Language Services for Kids with Heart Defects

Speech and Language Pathologists (SLPs) are experts in how people learn to speak, use, and understand language.   

SLPs can help children with skills such as: 

• pronouncing sounds and words clearly

• understanding and using more words

• understanding and using many different kinds of sentences

• using their voice loudly and clearly

• using gestures and tools to communicate

• having a conversation

• understanding the social norms of interactions and conversation

• telling and understanding a story 

• understanding directions

• understanding nonliteral language

Pediatric Speech and Language Pathologists work in many settings.  They work in: 

• Schools 

• Hospitals 

• Clinics 

Children with a heart defect often qualify for free Speech and Language Therapy through their school district.  Families can call their local school district and ask for a Special Education Eligibility Evaluation for their child.   If a child already receives Special Education and a family worries about their language, they can request a speech and language evaluation.

When a child has a heart defect and language problems, medical insurance will often pay for Speech and Language Therapy.  Families can talk with their doctors about options for Speech and Language services in their area.   

Children with language problems can often get services and accommodations from their school through either Special Education or a 504 Plan. Public school services and accommodations are free to qualifying families. 

Special Education services for language skills could be:

• Individual classes with a Speech/Language Pathologist

• Classes with a Speech/Language Pathologist and a group of kids

• Conversation groups

• Supervised lunches

• An aide to help in class

• An augmentative communication evaluation, to figure out tools that can help the child communicate

• Regular meetings between the Speech/Language Pathologist and the classroom teacher

Accommodations are changes to how a child is taught.  Special Education accommodations for language could be:

• All assignments in both writing and speech

• An outline of every lesson

• Lessons or books that use shorter sentences

• Extra time to answer questions

• An FM system (special speaker) to make speech easier to hear and focus on

• The teacher checking for understanding

• Using an electronic device to communicate (augmentative communication device)

• Using illustrated cards to communicate

Some children with a heart defect have trouble using spoken language to communicate.   

It may be hard for them to: 

• Make sounds 

• Say words 

• Use their voice 

• Remember words 

• Form sentences 

Augmentative and Alternative Communication (AAC) includes tools and strategies that children can use to communicate in many ways. 

AAC can help children to: 

• Say what they want and need 

• Share their ideas 

• Feel heard and validated 

• Have conversations 

• Build relationships with others 

• Develop speech 

• Write

There are many different kinds of AAC, and new tools are being developed all the time.  

AAC for children can include: 

• Communication boards with pictures 

• Spelling words by pointing to letters

• Drawing or writing

• Devices that speak when a picture is chosen

• Devices that speak when words are chosen

• Devices that speak when a person types

• Typing words and sentences

• Gestures and facial expressions 

Some children only use AAC. Other children use AAC plus speech or sign language.  

When a child has a lot of trouble using either spoken language or sign language, families might be recommended. 

AAC Specialists are usually Speech and Language Pathologists with extra training. They work in many settings: 

• Hospitals 

• School systems 

• Private clinics 

• Early Intervention (EI) 

When a child needs AAC, the first step is to get an AAC Evaluation, typically by a speech-language pathologist. Depending on a child’s situation, families have a few choices for finding an AAC Evaluation: 

• When a child is inpatient at a hospital, SLPs can often help young children explore and use AAC. 

  • This kind of evaluation is usually covered by medical insurance 

  • Inpatient SLP services may focus on short-term or longer-term AAC solutions   

• Many hospitals and Speech-Language Pathology clinics offer AAC evaluations 

  • This kind of evaluation is often covered by medical insurance or Medicaid 

• School districts offer AAC evaluations to children

  • This kind of evaluation is free to families as long as parents request it as part of a Special Education evaluation 

Families should talk with their doctor about the best way to get a good AAC evaluation in their area. 

After the evaluation, the AAC specialist will recommend the best tools and strategies for the child.  Families should talk with the evaluator about how to teach their child, family, and teachers to use the tools. 

Applied Behavior Analysis (ABA) is a way of understanding people’s actions, and teaching people new skills.  ABA can help some children with a heart defect to communicate. ABA is most effective for language development when it is offered in addition to Speech and Language Therapy. 

 ABA is provided by a Board-Certified Behavior Analyst (BCBA), or an ABA technician.   

ABA providers often use a combination of language and other types of communication, such as pictures and gestures. 

ABA treats language as a “function.”  This means that ABA providers look at how children use language to accomplish goals.  ABA providers help children to communicate their wants, needs, and ideas more effectively.   

ABA is most often used with children who have Autism Spectrum Disorder (ASD), but it can also be very helpful for children who have delays in thinking and learning.   

In almost all US states, children with Autism Spectrum Disorder (ASD) can receive free home-based ABA through their medical insurance. When a child has an ASD diagnosis, families can talk with their doctors or insurance to set up this program. 

Many children can qualify for free ABA through their school district.  Families can request a Special Education evaluation by contacting their local school district. 

Some families choose to pay privately for ABA.  They may make this choice because: 

• Their child does not qualify for free ABA (usually because they do not have an ASD diagnosis) 

• They want to add more ABA 

• They prefer a private provider 

Families can learn more about ABA providers in their community by asking their doctor. 

When children have a language problem, they require intervention in order to continue making progress. In many cases, intervention can allow children to catch up to their peers, or can prevent them from falling farther behind their peers. In some cases, kids are not able to catch up, but intervention allows them to develop skills as well and as quickly as possible.

Families and providers should not "wait and see" if a child has a language delay or disorder. Intervention is most effective when it is early and intensive.

This content was reviewed by a Speech and Language Pathologist at Boston Children's Hospital.

Families local to Boston can reach out to Speech and Language Pathology and/or the Cardiac Neurodevelopmental Program for questions about language development.