Speech Delay

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What are speech/language delays and disorders?
Speech is the sound that comes out of our mouths. When it cannot be understood, there is a problem. Speech problems, such as stuttering and mispronunciation can be very frustrating. Language has to do with meanings, rather than sounds. Language is a measure of intelligence and language delays are much more serious than speech problems.

Language delay is when a child’s language is developing in the right sequence, but at a slower rate. Speech and language disorder describes abnormal language development. Speech/language delays and disorders are the most common developmental problem among preschool kids. Delayed speech or language development is the most common developmental problem. It affects five to ten percent to preschool kids.

How can I tell if my child’s speech and language development is on track?
If your child is not on track with the following speech/language development milestones, you should talk to your pediatrician.

What causes speech and language problems?
Developmental speech and language disorder is a common reason for speech/language problems in kids. This is a learning disability that is caused by the brain working differently. These kids may have trouble producing speech sounds, using spoken language to communicate, or understanding what other people say. Speech and language problems are often the earliest sign of a learning disability or of autism. Find out more about language-based learning disabilities.

Hearing loss is often overlooked, and easily identified. If your child is speech/language delayed, their hearing should be tested.

Mental retardation is a common cause of speech and language delay.

Extreme environmental deprivation can cause speech delay. If a child is neglected or abused and does not hear others speaking, they will not learn to speak.

Prematurity can lead to many kinds of developmental delays, including speech/language problems. Find out more about prematurity and speech and language delays.

Auditory Processing Disorder describes a problem with decoding speech sounds. These kids can improve with speech and language therapy.

Neurological problems like cerebral palsy, muscular dystrophy, and traumatic brain injury can affect the muscles needed for speaking.

Structural problems like cleft lip or cleft palate can interfere with normal speech.

Apraxia of speech is a specific speech disorder in which the child has difficulty in sequencing and executing speech movements.

Selective mutism is when a child will not talk at all in certain situations, often school.

How can my child communicate, if not verbally?
Children who are nonverbal, or not communicating well enough due to hearing loss, autism, apraxia, or similar problems, can use other methods. These include sign language, the Picture Exchange Communication System (PECS), and Augmentative and Alternative Communication.

How can I help my child with language development?
It is important to identify speech/language problems early, so your child can begin treatment. Many people believe that speech and language treatment cannot begin until a child starts talking. This is not true. Treatment can and should begin as soon as possible. Research shows that children know a lot about language long before the first word is ever said. If your child has any risk factors (for example low birth weight) or any of the problems listed above, they should be tested early and periodically for speech/language problems. If your child needs treatment, it should be developmentally appropriate and individualized. Your child’s treatment team might include a doctor, an audiologist, a speech-language pathologist, an occupational therapist, and/or a social worker.

Here are some parenting tips for helping along your child’s speech and language:

• Start talking to your child at birth. Even newborns benefit from hearing speech.

• Respond to your baby’s coos and babbling.

• Play simple games with your baby like peek-a-boo and patty-cake.

• Listen to your child. Look at them when they talk to you. Give them time to respond. (It feels like an eternity, but count to 5—or even 10—before filling the silence).

• Describe for your child what they are doing, feeling and hearing in the course of the day.

• Encourage storytelling and sharing information.

• Don’t try to force your child to speak.

• Read books aloud. Ask a librarian for books appropriate to your child’s age. If your baby loses interest in the text, just talk about the pictures.

• Sing to your child and provide them with music. Learning new songs helps your child learn new words, and uses memory skills, listening skills, and expression of ideas with words.

• Expand on what your child says. (For example, if your child says, “Elmo!”, you can say, “You want Elmo!”)

• Talk a lot to your child. Tell them what you are doing as you do it.

• Plan family trips and outings. Your new experiences give you something interesting to talk about before, during, and after the outing.

• Look at family photos and talk about them.

• Answer your child every time they speak—this rewards them for talking.

• Ask your child lots of questions.

• Use gestures along with words.

• Don’t criticize grammar mistakes. Instead, just model good grammar.

