People today have very busy schedules. It is a very convenient and a time saving service to be seen in your own home or office.

Being seen in your own environment allows you to practice your newly learned skills where you will be using them and in this way helps with carry-over.

In addition, services offered in your own home allow for privacy. I believe the quality of the therapy is better and more personalized.

Contact me to schedule an appointment...

Interview with Ela Britchkow, Speech-Language Pathologist

General Questions

I: What are some of the things that you do that are in your opinion unique?
E: Just being in private practice and going to clients’ homes is unique. I channel a great deal of enthusiasm and energy into each one of my clients as they are very important to me. I go out to the home where people are more relaxed and comfortable about working on improving their speech. To be effective, I need to be creative to keep the therapy exciting for me and my clients. I am your advocate, working for you and not in any way obligated or connected to any school, hospital or any institution that could create a conflict of interest.

I: My insurance pays for speech therapy, is there something more that I should be concerned about?
Pennsylvania speech pathologist Ela Britchkow makes house calls

Pennsylvania speech pathologist Ela Britchkow makes house calls

E: Sometimes a patient in a hospital, clinic, or nursing home facility, will be discharged from therapy because the coverage has run out, not because the patient has accomplished all his/her goals. There are facilities that will then absorb the cost themselves, but these have become rarer and rarer. One of the reasons I went into private practice because this bothered me when I worked for others. I can provide an independent opinion about a patient’s status and treatment options.

I: Money is a problem for me; can I get treatment for my communication problem that I will still be able to afford?
E: Check with your insurance company about coverage in and out of network. My listing of medical factors related to speech improvement may be helpful to share with your doctor.

I: Why did you want to go into speech therapy?
E: I have had great satisfaction from helping people acquire speech skills when others thought it would not be possible.

I: Doesn’t it take a lot of patience to do this kind of work?
E: I see this as a challenge and use a large variety of activities, games and materials to make the sessions interesting. Frequently, I develop my own original materials in order to enhance learning speech and language concepts. When I work with adults, my role is to encourage them to work towards their goals and not become discouraged. I enjoy being a speech therapist and that helps with being patient with difficult challenges.

I: Why do people develop speech and language difficulties?
E: People are either born with a condition which results in a speech, language deficit or develop it at different stages in their life. A common problem is functional articulation and/or phonological disorders. Articulation (the production of speech sounds) is developmental. Many children outgrow making incorrect sounds, but some children don’t. By 7-8 years, children should be producing all their sounds correctly and be 100% intelligible. Other people have difficulties with stuttering or voice problems for a variety of reasons. Some causal factors include: deficits secondary to neurological diseases, traumatic brain injuries, Mental Retardation, a variety of syndromes, stroke, cancer, craniofacial disorders (e.g., cleft lip/palate), Orofacial Myofunctional Disorders (including tongue thrust swallow) Cerebral Palsy, people on the Autism spectrum, auditory processing, and hearing loss.

I: Can you tell me something about your background and qualifications?
E: I am a highly effective, competent and ethical therapist with 26 years of experience. I work with people from preschool to adult providing evaluations and treatment for a wide variety of communication disorders. I have experience working in a variety of settings such as early intervention, schools, hospitals and long term care facilities. My credentials include the Pennsylvania Department of Education Certificate in Speech Correction and Pennsylvania License in Speech and Language Pathology. I am also certified by the Institute of Language to provide accent reduction training utilizing the Compton P-ESL program. I am a member of the Pennsylvania Speech-Language-Hearing Association. Other organizations with which I am affiliated include National Speech Pathology Network; National Stuttering Association; Stuttering Foundation of America; Autism Society of America, Greater Philadelphia Chapter, National Parkinson Foundation Inc.; Alexander Graham Bell Association; Childhood Apraxia of Speech Association (CASANA) Corporate Speech Pathology Network and Promoting Accent Training Help (PATH), Institute of Language and Phonology and the International Association of Orofacial Myology. To learn more about my qualification and experience, view my resume...

Questions Referring to Adults:

I: I have had this speech impediment through childhood and I am now an adult, and would really like to improve. Is it too late for me?
E: No, it’s usually not too late, although it will probably be more difficult. The good news is that adults who are interested in improving a speech disorder are usually highly motivated and as a result can often make demonstratable progress. It takes courage to pick up and try again, but it could make a big difference in how you feel about yourself. The field has experienced growth due to research that has improved intervention and techniques used so you might benefit now from those advances.

