Speech Disorders in Children

There are different contents in speech and language disorders depending on the problem area: Subheadings such as verbal expression disorder, speech and voice disorder, stuttering and social communication disorder are among the main areas of difficulty.

Verbal Expression Disorder

Symptoms such as the limited number of words used, difficulty in expressing in a way that is compatible with grammar (such as using past tense instead of future tense), difficulty in remembering words, and inability to form sentences of the expected length and complexity in line with age are observed. In some cases, it may be accompanied by difficulty in understanding various words, sentences or specific terms. This situation disrupts basic communication skills and negatively affects academic success and future professional life.

Speech and Voice Disorder

It is a condition that includes not being able to produce speech sounds that are developmentally appropriate for age, producing incorrect sounds, saying a sound instead of another (such as using the “t” sound instead of the “k” sound) or making omissions such as pronouncing the next consonant, and articulation problems. It brings with it various difficulties in maintaining daily communication, academic and social areas.

Stuttering

There is a problem with the normal fluency and timing pattern of speech. Sound and syllable repetitions, prolongation of sounds, exclamations, word fragmentation (pauses within a word), audible or silent blocks (pauses that can be filled or not filled during speech), circumlocution (using other words instead of difficult words to avoid them), saying words with excessive physical tension, and monosyllabic word repetitions are seen. School success, as well as social relationships and professional life, are negatively affected. In such cases, it is recommended that parents and teachers give the child the opportunity to speak, not interrupt him while he is speaking or say the word instead of him, and if necessary, he should definitely seek support from a professional who is specialized in speech and language.

Social Communication Disorder

It refers to difficulty in providing basic communication in social relationships (such as greeting, sharing information). Difficulty in changing the content of the conversation when necessary and adapting to the needs of the listener. Difficulty in following the necessary rules in conversation, correcting misunderstandings, and understanding the content (implication) implicitly presented in the conversation. It negatively affects social relationships, academic success, and daily life.

Speech Disorders in Children

Perhaps your greatest happiness can be to rejoice in the joy of your chatty children. Sometimes this process can be later than you expect. In some children, delayed speech is considered a speech disorder. You should also remember that each child’s developmental process is different.

Differences of a few months are not considered a problem. Some children may start making meaningful sounds in their second month, while others can do so in their third or fourth month. If you notice that your child who has completed the first six months is not making any sounds or is not making as many sounds as his/her peers, you can seek the opinion of a specialist. Early detection of the factors that cause speech disorders helps your children overcome the difficulties they experience in speech more quickly.

There can be many different reasons for speech disorders. In children, speech disorders can sometimes occur due to developmental delays and sometimes due to psychological reasons. Speech disorders can also occur due to motor skills, i.e. neurodevelopmental delays.

When the nerves and muscles that enable speech are not sufficiently developed, speech disorders may occur. These occur in different ways such as articulation disorders, stuttering, voice disorders, and language disorders. You should take your child to a neurological examination to determine the source of the speech disorder. You can ensure that your child receives the right support by learning whether his speech disorder is neurological or psychological.

If there is no negative situation in terms of muscle, nerve tissue and speech organs, the cause is most likely psychological. In this case, you should get the necessary support from expert child psychiatrists and psychologists in the field without delay. With support from an expert, you may notice that your child’s speech delay and disorder improves over time.

What are the Speech Disorders in Children?

Speech disorders seen in children are divided into multiple types. These are: developmental delay, articulation disorder, phonological disorder, apraxia, stuttering, social communication disorder, sensory auditory processing disorder.