• Play with your child one-on-one, and talk about the toys and games you are playing.

• Follow your child’s lead, so you are doing activities that hold their interest as you talk.

• Have your child play with kids whose language is a little better than theirs.

On Stuttering:
Many young kids go through a stage between the ages of 2 and 5 when they stutter, repeating certain syllables, words or phrases, prolonging them, or stopping, making no sound for certain sounds and syllables. Stuttering is a form of dysfluency – an interruption in the flow of speech. In many cases, this stuttering goes away on its own by age 5, as the child learns how to speak and how to coordinate the muscles that are used for talking. In other cases, stuttering lasts longer. While there is no cure for stuttering, there are many effective treatments for it and ways that you can support your child until he or she overcomes trouble speaking.

What Causes Stuttering?
Experts think that a variety of factors contribute to stuttering:

• Genetics: About 60% of those who stutter have a close family member who stutters.

• Other speech and language problems or developmental delays.

• Differences in the brain’s processing of language: People who stutter process language in different areas of the brain. And there’s a problem with the way the brain’s messages interact with the muscles and body parts needed for speaking.

Early Signs of Stuttering
The first signs of stuttering tend to appear when a child is about 18 to 24 months old and starting to put words together to form sentences. To parents, the stuttering may be upsetting and frustrating, but it is natural for kids to do some stuttering at this stage of development. It’s important to be as patient with your child as possible. A child may stutter for a few weeks or several months, and the stuttering may be sporadic. For most kids who begin stuttering before the age of 5, the stuttering eventually goes away without any need for intervention such as speech or language therapy. However, if your child’s stuttering is frequent, continues to get worse, and is accompanied by body or facial movements, it’s a good idea for a speech-language therapist to evaluate your child before he or she is 3 years old.

The School Years
Usually, stuttering drops to very low levels when kids enter elementary school and start sharpening their communication skills. If your school-age child continues to stutter, he or she is likely aware of the problem and may be embarrassed by it. Classmates and friends may draw attention to it or even tease your child. If this happens, talk to your child’s teacher, who can address this in the classroom with the kids. The teacher also may be able to decrease the number of stressful speaking situations for your child until his or her speech therapy begins.

When to Seek Help
If your child is 5 years old and still stuttering, talk to your child’s doctor and, possibly, a speech-language therapist. You also may want to consult with a speech therapist if:

• Repetitions of whole words and phrases become excessive.

• Sound and syllable repetitions begin to happen more frequently.

• There is an increase in the prolongations of words.

• Your child’s speech starts to be effortful or strained.

• You notice increased facial tension or tightness in the speech muscles.

• You notice vocal tension resulting in rising pitch or loudness.

• your child chooses to avoid situations where he or she would have to talk.

• Your child has facial or body movements along with the stuttering.

• You have other concerns about your child’s speech.

Most schools will offer testing and appropriate therapy if you have been concerned about the stuttering for 6 months or more.

What Parents Can Do
Try these steps to provide a nurturing environment for your child:

• Don’t require your child to speak precisely or correctly at all times. Allow talking to be fun and enjoyable.

• Use family meals as a conversation time. Avoid distractions such as radio or television.

• Avoid corrections or criticisms such as “slow down,” “take your time,” or “take a deep breath.” These comments, however well-intentioned, will only make your child feel more self-conscious about the way that he or she is speaking.

• Avoid having your child speak or read aloud when he or she is uncomfortable or when the stuttering increases. Instead, during these times encourage activities that do not require a lot of talking.

• Don’t tell your child to start over.

• Don’t tell your child to think before speaking.

• Provide a calm atmosphere in the home. Try to slow down the pace of family life.

• Speak slowly and clearly when talking to your child or others in his or her presence.

• Maintain natural eye contact with your child. Try not to look away or show signs of being upset.

• Let your child speak for himself or herself, and allow your child to finish thoughts and sentences. Pause before responding to your child’s questions or comments.

• Talk slowly to your child. This takes practice!