Frequently Asked Questions

 

Are you seeing clients in person during the COVID-19 pandemic?

Yes, on a limited basis and with safety measures in place. We are also seeing many clients via various online platforms for both assessment and treatment. Please feel free to email us with any specific questions about your situation and we would be happy to provide more details.

Do I need a doctor's referral to make an appointment?

No. We do not require a doctor’s referral* in order to see you or your family member. However, if someone else besides you has initiated your or your family member’s referral, please let us know and provide relevant documents such as previous speech-language pathology reports, referral letters or relevant reports from other health professionals, or written comments from teachers. 

*Please note that, although we do not require a referral from your doctor, extended health benefit plans sometimes require this in order to accept your claim. We strongly encourage you to check with your own extended health benefit plan to learn what specific requirements and limitations might be in place.

How, when, and how much do I pay?

Payment is required at the time of booking. During COVID-19, e-transfers are our preferred method of payment (cheques are also accepted); we are unable to accept cash, credit, or debit. Once our usual in-person services are resumed, we accept cheques (preferred), credit (Visa or Mastercard), debit, or cash. Please email us for information about fees. 

Do you bill extended health plans directly?

No, we do not. Each plan negotiates different benefits with each employer, and we are simply not in a position to know what your particular benefits and/or restrictions might be. Instead, we will provide you with a detailed receipt that you can submit to your extended health benefit plan. As mentioned before, we strongly encourage you to check with your own extended health benefit plan to learn what the requirements and limitations are – and we advise you to do it before your first appointment to avoid surprises!

All of our speech-language pathologists are registered with our College, so if your plan covers speech-language pathology services, we meet the requirements in terms of the appropriate registration/licensing.

Do you provide a guarantee that treatment will be effective?

No. Our code of ethics prevents us from doing so, and for very good reason, as there are so many variables affecting treatment outcome! You have our assurance, however, that the same code of ethics prevents us from providing treatment if we don’t believe you or your family member has a reasonable chance of benefiting from the treatment.

Can I get this service for free elsewhere or through a funding source?

Maybe. Some speech-language pathology services are covered under/funded by various public sources such as health units (young children), the school system (school-aged children),  or outpatient clinics at hospitals. In general, SLP services in the public system are much less available for adults than they are for children.

For more details, please see the Children’s Treatment FAQ section, the Adult Treatment FAQ section, or the Adult Intensive Stuttering Clinic treatment page. 

Our clinic director has compiled a document of potential funding sources that we would be happy to send to you to help you in your search. Please email us.  

How long will I need to come for treatment?

It depends. We will assess your needs and your potential to benefit from treatment before providing you with any estimation regarding duration of treatment.

Children’s Treatment

Do you have any general guidelines for parents, letting them know when it's appropriate to see a speech-language pathologist?

We firmly believe that you know your child best. If you have a concern, or if your child’s self-esteem, behaviour, academic or social progress seem to be impacted by a speech or language problem, or if your child is frustrated or is getting teased about his/her speech, we feel you are right to have the problem checked out.

There are a number of good websites that include information on children’s speech and language developmental milestones. Please see our resources page.

My son is only two but I am very concerned about his speech and language development. Is he too young for treatment?

No. First, we will assess his needs through a detailed case history, observation of him at play, and, if necessary, some testing. If we find that he needs support from a speech-language pathologist, we will do it in an age-appropriate manner. For example, we can teach you to help your son at home, where he is more at ease. We can develop a home program and then meet with you and your son as needed to update the program and monitor his progress. Or we can plan clinic-based activities, based on your son’s interests, which are meaningful and fun for him.

I'm reluctant to bring my daughter in to see a speech-language pathologist because she is very shy and I'm afraid that her self-esteem may suffer if attention is focused on her poor speech. What is your advice on this?

It is true that it is not helpful to focus attention on a child’s speech in a negative way; however, your speech-language pathologist will use positive techniques to help your child and can design a treatment program that is play-based.

My four-year-old daughter has recently started stuttering. I've heard that all kids do this around this age. Should I consult a speech-language pathologist?

Maybe. It is true that many (but, by no means all) children go through a normal phase of “dysfluency” (stuttering) around ages two to four for a few weeks or so. However, this is also a very common age for true and persistent stuttering to begin. You know your child best. If she seems to struggle with her speech, is self-conscious about it, is getting teased, or if you find that her speech is interfering with your relationship or with any of her activities, we advise you to have your child seen by a speech-language pathologist. Or, if your daughter has relatives who stutter, or if she has been stuttering for six months or more, we suggest you see a speech pathologist. Your speech-language pathologist will be able to give you advice about how to deal with your child’s stuttering, or to reassure you if there is no need for concern.

