Language Services for Teens with Heart Defects

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

SLPs can help people 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

• understanding what they read

Kids 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 student is taught.  Modifications are changes in what a student is taught. Special Education accommodations or modifications for language could be:

• All assignments in both writing and speech

• An outline of every lesson

• Lessons or books that use shorter sentences or a simpler vocabulary

• 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

Sometimes, students do not qualify for Special Education, but do qualify for a 504 Plan. Qualifying students can get accommodations through a 504 Plan. 

504 Plan accommodations for language skills 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)

Some kids 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 teens can use to communicate in many ways. 

AAC can help teens to: 

• Say what they want and need 

• Share their ideas 

• Show what they know and what they have learned

• 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 teens 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 teens only use AAC. Other teens use AAC plus speech or sign language.  

When a teenager has a lot of trouble using either spoken language or sign language, AAC 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 teen needs AAC, the first step is to get an AAC Evaluation, typically by a speech-language pathologist. Depending on a teen's situation, families have a few choices for finding an AAC Evaluation: 

• When a teen is inpatient at a hospital, SLPs can often help them 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 students who require them

  • 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 teenager.  Families should talk with the evaluator about how to teach their teen, 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 teens with heart defects to communicate, especially teens with intellectual disability (ID) and/or autism spectrum disorder (ASD). 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 people use language to accomplish goals.  ABA providers help young people to communicate their wants, needs, and ideas more effectively.   

ABA is most often used with kids 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. 

Teenagers can continue learning language through adulthood. If teens are impaired by reduced language skills, they should continue to get help to make as much progress as possible. Language is an important gateway to both cognition and social connection, and increased language development almost always has significant positive effects in a person's life.

This content was reviewed by a speech and language pathologist at Boston Children's Hospital.

Developmental care is best when it is local. Families local to Boston can receive care from the Cardiac Neurodevelopmental Program (CNP) and/or the Speech-Language Pathology department. Families from other regions can use the link below to find their local care team.