Speech-Language Pathology for Children

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Duke’s pediatric speech-language pathologists work closely with children from birth through adolescence who have communication disorders and swallowing disorders. We have expertise in diagnosing uncommon conditions and needs that may be unfamiliar to community or school-based speech pathologists. Our goal is to provide each child with a unique plan that supports growth and development and can be incorporated into their daily life. We are committed to helping your child thrive.

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How We Can Help

Our pediatric speech-language pathologists have a family-centered approach to care, meaning we value your input and consider your family’s needs. We collaborate with pediatricians and other specialists as necessary to treat a wide range of challenges. Speech-language pathologists, also called speech therapists, are specially trained to diagnose and treat problems with:


How we produce and combine sounds and words. Because there are many types of speech difficulties -- including speech delays, childhood apraxia of speech, articulation/phonology, dysarthria, velopharyngeal dysfunction, velopharyngeal insufficiency, hypernasality, and resonance disorders -- it is important to determine which specific issue(s) a child has so we can provide therapies that will help the most. Difficulties can be related to a developmental delay, cleft palate, hearing loss, tracheostomy, or Down syndrome, among other conditions. 


How we process and understand what we hear when others are talking and how we communicate what we are thinking and feeling. Children with language difficulties are sometimes said to have a developmental delay or be a late talker. These children may have associated hearing loss or an auditory processing disorder

In addition to approaches aimed at improving language skills, we also offer augmentative and alternative communication options like speech-generating devices, apps that facilitate communication, manual signs, picture symbol books, and more. 

We have a number of bilingual Spanish-English speech-language pathologists on staff as well as interpreters who can work with your child in their primary language.

Cognitive Communication

How the brain combines thinking and communicating. Areas of memory, attention, planning, problem-solving, or organization can be affected. Challenges with cognitive communication can be related to many disorders. Rarely, these problems can be linked to traumatic brain injury, concussion, or other neurological issues.

Social Communication

How we interact with other people by understanding and applying social rules. This is also called pragmatics. It can be associated with autism spectrum disorder, Down syndrome, and other conditions.

Feeding and Swallowing

The ability to eat and drink safely and appropriately. Feeding and swallowing difficulties are also known as dysphagia. Therapy approaches include sensory-, motor-, and behavioral-based options. We address the individual needs of your child and family to make the best recommendations for you.


How speech flows. Problems with fluency are often called stuttering. Sometimes these issues resolve on their own in young children, and other times they require therapy. 


How we read and write. Speech and language difficulties can contribute to problems with reading, spelling, and writing.

Specialty Treatments

Duke’s speech-language pathologists also provide specialty treatments, including:

  • Augmentative and alternative communication
  • Respiratory muscle training
  • Speaking valves to support voice production in children with tracheostomies
  • Speech therapy for children with hearing loss and hearing disorders
  • Social groups for children who have trouble with the social aspects of language, to help them learn and practice skills with peers
  • Therapy for velopharyngeal dysfunction (when air leaks into the nasal passages and causes nasal-sounding, difficult-to-understand speech)

Speech-Language Evaluation

Your child’s initial speech-language pathology appointment will be focused on interviewing and testing. To start, the speech therapist will spend time listening to you -- the caregiver. We’ll ask about your child’s medical and developmental history. We will also address your questions and concerns and discuss goals for your child. This allows time for your child to become more comfortable in the environment and with the speech therapist, and the information you share will help guide the evaluation. 

Next, we’ll spend some time observing and interacting with your child. We’ll evaluate your child’s strengths and needs using carefully chosen, up-to-date, and evidence-based tools and measures.

Finally, the speech-language pathologist will talk with you about next steps, additional testing, and treatment plans. Altogether, this appointment lasts about 60 to 90 minutes.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Additional Testing

Additional tests your child’s speech-language pathologist may request include:

A thin, flexible tube with a camera on the end (called a nasopharyngoscope) is inserted through your child’s nose to the back of the throat. This helps the provider see how parts of the mouth move during speech. 

Your child wears a headset equipped with microphones and is asked to read or repeat phrases. The audio is recorded and analyzed by a computer program. This test measures the velopharyngeal opening, which connects the oral and nasal air passageways. 

Respiratory Pressure Manometry
Your child is asked to exhale and inhale into a device to help the speech therapist understand their respiratory strength for speech and/or swallowing and to direct therapy recommendations.

Swallowing Tests
Our specialists use tests like videofluoroscopic swallow studies and fiberoptic endoscopic evaluation of swallowing to diagnose swallowing disorders.

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Why Choose Duke

A Team Approach
Our team of speech-language pathologists is large and part of a renowned health care organization. This gives us access to the most recent advances in the field of speech pathology. We collaborate with you, other members of your child’s care team, and schools to provide the best-possible care.

Advanced Technology
We use sophisticated instruments, equipment, computer software systems, and other tools to diagnose and treat your child’s communication or swallowing disorder. This technology can provide specific information about the type and severity of your child’s impairment and can lead to a more precise diagnosis and treatment plan.

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 10 pediatric specialties.

This page was medically reviewed on 04/03/2023 by