Language Delays & Disorders

Articulation Disorders

• The child does not make speech sounds correctly due to incorrect placement or movement of the lips, tongue, and teeth
• May be caused by a physical problem interfering with speech production such as impaired muscle ability, a short tongue length, or cleft palate
• A child's speech is described as unintelligible when other people almost always misunderstand the child

Apraxia (a Motor Speech Disorder)

• Difficulty accessing vocabulary and problems finding the words he wants to say quickly.
• The young child, if they cannot think of words to use to enter into play with friends, they may choose to push, hit, or disrupt their play. In older children, difficulty finding the right words may show up as shyness or a tendency to rely on "I don't know" as a response to questions.
• Trouble putting sounds in the right order for words. This difficulty may also be found later as they learn written language.
• May have problems learning to read and spell. They cannot retrieve words from their memory and they cannot sequence the letters into words or the words into meaningful sentences.
• May show the same motor planning difficulties with tasks such as cutting, coloring and writing. An OT can assess motor planning problems that are affecting fine motor skills.

Voice Disorders

• The most common voice problem in children is vocal nodules
• Vocal nodules are hard calluses that develop on the vocal folds
• The voice is hoarse and sometimes weak and breathy if the nodules are large
• Caused by vocal abuse behaviors such as screaming, talking at the wrong pitch, frequent coughing or throat clearing or even constant loud talking and making sound effects for cars, motorcycles, etc.
• A child with a voice problem must be seen by an ear, nose, and throat doctor (ENT) prior to coming for a speech evaluation

Fluency Disorders

• The child has difficulty saying sounds, words and phrases in a smooth flow
• The most common fluency disorder is stuttering
• Many children do outgrow stuttering, but the most effective time to help children with a stuttering problem is in the preschool years
  • Repetitions: Syllable ("bu-bu-butter"), word ("I-I-I-I want to go"), phrase or a whole sentence
    • The more times a child repeats — more serious the problem
    • Syllables and words indicate a worse problem than phrases or sentences
  • Prolongations: prolong a sound "ssssssssock"
    • The longer the prolongation lasts, the more serious the problem
  • Signs of Tension:
    • The child may blink or squeeze the eyes shut while trying to say a word
    • The voice of the child may sound tense
    • The child may clench his fists

Language Disorders:

The Child may:

• Understand words and sentences as well as other children the same age, but may not use words to express meaning
• Struggle choosing the correct words to express meaning
• Rely on non-verbal or limited means of communicating, such as lifting a cup up to indicate "more milk" rather than simply asking for it
• Not take turns in conversation and allow the adults to do most of the talking
• Not use proper grammar such as plurals, past tense verbs, and other grammar forms that other children the same age use

Language Delay

Developmental delay refers to when a child's development lags behind established normal developmental milestone ranges for his or her age. Variations in development do occur and do not necessarily indicate a problem. If you have concerns about your child, consult your pediatrician or family doctor.

Please refer to our Speech & Language Developmental Milestones as a guide

Red Flags in Speech-Language Development...consult with your Pediatrician if...

• No or limited babbling by 9 months.
• No first words by 15 months.
• No consistent words by 18 months.
• A vocabulary less than 50 words with no two word combinations by age 2yrs.
• Slowed or stagnant speech development.
• Problems understanding your child's speech at 24 months of age; strangers having problems understanding your child's speech by 36 months of age.
• Not showing an interest in communicating.
• Excessive drooling.
• Difficulty sucking, chewing, or swallowing.
• Problems with control and coordination of lips, tongue, and jaw.
• Stuttering that becomes more consistent and lasts for periods beyond 6 months or causes child embarrassment, frustration, or difficulty with peers.
• Poor memory skills by the time your child reaches kindergarten age (5 to 6 years). He or she may have difficulty learning colors, numbers, shapes, or the alphabet.

Other Red Flags Include:

• Failure to respond normally, such as not responding when spoken to. This may or may not include signs that the child does not hear well, such as not reacting to loud noises.
• A sudden loss of speech and language skills. Loss of abilities at any age should be addressed immediately.
• Not speaking clearly or well by age 3.

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