Childhood Speech Disorders
and Language Disorders
During the first five years of children's lives most will pass through the same stages while learning to talk, but the rate at which they progress from stage to stage will vary.
Cooing and babbling heralds the one-word phase, the one-word stage graduates to the two-word level, two becomes three. At the same time children learn and refine the grammar and perfect their pronunciation. They learn how to manipulate the language in a wide range of social situations.
Most five year olds should talk like little adults. Some children however experience difficulties learning their language.
A child may have a speech disorder only, she may have a language disorder only or she may have both.
Language disorders can be further divided into two subcategories, receptive language disorders and expressive language disorders.
A child with a receptive language disorder has difficulty understanding.
A child with an expressive language disorder has difficulty expressing himself.
Childhood speech disorders may be caused by abnormalities with the structures that are involved in producing speech (lips, tongue, back of the mouth, palate), neurological abnormalities, developmental delays, injury, disease, genetic conditions, hearing impairment, and for unknown reasons.
Childhood language disorders can be caused by developmental delays, neurological impairments, illness and disease, injury, genetic conditions, hearing impairment and unknown reasons.
Speech Sound Disorders
A child who has difficulty producing speech sounds, or who does not produce speech sounds clearly has a speech sound disorder, which is also called an articulation disorder. Sounds may be substituted, omitted, added or altered.
If there is a pattern to the misarticulated sounds, then it is called a phonological disorder. Some patterns might be:
Final consonant deletion
Final sounds of words are omitted - a child may say 'ca' for cat, 'mi' for milk, 'I wa da boo' for I want that book
Clusters of speech sounds such as str-, bl- pl- are reduced - a child may say 'peas' for please, 'tring' for sting, 'top' for stop
Sounds which have a continuation of air flow (f, v, s, z, sh, th) are produced with a sound that has no air flow - a child may say 'pery punny' for very funny, 'tide dape' for five shapes, 'dode doed' for those shoes
Sounds produced at the back of the mouth (k, g) are produced in the front of the mouth - a child may say 'tat for cat, and 'tiss' for kiss.
A child with childhood apraxia of speech (sometimes referred to as dyspraxia) typically does not have a muscle or structural impairment but a motor planning problem. Muscle movement for speech is intact. The speech message from the brain is not relayed properly to the speech muscles and so the child has difficulty coordinating the movement for speech sounds even though he knows what he wants to say. She will have difficulty saying speech sounds and blending them together to produce words. Words with more than one syllable generally are more difficult as are longer phrases and sentences.
A child with orofacial myofunction disorder, also called tongue thrust, carries or holds her tongue in a more forward position than is normal when in a resting position, when speaking and/or swallowing. The tongue thrusts forward up against the front teeth or protrudes beyond the front teeth. Speech may or may not be affected. The s and z sounds may be produced as a th: thun for sun, thoo for zoo, Thally for Sally. The sh, zh (as in measure), ch and j sounds may also be affected, as well as the t, d and n sounds.
If you are concerned about your child's speech development or suspect that she has a speech disorder, a certified speech language pathologist will be able to determine if indeed there is an articulation disorder, the degree of the disorder, and suggest an intervention plan.
A child who stutters has non-fluent speech which can interfere with her ability to communicate. We all have some normal disfluencies when talking: we say uh, or pause momentarily, or repeat a phrase.
However disfluencies that occur more often or are more severe than normal can hinder normal discourse.
A child with disfluencies may have repetitions of sounds (p-p-p-p-pass the salt), words (I I I I I want the salt), and phrases.
She may prolong the beginnings of words (ssssssalt, mmmmmmman) or she may prolong vowels within words (haaaaaaaaat).
She may pause and hesitate more frequently than is normal; she may interject more uh's and um's than is normal.
A child may avoid saying "difficult" words as well. The frequency and severity of these features varies within a child's speech and from child to child.
If you are worried that your child may be more disfluent than normal, a certified speech language pathologist will be able to assess and diagnose the severity of the stuttering and provide recommendations for a treatment plan.
The vocal quality of a child with a voice disorder will not sound normal. We all have different and distinct voices, but when the vocal quality is atypical, usually there is a voice disorder.
The vocal cords, made up of two muscles shaped like a /\ (with the apex facing forward) sit in the larynx (the voice box). When air passes through the vocal cords from the lungs, they vibrate (open and close) very quickly, which creates sound - your voice.
If the vocal cords do not close completely, the features of the voice change. It may sound breathy, hoarse or harsh. There may be some difficulty with changing the pitch (speaking in a high or low voice) and volume (speaking loudly).
Nodules, polyps, lesions, paralysis (where one or both of the cords cannot vibrate) or weakness can be caused by injury, vocal abuse (shouting, talking too much, clearing your throat), pathology or disease. These affect the condition and movement of the vocal cords, consequently affecting the quality of the voice.
If you wonder about your child's voice, that it may be too hoarse, harsh or breathy, consult a certified speech languagepathologist who will be able to confirm the existence of a voice disorder, refer you to the appropriate medical specialist, and based on medical diagnosis recommend a treatment plan.
Receptive Language Disorder
A child with a receptive language disorder has difficulty understanding what is said to him.
He may be unable to answer simple questions or follow simple directions, or he may have difficulty following a story.
An older child may be unable to answer who, what, where and why questions. He may have difficulty following more complex directions. He may not remember what was said or read to him.
Generally a child with a receptive language delay/disorder will also have difficulties with expressive language.
Expressive Language Disorder
A child with an expressive language disorder has difficulty expressing himself. An expressive language disorder may exist on its own or it may be combined with a receptive language disorder.
A child may not be combining two words at two years of age, he may have difficulties with pronouns, he may not use the correct verb tenses, or he may have difficulty describing an object or an event. He may confuse words.
An expressive language disorder may be seen early in a child's development or at a later stage.
It can be a difficult task to decide whether your child has a speech disorder a language disorder, or is delayed in learning to speak.
If you are doubtful about her progress in acquiring language or are suspicious of a delay or a disorder, seek the advice of one of our certified speech language pathologist who will be able to assess the presence of a disorder, the severity, and make recommendations for your child.
If you would like to contact one of the certified speech language pathologists at Canto Speech Therapy, please click here.
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