Speech and Language

Photo by Gustavo Fring on Pexels

A child who has atypical language acquisition i.e. has not spoken their first word by the time they are 1 years old may be considered to be a ‘late talker’ or be diagnosed by their paediatrician to have a language delay.

These words often send parents into a frenzy of worry. Some people may advise you to wait and see. However, in my experience it is never too early to get some help and advice from a professional. A speech therapist probably won’t give you intensive therapy at this stage but will provide you with an assessment and guide you in areas that would promote language development.

The ‘talking’ is just the tip of the iceberg – what we can see and hear. However, there are a whole host of pre-verbal skills that children need to acquire before they learn how to speak. These include joint attention, eye contact, taking turns, play (symbolic, imaginative, creative) and comprehension of words, the way things work and following simple instructions.

Some key elements in promoting language is SPEAK to your child all the time and explain what you are doing.

Use simple language (not baby talk)

Interact, communicate with words, varied intonation.

Engage children in simple play – rolling a ball, building blocks, pushing cars, pretend play with animals, food, vehicles, peek-a-boo, board books, finger painting, play dough, singing, playing with musical instruments – creating your own drum, xylophone, bells, tambourines, going to the playground and exploring slides, tunnels, running.

Below the age of 5, there is no need for devices – TV, iPad, iPhones and it is far better to engage in good old fashioned play to develop your child’s social and language skills.

If your child has limitations in any of the pre-verbal skills it is always a good idea to book an appointment with a speech and language therapist.

Click here for a checklist on speech, language and communication for children from Birth to 5years.

Phonological / Speech / Articulation delay/disorder indicates that a child has difficulties with particular speech sounds or the listener is finding it hard to understand the child’s speech.

It is important to note that children are not expected to speak articulately from the moment they acquire words. In fact they acquire certain speech sounds at particular ages and should be able to articulate all these sounds by the time they are 7 years old.

Click here for information on norms for speech sound acquisition.

Some tips to help your child at home are firstly, the adult has to model the correct way to say the word.

SPEAK SLOWLY so that your child can hear the word easily. Children also tend to mimic the way the adults in their environment speak. Hence, if the adults speak quickly, the children will try to speak quickly as well which does not give their muscles time to get into the correction position for the word.

STRESS the SOUND that your child is struggling with so that they can hear the sound in that word.
Have a WORD of the WEEK that you can focus on and give many opportunities in play and daily communication for your child to use that word.

Aphasia / Dysphasia is a language disorder that occurs following a brain injury e.g. stroke, encephalitis, traumatic brain injury. It could affect one or a few components of language which include understanding of spoken language, understanding of written language, expressive language and written language.

Dyspraxia is a motor speech disorder that affects the coordination of muscles involved in the production of speech. In pure dyspraxia, the muscles have adequate strength for speech but there is an inability to move the muscles in the desired (or correct) way to speak accurately.

You will find that automatic / involuntary speech comes easily, words may be spoken clearly at times and not repeatable, singing or known prayers may be easier and there could be inconsistencies in how they say words.

It can be a very frustrating difficulty to have especially when the client is aware of their speech errors and find it hard to coordinate their muscles to say things the correct way.

Dysarthria is a motor speech disorder that affects the speech subsystems that include the jaw,lips, tongue, soft palate, larynx (voicing) and respiration (breath support for speech). It may present as weakness, decrease of speed or range of movement in one or many of the speech subsystems.

Voice disorders or dysphonia could affect both adults or children.

It could be as a result of a brain injury, vocal abuse or misuse.

It is very important to get an ENT evaluation when a patient has a voice disorder to look into the structure of the larynx and vocal cords.

For more information and tips on vocal hygiene.

Stammering / Stuttering / Dysfluency is when a child or adult is unable to express themselves fluently. Primary characteristics of dysfluency include repetitions, prolongations and blocks. The dysfluent speech could consist of one or a combination of these characteristics. Some clients may also present with secondary characteristics associated with stammering such as excessive blinking, facial grimacing, tapping or hitting.

Stammering can begin in childhood from the age of 3years and is diagnosed as a chronic stammer when a child has been stammering consistently over 6 months. Children below the age of 3years may present with dysfluent speech as they acquire language but this is called ‘normal non-fluency’. If a parent notices this and is concerned, it is always a good idea to get a second opinion from a speech therapist as early intervention is vital in overcoming dysfluency.

Some strategies to implement at home with young children who have normal non-fluency or beginning to stammer are:

  • Parents model a slower rate of speech.
  • Encourage your child to take their time when they are speaking to you and reassure them that you are listening.
  • Ensure that they are not fighting with environmental / background noise (TV / Radio, other children) to get your attention.
  • Praise your child when they have spoken slowly by using specific words ‘that was good slow talking’ or ‘that was good smooth talking’.

A severe anxiety disorder whereby a child speaks only to a select few and in a selected environment. These children may or may not have a speech and language difficulty. 

Children with selective mutism could also have a speech and/or language difficulty. Hence, it is a good idea to get them evaluated by a child psychologist and/or a speech and language therapist.

For more information on selective mutism