I am reluctant to bring my preschool child in to see a speech pathologist because I've heard that focusing attention on a child's stuttering can make it worse. Is this true?

Maybe. The public schools in B.C. hire speech-language pathologists as part of their comprehensive educational teams. If your child is school-aged, you should check with your school-based speech-language pathologist to see if your child can be seen at school. Some school district speech-language pathologists prioritize younger children, such as those in kindergarten through grades 3 or 4. Children in high school do not often get regular service from speech-language pathologists. Most private schools do not hire speech-language pathologists. Younger children, depending on their needs, may receive treatment through health units, child development centres or infant development programs; your family doctor can put you in touch with these agencies.

Sometimes a publicly available speech-language pathologist may have to put your child on a wait-list for a longer period of time than you are comfortable waiting, or may not be able to see your child as often as your child can benefit from. In those situations, you may want to give us a call. We are happy to work with any public speech-language pathologist to supplement your child’s treatment.

Our clinic director has compiled a document of potential funding sources that we would be happy to send to you to help you in your search. Please email us.  

 

Will my child "grow out of" his stuttering on his own?

Maybe. Studies find that many children will indeed grow out of stuttering by their early teen years. However, a substantial minority of children (up to around 30%) will continue to stutter into their adulthood. Children more likely to continue stuttering are: boys, those with a relative who stutters, and those who have been stuttering for six months or longer. We advise parents to seek help from a speech-language pathologist if their children seem adversely affected by their stuttering – for example, if they are teased or reluctant to speak out in class.

Can my child receive the stuttering treatment he needs through his school district speech-language pathologist?

Possibly. In many schools, however, it is not possible for the speech-language pathologists to provide the type of intensive treatment required by some children. We encourage you to call your school-based speech-language pathologist to discuss available services.

Accent Reduction

How does the program work?

Prior to beginning lessons, each client meets with us for an individual consultation including a recorded speech assessment.  We use that assessment to complete a personalized analysis of your speech.  This analysis becomes the blueprint for your program.  Whether you are in our individual, group or intensive program, you will only work on sounds that you have difficulty with.  If you don’t have a problem with the “th” sound, for instance, we will never waste your time working on it.  We will work on those things that are relevant to you.  Each time you meet with your instructor, she will provide you with a new target sound or target skill.  She will explain to you how it is pronounced by native speakers of Canadian English and will also explain to you how your production differs.  You will have lots of practice hearing the difference and will be given customized accent reduction tips based on your errors.

Does the program only work on improving speech sounds?

No.  Speech sounds are a very important part of Canadian English pronunciation but only one part.  In addition to working on sounds, we will work on intonation, muscle use, resonance, rate of speech, word juncture and more. (If any of these terms are unfamiliar to you, don’t worry – we will explain them at length during the program.)

*Please note that, although we do not require a referral from your doctor, extended health benefit plans sometimes require this in order to accept your claim. We strongly encourage you to check with your own extended health benefit plan to learn what specific requirements and limitations might be in place.

Why would I come to a speech-language pathologist (SLP) to work on accent reduction training instead of an English teacher?

SLPs are clinical professionals trained to the master’s degree level and beyond in all aspects of speech production and techniques to improve speech. SLPs have detailed knowledge about how the mechanics of speech, such as your tongue and lip movements and voice, can affect your accent.  Even more importantly, we have practical training and experience in how to guide people in the complicated process of changing the way you speak and making these changes become a habit.  SLPs routinely help people with serious speech problems, such as stuttering or voice disorders, that are much more complicated than accent reduction therapy.  We use accent reduction exercises and accent modification techniques that are based on our skills, training and experience with speech therapy.  A final advantage of seeing an SLP for your accent reduction therapy is that the SLP can also give you guidance with other aspects of your speech, such as voice difficulties, so that you can get voice and accent training in one place.

Why is it so expensive?

There are two main reasons why we charge a professional rate.  First, your accent reduction program will be delivered by a speech pathologist with a master’s degree (and years of further training and experience in delivering accent modification services) who is a member of a regulated profession.  You should not confuse this service with that provided by an accent reduction tutor, teacher or accent coach who does not need to meet the same qualifications or have the same training. 

