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Providing family-focused, child-centered support
in communication & literacy

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  • According to research, a 3-year-old should be easily understood by unfamiliar listeners at least 75% of the time. A 4-year-old should be understood by others 90-100% of the time (Coplan & Gleason, 1988).

  • A recent study has confirmed that English-speaking children acquire almost all speech sounds by the age of 5; many are acquired by age 4 (Crowe & McLeod, 2020).​

  • Research has shown that children with speech sound disorders are at higher risk of having literacy-related and social-emotional deficits, including children with just one single speech sound error (Farquharson, 2019).

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Cassandra received her Master of Science degree in Speech-Language Pathology from the MGH Institute of Health Professions, the graduate school of Massachusetts General Hospital, in Boston, MA. She holds a Certificate of Clinical Competence (CCC) with the American Speech-Language-Hearing Association (ASHA) and is also a member of the Massachusetts Speech-Language-Hearing Association (MSHA). 

Throughout her clinical practica and professional career, Cassandra has provided evaluation and treatment to diverse populations in the school, skilled nursing, hospital, outpatient, and home care settings. Her extensive clinical interests have ranged from adult neurogenic and radiation-associated swallowing disorders to pediatric speech sound disorders and dyslexia.

A lifelong lover of language, prior to becoming a speech-language pathologist, Cassandra spent time abroad teaching English in both France and South Korea before later working as a French teacher in the Massachusetts Public Schools. In addition to her native English, she maintains professional working proficiency in French. She enjoys yoga, traveling, learning foreign languages, nature walks on the local trails with her family, and practicing the fiddle.

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We utilize a combination of single-word articulation tests, phonological analysis, connected speech sampling, dynamic assessments, and/or any other measures necessary to capture your child’s unique profile and to formulate the most effective plan of treatment. Assessment serves to identify and differentiate sound errors and/or patterns that are atypical from those that may be developmentally age-appropriate. 

Evaluations can be conducted either in-home or at the clinic, depending on the individual needs of your child.

If your child has an active school-based IEP or has received a thorough evaluation from another service provider in the past year, additional formal assessment may not be necessary. 


Articulation impairments refer to difficulty with the physical production of speech sounds. They may be characterized by individual sound substitutions (unlike the pattern-based substitution errors seen in phonological disorders), sound additions, omissions, or distortions.

A 2018 research study by McLeod & Crowe, one of the most comprehensive to date, looked at speech sound acquisition norms across 27 languages and showed that children acquire most consonants sounds by age 5. Their 2020 review of 15 studies on English-speaking children in the U.S were consistent with their earlier findings: Typically-developing children are able to produce almost all English consonants correctly by the age of 5; most sounds are acquired by age 4. See the chart here.

The takeaway? The "wait-and-see" approach does not jibe with what the research evidence tells us about when speech sounds are acquired. 



Phonological disorders are language-based impairments that result in difficulty learning and applying the underlying, rule-based system by which sounds are stored and organized in the mind. 

Phonological patterns refer to consistent sound substitutions or omissions that a child may apply to an entire class of sounds (e.g. substituting sounds produced in the front of the mouth for ones produced in the back, as in "tea" for "key"). 

While all children demonstrate phonological patterns during typical development as a means to simplify adult speech, they generally disappear by age 4-5. A child who continues to exhibit such patterns beyond this age may have a phonological delay/disorder. For a list of the more frequently-encountered phonological patterns, including examples and the likely age of elimination, click here


Childhood Apraxia of Speech (CAS) is a rare neurological motor speech disorder characterized by difficulty executing sounds, syllables, and words due to deficits in motor planning. In most cases, the cause for CAS is idiopathic, or unknown.

Speaking is an extremely complex process: the brain must tell the anatomical structures involved in speech to move at the right time, with a certain speed, in a particular direction, and with a specified amount of force and muscle tension. Children with CAS know exactly what they want to say, but their brains have difficulty planning and programming these precise movement parameters.

CAS can be very difficulty to identify, is easily confused with other speech sound disorders, and should only be diagnosed by a speech-language pathologist. To learn more about CAS, visit 


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We are located within the Salt Marsh Pottery studio in the heart of the historic Smith Mills village of South Dartmouth. A former schoolhouse, the building's iconic Crayola yellow and green trim can't be missed! 

In-home services are available on a limited availability basis to the following Massachusetts & Rhode Island towns:

Dartmouth, Fairhaven, Fall River, Little Compton, Marion, Mattapoisett, New Bedford, Somerset, Swansea, Tiverton, and Westport.

Teletherapy is additionally available to all Massachusetts and Rhode Island residents. 

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Please complete this form to request more information or to schedule an initial consultation. We will make every effort to respond to your inquiry within 2 business days!

Cassandra Facchiano, MS, CCC-SLP
beSpoke Speech Therapy 
1167 Russells Mills Rd. 
South Dartmouth, MA 02748

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Coplan, J., & Gleason, J.R. (1988). Unclear speech: recognition and significance of unintelligible speech in preschool children. Pediatrics, 82,447-452.

Crowe, K., & McLeod, S. (2020). Children's English consonant acquisition in the United States: A review. American Journal of Speech-Language Pathology.

Farquharson, K. (2019). It Might Not Be “Just Artic”: The Case for the Single Sound Error. Perspectives of the ASHA Special Interest Groups, 4(1), 76-84.

McLeod, S. & Crowe, K. (2018). Children’s consonant acquisition in 27 languages: A cross-linguistic review. American Journal of Speech-Language Pathology, 27, 1546-1571.

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