What are speech and language problems?

Speech problems are problems with the way your child’s speech sounds. Language problems include problems with gestures, use and understanding of words, or writing.

Speech or language problems can be either a delay or a disorder.

• Children with a speech or language delay develop speech and language skills more slowly than other children.
• Children with a speech or language disorder are not developing speech or language normally. This is the most common developmental problem in preschool children.

Speech problems may involve articulation, voice, or fluency.

• Articulation problems affect the way your child makes sounds. Children who have articulation problems probably leave out sounds, use other sounds instead of the correct sound, or change normal speech sounds. For example, it’s not unusual for 3-year-olds to use the “f” sound instead of “th” in their speech; “I am firsty (thirsty).” These errors should be gone by the time your child is 5 years of age.
• Voice disorders may be a voice that is hoarse, too high or too low, too loud, or too nasal.
• Fluency disorders are problems in how the words are spoken, such as stuttering and stammering.

Language disorders include not being able to:

• Express thoughts through spoken or written words
• Understand what others are saying
• Solve problems
• Read and understand what is being read

What is the cause?

Many things can cause speech and language problems:

• Developmental problems, such as autism or problems with muscle movement
• Hearing loss
• Intellectual disability, which is problems with learning, growth, and behavior
• Learning disabilities, which are problems with the way the brain receives, processes, stores, or responds to information
• Nerve or muscle problems, such as cerebral palsy, muscular dystrophy, or a brain injury
• Problems with the roof of the mouth or the tongue, such as cleft lip or cleft palate
• Exposure to chemicals that can affect the brain
• Screaming a lot, which can irritate your child’s throat

What are the symptoms?

Symptoms may include:

• Not babbling or making other sounds by age 6 months
• Not seeming to hear or not responding to sounds
• Not knowing her name, the meaning of “no,” and a few words or simple commands by age 1 year
• Not saying words by 14 to 16 months of age
• Not being able to answer basic “what,” “where,” “who” questions by age 3 years
• Having trouble being understood by people outside the family after age 3
• Having unusual facial expressions, breathing, or voice sounds when speaking
• Sounding hoarse all the time without having a cold
• Not being able to tell a simple story by age 5 or not being able to tell a more detailed story by age 7
• Having a hard time learning new words
• Not doing well in school

You should not wait and see if a problem goes away. You may miss many months of helpful therapy. Even babies can be helped with speech therapy. The earlier a speech or language problem is diagnosed, the better.

How are they diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and medical history and examine your child. Your child will have hearing and vision tests. Your provider may refer your child to a speech and language specialist or a child development specialist.

How are they treated?

If your child also has a hearing problem or other medical condition, it will be treated.

The most common treatment combines language and speech therapy to:

• Help your child understand and use words
• Increase the number of words your child knows
• Help relax face and mouth muscles by teaching your child breathing and relaxation exercises

Many public schools have a speech therapist or tutor who works with children diagnosed with speech or language disorders.

If your child cannot speak, language therapy will focus on learning to use gestures, sign language, picture boards, or an electronic device to communicate.

How can I help my child?

• Talk to your child. Children learn words and the rules for using them by listening to others talk. Talk to your child at mealtime, bath time, and dressing. Encourage your child to ask for items, make choices, and answer questions. Teach your child to use words instead of crying or pointing to get what she wants.
• Listen to your child. Encourage her to tell stories and share information.
• Use music. Singing songs can help your child learn new words, sentence patterns, and listening skills and how to put thoughts and feelings into words. Playing instruments or dancing can help your child relax and improve concentration, attention span, and memory.
• Plan family trips and outings. Explore museums, amusement parks, or other fun places. Talk with your child and ask questions about what she saw and what she liked.
• Be specific when you talk to your child. Tell your child in simple steps what you want her to do. It also helps to show your child how to do something rather than just tell her.
• Be patient with your child. She may not be able to put her needs and feelings into words. Watch your child’s body language for signs that she is upset or that something is wrong.
• Start reading to your child before your child is 6 months old. Reading helps your child learn words and ideas. Once your child learns to read, let her read out loud to you.

You can get more information from:

• American Speech-Language-Hearing Association
  301-897-5700
  http://www.asha.org