Second, your training will be provided on a very individualized basis – either one-on-one, or in a very small group.  Every client, whether seen privately or in a small group, has an individual assessment and analysis of their speech prior to the first session;  the program is always customized to your own needs.  This is not simply an accent reduction “class” with numerous students taught by one instructor.  This is a customized, individualized service delivered by highly trained professionals who use different accent reduction exercises for different clients based on their needs.  In our 27 years of experience, we have discovered that it is critical for each client’s program to be tailor-made for them based on their own speech analysis

Will my accent be completely gone when I finish the program?

No.  Participants can improve pronunciation and learn to speak English with more confidence, but “accent elimination” or “accent neutralization” is not a realistic goal for most people.  You will learn how to improve your English pronunciation and how to speak English with a Canadian accent to a better degree than before you entered the program, but you should not expect that you will lose your accent completely.  We advise you to set the goal of “pronunciation improvement.” It is also worth noting that our code of ethics prohibits us from providing any guarantee of outcome, but the single biggest factor in determining the outcome of the program is the effort that you put in to “train your accent”.

Will I have homework?

Yes.  The homework is not difficult, but it is important that it is done regularly and with focused attention.  Your home program and your own accent reduction tips will be customized to your needs based on your own speech analysis.  It is entirely up to you how much time you spend on it, but, quite simply, the more you put into your home practice, the more you will get out of your Vancouver accent modification program.

Will I get practice materials?

All clients registered in any of our prepaid accent reduction courses receive a complete set of complimentary practice materials including both practice handouts and audio recordings.  (These materials are reserved for clients who enroll in a course and are not available for people who receive instruction on a session by session basis.)

I notice that you offer this program either one-on-one or in a small group. Isn't it always better to be seen individually?

No, not necessarily.  People tend to meet their goals more easily by taking a program with a group component, such as our small group program or our intensive accent reduction program. In a group program, you practice your new speaking skills with other participants, not just with your instructor.  In one-on-one programs, you must work harder to “transfer” your new speaking skills to situations outside of the instruction room. 

If, as you have said, a group component is important for most people, then why do you offer the option of taking this program on a one-on-one basis?

There are several situations in which individual accent reduction training is better.  For instance, you may have a work schedule that takes you out of town periodically or requires evening meetings on short notice.  If so, you may miss too many group sessions to benefit from a group program;  in this case, we would recommend that you take the program on an individual basis.  Or, if your comprehension of English is not sufficient to keep up with the pace of the group program, we would recommend that you have one-on-one sessions.  Or, it may be that you need to complete the program by a certain deadline that conflicts with our group schedule, in which case we will design a schedule that meets your individual needs.

Will the other group members have the same language background as me and similar accents?

Probably not, but this is a good thing! Our Vancouver accent modification groups include people from a wide variety of language backgrounds. Participants get to compare their original languages and enjoy interesting discussions about the challenges of pronouncing the sounds of Canadian English. This is often very helpful as it is usually easier to learn how “not to pronounce a sound” by listening to the mispronunciation of someone from a different language background and then applying that critical listening skill to your own speech.  Each person works towards goals set with instructors after the initial, customized,  speech assessment.

I’ll be going away for two weeks. Will it be okay for me to miss a couple of weeks or should I wait until I’m back to start an accent reduction program?

If you are taking an individual program, it doesn’t matter if you are away for a week or two as we will simply schedule around your availability.  If you are taking a group or combined program, you should give us as much notice as possible so that we can plan the group session for the week you are gone to be targeted around accent reduction tips that are less relevant for you.  We will also ask other group members if they might be willing to reschedule the session you need to miss.  If you will be gone for more than one or two weeks in a group program, we recommend that you wait until you expect to be more available.  Although timing of appointments is more flexible in an individual program, if you plan to be gone for an extended period of time or for multiple trips, we recommend that you delay your enrollment to a time that you are more available.

Stuttering (adults)

I want to take stuttering treatment individually, rather than in an intensive group program, because I'm not comfortable speaking in groups. Why do you encourage people to take a group program?

Studies have consistently shown group treatment to be more effective than individual treatment for adults who stutter. People tend to control their speech better after group treatment in an intensive program (i.e. many hours in a short period of time) that focuses on long-term maintenance and daily speech exercises. If you do not feel ready for this approach, we can recommend speech-language pathologists who are skilled in counselling or in other approaches to supporting people who stutter.

