Common Speech Problems in Young Children
When Vickie Muhammad's son was born he passed all his newborn screenings. Yet as he began to grow, she suspected something was wrong. He wasn't picking up on words at a rate that most of the charts showed he should be, and she had to constantly talk loudly to get his attention.
She insisted on a referral to a speech therapist from her pediatrician. The therapist began by giving him another hearing test. "This test showed that my son had a hearing loss," says Muhammad. "We got hearing aides and he was given speech therapy."
Little did she know, her son's hearing loss was progressive. "Thanks to the wonderful speech therapist and teachers, today he is enrolled in an oral school that teaches him how to speak and listen," says Muhammad.
Common Speech Problems
"The common speech problems I see in my office are speech delay, stuttering and articulation difficulties," says Dr. Dave Olson of the Grand Traverse Children's Clinic in Traverse City, Mich. "These are quite commonly seen in a pediatric office, and often they are self-limited problems that resolve with time." Dr. Olson explains that he first conducts a hearing test and then will usually refer the child to a speech specialist.
Sandra Coulson, president of the International Association of Orofacial Myology (IAOM), is one such specialist that gets the referrals. As an Orofacial Myologist, she specializes in working with the muscles of the face and tongue. These muscles facilitate proper movement of the facial muscles to be able to create specific speech sounds.
What Causes Them
According to IAOM, an orofacial myofunctional disorder is believed to be prevalent in 81 percent of children that show speech or articulation problems. The disorder involves incorrect habits of using the tongue, jaws, lips and face. There are several things that can cause such disorders, including the following:
- Developmental abnormalities
- Improper oral habits (e.g., thumb sucking, teeth grinding, nail biting)
- Enlarged tonsils or allergies that are restricting nasal airway
"I find quite often that the length of the lingual frenum, the attachment under the tongue, is extremely short or tight, which limits a child's ability to elevate the tongue for certain sounds," says Coulson. "This is often overlooked by the pediatrician, dentist or speech pathologist."
There are many reasons for speech delays, including cleft palate, accidents, mental retardation and psychosocial deprivation. The treatment method varies depending on the source of the problem. Some of the more common speech delays and problems can be caused by these factors:
- Hearing problems. Even if your child passed a newborn screening it's important to test again to rule out a hearing impairment.
- Stuttering. According to the Stuttering Foundation of America, around 60 percent of those that stutter have a family member that does as well, suggesting a genetic link. They also report that around 20 percent of children go through a stuttering period.
- Siblings. "Sometimes if the child has an older sibling who speaks for him he has no need to produce articulate sounds," says Coulson. Encourage your child to speak for himself instead.
- Tonsils. Having large tonsils can cause a delay in speech because the tongue is pushed forward, making it difficult to make sounds.
- Allergies. Frequent allergy problems can play a role in speech delay. "If a child is often congested, [then] hearing can be affected, the mouth rests open, the tongue rests forward and can become quite flaccid," says Coulson.
According to the American Academy of Family Physicians, it's important to understand what speech milestones are in order to determine if a child is having a speech problem or delay. The toddler milestones that they outline include the following:
- 12 months – Should be saying "mama" and "dada" with meaning and often imitate two and three syllable words.
- 16 to 18 months – Should have a vocabulary of 10 words.
- 22 to 24 months – Should have a vocabulary of up to 50 words.
- 2 to 2 1/2 years – Should have a vocabulary of up to 400 words.
- 2 1/2 to 3 years – Should be able to use plurals and past tense, count three objects correctly and have three- to five-word sentences, with up to 90 percent of speech being understood by strangers.
If your child is speech delayed or having problems, it should be addressed. Delaying treatment can lead to a child not feeling confident, which can hamper emotional growth. "Generally all kids undergo a dramatic acquisition of speech between 18 and 24 months," says Dr. Olson. "If your child is not exhibiting this explosion of speech then an initial pediatric evaluation is warranted."
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