Speech as an emergent outcome of coordinated sensory, motor and regulatory systems.

I am an occupational therapist and researcher. My work asks one question: how can occupational therapy principles help a child find their speech? The Speech Elicitation Programme (SEP©) is the structured, therapist-led framework I developed in response. This page outlines its rationale, process and research, and the training available to clinicians.

SEP© does not position speech production as its terminal outcome. From an occupational therapy perspective, the overarching aim is meaningful communication and participation in daily occupations. Targeted speech and language intervention lies within the scope of speech-language pathology, and SEP© is intended to complement it rather than substitute for it. Within this framework, speech elicitation is conceptualised as a preparatory motor skill that enhances a child’s readiness to engage in speech-language therapy sessions. Equally, the act of speaking during SEP© is itself an experience for the child, and the programme is designed to provide that experience, so that vocalisation and speech are encountered as part of purposeful, supported, sensorimotor engagement.

Dr. Vidhya Depgunde

Occupational Therapist, Researcher, and Founder of the Speech Elicitation Programme

Rationale

Why occupational therapy has a role in speech development.

Speech is a language skill and also a motor act. It rests on respiration, posture, oro-facial movement and sensory feedback, and early motor development is linked to later speech and language outcomes. Dynamic systems theory describes how such systems interact, and occupational therapists are trained to assess them within a child’s daily occupations.

SEP© offers a structured way to apply this in practice.

Conceptual framework

A multisystem model of speech elicitation.

The model organises clinical reasoning across five interdependent levels. Emphasis is hierarchical, so lower levels are screened and supported first, but interaction is dynamic, and all levels remain in play during any task.

Physiological regulation
The state from which a child can attend and attempt.
Postural and proximal stability
A stable base for movement.
Sensorimotor integration
Sensory input guiding motor planning
Speech-motor control
The motor basis of articulation
Speech production and participation
Carried into everyday life

That is why I teach parents to build communication into the whole day, not only into a therapy room.

Core principles

Three principles guide every session.

Intentional elicitation

Structured, graded and purposeful, guided by principles of motor learning[5]. Related cueing approaches have been studied in apraxia of speech.

Meaningful context

Practised in formal and natural settings to support generalisation.

Insight-driven analysis

Each elicited sample informs the next step.

Clinical reasoning process

From occupational profile to generalisation.

The process follows the occupational therapy evaluation, intervention and outcomes sequence and frames communication in ICF-CY terms.

Phase 1

Occupational profile and regulatory status

Participation goals and the child's regulatory profile.

Phase 2

Foundational systems assessment

Screening of the foundational systems.

Phase 3

Intentional elicitation

Structured, graded facilitation.

Phase 4

Insight-driven analysis

Interpretation of the elicited speech.

Phase 5

Generalisation

Carry-over into daily routines.

Scope

Populations and clinical applications.

Dr. Vidhya Depgunde, Occupational Therapist, Researcher and Founder of SEP© and Cuddle Centre for Occupational Therapy, Sanpada, Navi Mumbai.

Populations
  • Speech sound disorders
  • Autism spectrum conditions, including nonverbal and minimally verbal children
  • Developmental delay and late talkers
  • Neurological impairments affecting communication, including cerebral palsy and Down syndrome
Clinical applications
  • Articulation assessment and therapy
  • Phonological process evaluation
  • Narrative and language assessment
  • Conversational speech analysis
  • Fluency assessment
Research

Research in progress.

Research on SEP© is ongoing, with initial findings published and further studies in progress.

View the Research page
Interprofessional practice

Built to work alongside other disciplines.

SEP© is developed with respect for the Interprofessional Education Collaborative (IPEC) core competencies for collaborative practice: values and ethics, roles and responsibilities, interprofessional communication, and teamwork. It also adopts the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) and its children and youth version as a shared language, so that goals and participation can be described in terms every team member understands.

I gratefully acknowledge the expertise of speech-language pathologists, pediatricians, neurologists, audiologists, physiotherapists, psychologists, special educators and, above all, families. I expect their contributions to strengthen and refine this framework in future through joint research, shared outcome measures and collaborative practice.

SEP© is intended to complement, not replace, speech-language pathology assessment, diagnosis and intervention.

Professional certification

Speech Elicitation Programme (SEP©) Professional Certification

Advanced training for occupational therapists, speech-language pathologists and rehabilitation professionals. Learn the clinical principles behind the research-based programme and how occupational therapy can contribute to speech development.

Intended for: occupational therapists, speech-language pathologists, physiotherapists, early intervention professionals and special educators.

Programme content

  • Scientific foundations
  • Assessment framework
  • Step-by-step clinical demonstrations
  • Hands-on facilitation techniques
  • Case discussions
  • Research evidence
  • Clinical reasoning

Participants receive a Certificate of Participation.

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References

Selected foundational literature.

These sources situate the framework within motor, developmental and occupational therapy literature. They do not constitute evidence of SEP© efficacy.

  1. Iverson JM. Developing language in a developing body: the relationship between motor development and language development. J Child Lang. 2010;37(2):229-261.
  2. Gernsbacher MA, Sauer EA, Geye HM, Schweigert EK, Goldsmith HH. Infant and toddler oral- and manual-motor skills predict later speech fluency in autism. J Child Psychol Psychiatry. 2008;49(1):43-50.
  3. Thelen E, Smith LB. A Dynamic Systems Approach to the Development of Cognition and Action. MIT Press; 1994.
  4. Bernstein NA. The Co-ordination and Regulation of Movements. Pergamon Press; 1967.
  5. Maas E, Robin DA, Austermann Hula SN, et al. Principles of motor learning in treatment of motor speech disorders. Am J Speech Lang Pathol. 2008;17(3):277-298.
  6. Strand EA, Stoeckel R, Baas B. Treatment of severe childhood apraxia of speech: a treatment efficacy study. J Med Speech Lang Pathol. 2006;14(4):297-307.
  7. Ayres AJ, Robbins J. Sensory Integration and the Child: Understanding Hidden Sensory Challenges. 25th anniversary ed. Western Psychological Services; 2005.
  8. American Occupational Therapy Association. Occupational therapy practice framework: domain and process, fourth edition. Am J Occup Ther. 2020;74(Suppl 2):7412410010.
  9. World Health Organization. International Classification of Functioning, Disability and Health: Children and Youth Version (ICF-CY). WHO; 2007.
  10. Interprofessional Education Collaborative. IPEC Core Competencies for Interprofessional Collaborative Practice: Version 3. IPEC; 2023.
  11. World Health Organization. International Classification of Functioning, Disability and Health (ICF). WHO; 2001.

Correspondence and collaboration

Dr. Vidhya Depgunde, Occupational Therapist, Researcher and Founder of SEP© and Cuddle Centre for Occupational Therapy, Sanpada, Navi Mumbai.

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