-moving speech 
  • Resonance disorders/ phoneme-specific nasal air emission
  • Discriminating between speech sounds




What do we treat?

  • Grammatical structures (e.g., verb endings, combining more words in sentences, use of pronouns, prepositions, adjectives)
  • Understanding of language (e.g., following instructions, choosing items when named, understanding complex information)
  • Poor vocabulary
  • Social-Pragmatic Language Impairments (e.g., understanding and using body language, picking up on social cues from others, responding appropriately to others in a conversation, turn-taking, topic maintenance). 

Secondary to: 

  • Congenital hearing loss
  • Acquired hearing loss
  • Sensorineural hearing loss
  • Conductive hearing loss
  • Mixed hearing loss
  • Other

Secondary to:

  • Vocal nodules
  • Status post polyp removal
  • Muscle tension dysphonia
  • Paradoxical Vocal Fold Dysfunction (PVFD)
  • Puberphonia
  • Other