I really want to take the stuttering treatment program, but I'm going to have to miss part of it because of a scheduling conflict. Is this okay?

You really won’t get the best benefit from the program unless you can commit to being there the entire time. Your absence may also be disruptive to other group members. You may be able to make up a minimal amount of lost time for a medical appointment.

My stuttering is pretty mild. (Or, I don't stutter all the time.) Do I need an intensive program or can I benefit from just a few sessions?

Generally speaking, it is not the case that people only need a “bit” of treatment if they only stutter a “bit.” In fact, we find that people who stutter more severely often respond more quickly to treatment than people with milder stuttering.

I took stuttering treatment for years as a child. How will this adult treatment be different?

Chances are, your childhood treatment was not intensive and was not delivered in a group. Or maybe it was, and you – as a child – attended only to get out of class or to please your parents. You are now at a different point in your life, and can choose to commit to treatment in a way that you probably didn’t when you were younger.

I am 65 years old and have been stuttering all of my life. Am I too old to benefit from treatment?

No! You can never be too old to benefit from stuttering treatment.

Do you provide a guarantee that my stuttering will improve/go away once I've taken this clinic?

No. Not only would such a guarantee contravene our code of ethics, it also wouldn’t be consistent with our experience. We find that, while most adults who stutter benefit significantly from the clinic, almost all require follow-up and a maintenance program in order to maintain their gains. While we would love to tell you that our clients simply stop stuttering after our clinic, it isn’t the case. Rather, we counsel people to view treatment as a means to learn techniques to help them control their fluency. Long-term benefit requires long-term hard work from our clients and regular follow-up from us. Rest assured, however, that we do collect outcome data on our clients for a full five years; we are happy with the long-term outcome for most of our clients.

Aphasia treatment (intensive program)

Does your intensive aphasia treatment program have a website?

Yes!  Visit itawc.com for more information about iTAWC – Intensive Treatment for Aphasia in Western Canada.

What is aphasia?

Aphasia is a communication impairment resulting from damage to the language areas of the brain, such as may occur from a stroke or brain injury.  It can result in mildly to profoundly reduced abilities in any or all of the language modalities of listening, speaking, reading or writing.  Because communication is so central to every aspect of human life, aphasia can interfere with family roles, employment, hobbies and social life;  often, aphasia leads to social isolation and depression.

Who is this program designed for?

Our intensive aphasia treatment program is best suited to people who have “chronic” aphasia (that is, aphasia of more than one year duration).  However, we will certainly not turn someone away who is less than a year post-stroke, if we otherwise feel they will benefit from our approach.  In order to be eligible, you must have been diagnosed with aphasia by an SLP, neurologist or physiatrist (a rehabilitation medicine doctor);  you must be medically stable and have sufficient stamina and attention to take part in an intensive treatment program of this nature.  Participants must be independent for toileting, eating and transfers, or bring someone with them who is capable of assisting with these needs.  The program is designed for native speakers of English (or those who had fluent command of English prior to developing aphasia) who also have sufficient vision and hearing to participate in a non-adapted program.  To discuss whether or not this program is suitable for your needs, please contact itawc@columbiaspeech.com or call us at 604-875-9100.

What kinds of treatment will be offered?

The specific type of intensive aphasia therapy provided will be decided on a case-by-case basis, depending on your needs and goals.  The program is comprehensive, in that multiple treatment approaches are available.  In general, treatments will focus on speaking, auditory comprehension, reading and writing, conversational skills, functional communication, social participation and use of technology as appropriate.  All treatments used are evidence-based. For the summer session, you will receive two hours of one-on-one therapy each day with a highly experienced SLP along with small group sessions and labs run by one SLP and three graduate student interns (providing a ratio of 2/3 of an SLP and one graduate student intern to each client registered), for a total of 4 hours per day. At other times of year, you will receive 3 hours of daily therapy from our SLPs.

What sort of results should I expect?

No guarantee of outcome is provided.   However, you can rest assured that the treatment you will receive will be based both on extensive clinical experience and on current research, including the latest knowledge in the field regarding evidence-based practice.  The team developing our intensive aphasia therapy program includes veteran SLPs Wendy Duke and Alisa Ferdinandi, who together have almost 50 years of experience working with clients with aphasia and who have trained numerous student SLPs over the years.

Is the involvement of family members required?

