Speech Disorder

What is a speech disorder?

Children acquire speech and language skills during the course of their normal growth and development. However, some children may have problems in developing speech.

Speech disorder is a condition where the child has problems with articulation, voice, fluency, or creating and forming speech sounds required for communication although they understand words well and are good in language skills.

Note:Speech disorder is different from language disorder. Children with speech disorder have difficulty pronouncing the sounds of words. Language disorder is a condition where children have difficulty in communicating with others (expressive language disorder), or understanding what others are saying or communicating (receptive language disorder).

Types of speech disorders

  • Apraxia: A motor speech disorder where the child has difficulty in making voluntary movements of the tongue, lips, or jaws to make speech sounds. The child knows what they want to say but the brain cannot coordinate the muscle movements to form words.

  • Dysarthria: Paralysis, weakness or generally poor coordination of the muscles of the mouth. This can make speech slow, inaccurate, slurred, or hypernasal (when too much sound comes through the nose).

What is not a speech disorder

As children begin to speak, they take time to learn new words and express themselves. They may also tend to have broken speech during this phase. This is quite normal and is not a speech disorder. Paying excessive attention to the child's broken speech in this phase may lead to stuttering. 

What are the signs of speech disorders?

The number of symptoms and their severity may vary from one child to another. Sometimes, the symptoms may be too mild to identify. Such mild forms of speech problems tend to disappear on their own.

Some children may have other problems along with their speech disorder. These can include poor vocabulary, problems with reading, writing, spelling, or math; coordination or motor-skill problems; chewing and swallowing difficulties.

A very young child(0-5 years)

  • Does not babble as an infant

  • Experiences difficulty in putting sounds and syllables together in the correct order or sequence

  • Misses syllables and sounds while pronouncing a word

  • Has problems combining sounds; may show long pauses between sounds

  • Simplifies words by replacing difficult sounds with easier ones, or by omitting difficult sounds

  • May have problems eating

An older child(5-10 years)

  • Makes inconsistent sound errors that are not the result of immaturity

  • Can understand language much better than he or she can talk

  • Clearly has more difficulty saying longer words or phrases than shorter ones

  • Struggles to pronounce a word correctly and may make a mistake while repeating it

  • Sounds choppy, monotonous, or stresses the wrong syllable or word while speaking

  • Makes consistent mistakes while speaking

 

What causes speech disorders?

For most children, the cause of the speech disorder is unknown. Research says that the disorder could be caused by the brain's inability to coordinate the muscle movement needed for speech. Other conditions such as cleft palate, hearing loss or cerebral palsy could also cause speech disorder.  

How is a speech disorder diagnosed?

There is no specific age at which a child can be diagnosed with the disorder. Experts may not be able to diagnose the condition in a child below three years of age because the child may not cooperate or follow instructions in the tests and evaluations. Hence, the diagnosis largely depends on how the child responds and whether they fully participate in these tests. 

Some of these tests are conducted to diagnose speech disorders:

  • Denver Articulation Screening Examination
  • Early Language Milestone Scale
  • Denver II
  • Peabody Picture Vocabulary Test, revised edition
  • Hearing test

Speech test: A speech-language pathologist records the developmental history and checks for any other medical issues. The expert also checks to see if the child’s speech is developing in the normal pattern, or is slow compared when compared to other children. 

If the expert has observed characteristics that do not fit with normal speech/language development, then a different set of tests and evaluations are conducted to confirm that the child has a speech disorder.

Augmentative and alternative communication (AAC): This approach uses assistive technology such as computers, iPads and audio-video enriched modules to help improve speech.

Audiometry test: Intellectual disability and hearing loss may also cause speech disorders. Infants at risk of developing a speec disorder must be referred to an audiologist for an audiology exam. Audiological and speech therapy can then be started, if required.

Getting treatment for speech disorders

There is no single approach to treat speech disorders. Experts use a combination of treatment methods and therapies to help the child improve their speech. Each child responds to the treatment differently because some children may improve faster as compared to others. 

The expert may advise parents about providing appropriate support and care for the child. Parents can participate in therapy sessions so that they can learn and continue the therapy at home, as continuous practice enables faster improvement. A supportive and loving home environment is conducive to recovery.

A healthy child is more receptive to treatments and therapies. Children with any physical illness (ear and sinus infections, tonsils, allergies or asthma) may not respond to the treatment because treatment and medication of the physical illness may interfere with speech therapy. Hence, parents need to take care of the child's physical health, as this will help the child respond to therapies and improve their speech.

What happens if speech disorder is not treated?

If the child is not provided with treatment at an early stage, then he or she may develop other problems such as:

  • Delay in language development
  • Being confused with word recall or order of words in a sentence
  • Having difficulty with fine motor movement/coordination
  • Becoming over sensitive (hypersensitive) or under sensitive (hyposensitive) in their mouths (may not like brushing teeth or eating crunchy foods)
  • Having problems in reading, spelling or writing, which could affect their academic progress.

Caring for a child with speech disorder

Along with the prescribed therapy, you can help your child communicate by following some of these guidelines:

  • Practice some of the therapy activities at home so that your child becomes familiar with the correct sounds of words. 
  • Ask simple questions so that your child speaks and practices using words.
  • Encourage your child to talk slowly. Listen patiently to what your child is saying and appreciate them when they are pronouncing words accurately.
  • Let your child feel secure and know that you have all the time to listen to them, and that you are there to help them overcome their difficulty.