I: What about foreign accents that make understanding people from other countries difficult.
E: When you listen to someone with a foreign accent, you have to put more energy and attention into what they are saying. This can be very tiring for the listener. It also sets up awkward situations when the listener cannot understand what the speaker is saying even after a few repetitions. These situations can be remedied by seeing a speech therapist with training in accent modification. There are short programs, long programs, individual and group sessions.(link)

I: My parent is getting older. Can getting speech therapy for certain conditions be a life or death issue?
E: Yes, when people get older; sometimes they have swallowing disorders secondary to various conditions such as strokes, various diseases or sometimes due to general weakness. A swallowing disorder (dysphagia) may put a person at risk for aspiration pneumonia, a more threatening form of pneumonia than air pneumonia (nasocomial). Therapeutic and compensatory techniques by a competent and experienced speech therapist are very important.

I: How am I going to know whether I have a problem with speech or communication of needs intervention?
E: That depends on your type of work and the living and working demands of the living and working environment. A child or adult may be able to respond with brief answers, but what happens when he gives a presentation. This can impact on self image. If the way someone speaks or presents him/herself makes the person feel inadequate, then it’s a problem.

I: What are some of the conditions that you notice some adults have who have had speech therapy as a child and still exhibit speech/language issues as an adult?
E: There are some adults who still exhibit lateral or frontal lisps. These can be due to their occlusions which were not repaired and contribute to their speech pattern or to an abnormal swallow pattern. These individuals need to be trained as to how to strengthen their facial muscles including the tongue to eliminate the abnormal swallow pattern and improve speech.

I: What do insurance companies mean by rehabilitation?
E: If someone had a skill and lost it, then he/she would qualify for rehabilitation. For example, if someone has a stroke and loses the ability to speak or understand language he/she is a candidate for rehabilitation. Quality of life issues are not covered by insurance. For example, someone is on a feeding tube, but would enjoy eating some apple sauce or pudding, but needs some training to do this safely. If that person does not have the potential of eating orally to sustain himself nutritionally, insurance may not pay for it. Unfortunately, the consumer may have to pay out of pocket to be treated more compassionately

Questions Referring to Children:

I: At school my child gets speech therapy. He’s gotten a little bit better, but I notice he’s not seen too often and seems to be always given help in a group. Is there any way of knowing for my own peace of mind whether he’s getting the best help that he needs?
E: Speech therapists often have to deal with juggling unmanageable caseloads and tend to group students. This cuts down on each child’s actual practice time. Within a 30 minute therapy session, a child may actually be practicing their target speech goal for about 5 minutes (depending on group size) as arriving; leaving and settling into the session are all part of the 30 minutes. Not all grouping is disadvantageous. Some children need to work on socialization and carry- over skills. If your child’s speech is not improving, you need to take a closer look at his/her intervention. You may want to have an independent private re-evaluation. The reality is that it is well worth considering.

I: Why would someone want to seek out a speech therapist in private practice for their child?
E: Speech therapists in schools are frequently confined to a tight schedule which only allows for a limited amount of therapy time and usually in a group. When you choose a private speech therapist, you have more control. The relationship I develop has a positive influence over the outcome.

I: Can my child just grow out of his speech problem? What’s wrong with just waiting and seeing what happens?
E: Your 2, 3 or 4 year old may outgrow his speech problem or start talking. If your child exhibits speech and language delays early professional attention can be truly advantageous. A good idea is to check a speech and language developmental chart (link) to see how your child compares to the norms. If the average 3 year old produces 3-5 word sentences and your child has a vocabulary of 25 single words, he is significantly delayed and should receive help immediately. When or if to begin treatment should be made with professional guidance.

I: My child has a speech IEP. What do I need to know that you may be aware of?
E: Always be involved and informed of what is going on in your child’s program. Check to see that the goals are being followed. If your child comes home and tells you that he/she was working on a sound during his speech session that he is competent with, you need to look into this. It is a waste of your child’s precious therapy time and could indicate a more serious lapse in the oversight of the IEP. If your child is not being seen at the frequency that his IEP details, those sessions may have to be made up. You may refer to these links for more information:

I: I feel that my child has a speech problem but the school therapist has not recommended speech therapy. I am concerned that this will have implications in reading and other aspects of his life.
E: If you disagree with the results of his speech-language evaluation you have the right to seek an independent evaluation for your child. Here are some additional links for articles prepared by the Educational Law Center in Philadelphia that give help on how to proceed.

It is also a good idea to express your concerns with the speech therapist that did the evaluation.

I: Why is what you do important?
E: I love what I do, and that is conveyed in my work .Children who may have never talked, have learned to talk. I try to find whatever will motivate my clients to help them reach their goals.

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