Speech disorders are characterized by a difficulty in producing normal speech patterns.
Children go through many stages of speech production while they are learning to communicate. What is normal in the speech of a child of one age may be a sign of a problem in an older child. Speech disorders include voice disorders (abnormalities in pitch, volume, vocal quality, resonance, or duration of sounds), articulation disorders (problems producing speech sounds), and fluency disorders (impairment in the normal rate or rhythm of speech, such as stuttering .
Speech disorders are common. More than a million children in the public schools' special education programs have been diagnosed with a speech disorder. One in 10 people in the United States is affected by a communication disorder (speech, language, or hearing disorders).
Causes and symptoms
The causes of most speech disorders are not known. Deafness and hearing loss are significant causes of speech delays and disorders. The symptoms of a speech disorder depend heavily on the age of the child. There are no symptoms of speech disorders that apply to all ages of children. Basic guidelines about what kind of speech is normal at what age can be helpful in determining if a child is missing significant speech milestones.
- Twelve months: By this time babies should respond nonverbally, have different types of cries, and may know one or a few simple words (e.g. "mama" or "dada"). At this age babies should coo and babble.
- Eighteen months: Children of this age should be increasing their vocabularies slowly and be able to produce five to 20 common words.
- Twenty-four months: At this point vocabulary building should begin to speed up. At this age children should be able to produce simple sentences made up of two words.
- Three years: Children should begin to be able to produce speech that is understood by those outside immediate caretakers. Sentences become longer and more complex, and vocabulary increases drastically.
When to call the doctor
If a child continuously misses speech milestones, or is significantly behind what is generally considered average for his or her age, a doctor should be consulted. If hearing loss is ever suspected, such as if a child only responds when the parent speaking is in eyesight, the doctor should be consulted without delay.
A doctor will do a hearing test on the child to ensure that a hearing problem is not responsible for the speech delay. The doctor may interact with the child to determine linguistic competence. In addition, he or she will interview the parents or other caregivers or have them fill out a list indicating the child's verbal skills. The doctor will typically refer the child to a speech pathologist—a professional specializing in treating speech problems. The speech pathologist will work with the child, the child's family , and any other caregivers to develop a plan to help the child.
Children with isolated speech disorders are often helped by articulation therapy, in which they practice repeating specific sounds, words, phrases, and sentences. For stuttering and other fluency disorders, a popular treatment method is fluency training, which develops coordination between speech and breathing, slows down the rate of speech, and develops the ability to prolong syllables. A child may practice saying a single word fluently and then gradually add more words, slowly increasing the amount and difficulty of speech that can be mastered without stuttering. The speaking situations can gradually be made more challenging as well, beginning with speaking alone to the pathologist and ending with speaking to a group of people.
Delayed auditory feedback (DAF), in which stutterers hear an echo of their own speech sounds, has also been effective in treating stuttering. When a speech problem is caused by serious or multiple disabilities, a neurodevelopmental approach, which inhibits certain reflexes to promote normal movement, is often preferred. Other techniques used in speech therapy include the motor-kinesthetic approach and biofeedback, which helps children know whether the sounds they are producing are faulty or correct. For children with severe communication disorders, speech pathologists can assist with alternate means of communication, such as manual signing and computer-synthesized speech.
When speech disorders are detected and treated early, the prognosis is generally very good. Many speech disorders that are not caused by other underlying problems resolve themselves, and most others can be resolved completely or nearly completely with prompt treatment. Stuttering resolves itself without treatment in about 50–80 percent of children.
There is no known way to prevent most speech disorders, although making sure that children have a language-rich environment is thought to help disorders related to lack of input.
Speech disorders and significant speech delays can have a lasting negative impact on children. Children who have speech disorders may not want to communicate with their peers or even adults which may adversely affect their performance in school and social development.
Speech pathologist —An individual certified by the American Speech-Language-Hearing Association (ASHA) to treat speech disorders.
Bahr, Diane Chapman. Oral Motor Assessment and Treatment: Ages and Stages. Boston: Allyn and Bacon, 2001.
Freed, Donald B. Motor Speech Disorders: Diagnosis & Treatment. San Diego: Singular Pub. Group, 2000.
Merritt, Donna D. and Barbara Culatta. Language Intervention in the Classroom. San Diego, Calif.: Singular Pub. Group, 1998.
American Speech-Language-Hearing Association. 10801 Rockville Pike, Rockville, MD 20852. (800) 638–8255. Web site: http://www.asha.org.