You need to bring a family member or communication partner with you but they do not need to be with you throughout the entire four week of the intensive aphasia therapy program.  They need to be there for at least the first day and the last day.  Additional family involvement is encouraged.  We recommend against having family members involved full-time, however, as we wish to foster independence for our clients.

Where does the program take place?

The programs will take place at the wheelchair-accessible offices of Columbia Speech and Language Services, Inc. in Vancouver at 750 West Broadway in Suite #1305.

Are there accommodations nearby?

You are responsible for finding your own accommodation, food, etc., but we are happy to provide you with a list of nearby hotels. Many past participants have also successfully found accommodation (some even within walking distance of our office!) via companies such as AirBnb or VRBO. Our office is very close to major transit stops should that be an option for you.

What are the upcoming program dates and costs?

Please see our main iTAWC page for information about our current program schedule and costs.

What if I can't make the program's dates work? Do you have other treatment available?

Yes! Firstly, we usually run approximately three programs per year, so you can keep an eye on our website or email us if you’d like us to keep you in the loop on future programs. Also, it’s possible that we can accommodate individuals for an intensive program at other times of year with sufficient notice. This would be the same structure and hours as iTAWC, but you would be the only participant. If this is of interest to you, please send us an email to enquire.

What is your application process?
  1. Please email us or give us a call at 604-875-9100 to enquire about the suitability of our program for you or your family member/friend.
  2. We will give you an application package, which you can fill out and return to us. This may take some time to complete, as it has several components (lots of information about the applicant, reports from previous SLPs, payment, etc.). Two cheques – not post-dated – need to be included in the application; one is a non-refundable application fee (this may be waived at our discretion for returning or current clients), and the other is a cheque for the full amount of the program (see our main iTAWC page for details about costs).
  3. The cheque for the application fee will be deposited upon receipt of the application, and we will review your application. Once we have reviewed it, we will be in touch with you about your acceptance, and the second cheque will be deposited.. In the event that we do not accept the application, the second cheque will be shredded or returned to you.
What is your refund policy?

Upon confirmation of each client registration, we immediately begin work to ensure the best possible experience for that client;  we also must commit to paying certain fixed costs, such as staffing and space allocation, for the program’s entire duration.  For these reasons, full refunds are not possible, regardless of reason, at any point after registration.  Under certain circumstances, we will consider written requests for partial refunds on the following schedule.

Up to August 6, 2021: $5000 CAD ($4350 USD) refund
Up to September 6, 2021 – $2500 CAD ($2175 USD) refund

After September 6, 2021: no partial refunds will be provided unless we are able to move a client from our waiting list into your spot;  in this case a $2000 CAD ($1200 USD) refund will be provided.

Note that the application fee of $395 CAD ($300 USD) is not refundable under any circumstances.

Is there any funding available?

There are no consistent funding sources currently available.  We recommend that you contact your local Health Authority’s Acquired Brain Injury Services to see if they would assist you with the funding and that you explore your extended health benefits if you have these, or any other sources of funding that might be specific to you, such as through the Department of Veterans Affairs, ICBC, WorkSafe or Crime Victims Assistance Program if relevant.  If you are an SLP referring a client, we recommend that you do not let financial considerations stop you from informing a client of this program;  in our experience, clients can be very resourceful about fundraising for their own treatment.

When should I register?

We are now accepting applications for our fall 2021 program. If you are interested in future programs, please enquire. For more information or to request an application package, please email us or call us at 604-875-9100.

Is there a lower or upper age limit for participants?

No.  An individual’s ability to participate is determined by their stamina, medical stability and willingness to work in an environment where many of their fellow participants will be middle-aged. An older person with energy and stamina is more than welcome in our program.  For younger people such as teens, we suggest only that they consider carefully if they would be comfortable in an environment in which they will likely be the youngest client present.

Will you accept people who are very high functioning?

Yes.  In fact, if you or your family member have mild aphasia, you may be interested to know that the clinicians at iTAWC have had extensive experience assisting people with stroke or traumatic brain injury in returning to work and/or school.

Will you accept people with fluent aphasia or with concurrent apraxia of speech?

Yes and yes.

Still have questions? We would love to hear from you. Please give us a call at 604-875-9100 or send us an email!

Columbia Speech & Language Services Inc.

604-875-9100

info@columbiaspeech.com

#1305 - 750 W. Broadway Vancouver BC V5Z 1J3