1. Developmental Delay: Sometimes congenital or acquired hearing impairment in children can cause developmental delay. In addition, speech disorders can occur due to reasons such as the lip and tongue structure not developing as it should be, or the child having a muscle or nerve tissue disorder.
2. Articulation Disorder: Articulation disorder is the correct pronunciation of words that come out of the mouth, called articulation. Structural disorders such as lisping, mouth structure disorders, and cleft lips can prevent the correct sounds from coming out of the mouth.
3. Phonological Disorder: In this type of speech disorder, the child cannot produce sounds adequately. This situation, which occurs due to developmental delay, causes the child to be deprived of the ability to combine syllables and speak like his friends.
4. Apraxia: It is a type of psychomotor, or neurological disorder. It is a neurological disorder in which the brain cannot fully coordinate with the muscles and nerve tissues. The brain cannot transmit commands to the muscles in a sequential manner. The child cannot produce sounds correctly, cannot say words and sentences correctly.
5. Stuttering: The state of not being fluent while speaking, saying a syllable more than once. Stuttering can be a psychological disorder or it can occur due to a developmental disorder.
6. Social Communication Disorder: A person’s difficulty in making meaningful sentences, telling stories, etc. is called a social communication disorder. People with social communication disorder cannot distinguish how to speak to an adult, in a formal meeting, or to a child.
7. Sensory Auditory Processing Disorder: This is a condition in which the child does not fully understand the messages given and does not know how to respond. The causes of this communication and language disorder may include disorders such as hyperactivity, attention deficit, dyslexia, and autism. People with sensory auditory processing disorder have difficulty not only in the speech process but also in performing daily tasks. They cannot perform basic motor skills. They cannot do things that seem simple to everyone, such as getting dressed, doing things in order, and going up stairs.

Symptoms of Language Development and Speech Disorders in Children

If your child has a speech disorder, you may observe certain behavioral abnormalities that indicate this condition. Symptoms of a speech disorder include:

• The sounds produced do not contain meaningful wholes,
• Articulation disorder,
• Inability to adjust the volume of the sound correctly,
• Do not speak in a lower voice than necessary,
• Not being able to put the right emphasis while speaking,
• Lack of expression and insufficient vocabulary,
• There are various situations such as speech not being fluent.

Having difficulty speaking and not being able to understand the speech sufficiently are among the obvious indicators of speech disorder. Understandability is the most important issue here. In order for you to be able to articulate, the sounds must be processed correctly by the tongue, teeth and lips while being transmitted up the vocal cords and then coming out of the mouth. The tone of the voice, the use of the teeth and tongue greatly affect the quality of your speech.

If you do not have the right voice and pronunciation, you may not be able to express yourself effectively. If your voice is not clear enough and your accents are not correct, it may cause the people listening to you to think that you are not confident. If you are speaking louder than you should be, you may give the impression that you are angry to the other person. You should not forget that the vocal cords, tongue, teeth and lip structure must develop healthily for the correct voice formation. Speech disorders are not always caused by the person not using their voice well. If the speech organs do not develop properly, this may lead to speech disorders. Speech organs develop from the person’s birth.

Language development is a process that begins in infancy and continues throughout childhood. Babies can start making various sounds as early as 3 months. When they are 2-3 years old, difficulty forming sentences like their peers may indicate a speech disorder.

Other causes of speech disorders are not reading enough books and not using the speech organs correctly. Not being fluent causes your speech not to be as it should be and the people who listen to you to start getting bored. Not making a speech disorder and not repeating the same things while speaking helps you to achieve fluency.

Detection of Speech Disorders in Children

Early detection of speech disorders in children is very important in terms of intervention and subsequent gains. In the early stage, there are various behaviors that children should exhibit regarding language and speech within the scope of “normal” development. In the early stage after birth, babies are expected to smile and respond to social stimuli around them, albeit limitedly. In the first 6 months, babies make sounds called “babbling” (short syllables consisting of vowels and consonants: “ba” “da” de” “ma”). After six months, they make consecutive syllable sounds similar to the intonation of native language speech. They start using single words around the age of 1, and shortly after that, small sentences are formed where two words are combined but are not grammatically compatible (“mom-mama”). By the age of 2, sentences that are grammatically appropriate are seen (“mom give me food”, etc.).

It is expected that the vocabulary will be around 18 months, at least 20 words (such as mom-dad, give-and-take, food, baby, bye-bye, hot, etc.); and by the age of 2, it will be around 100-150 words.

When there is a delay or disruption in one of the normal developmental stages mentioned, language development is affected. If the baby is not babbling at all despite being 6 months old, if he/she shows his/her wishes by “only” pointing, if he/she cannot understand what people around him/her say despite being around 2 years old or if he/she makes incomprehensible sounds when he/she speaks, if the expected vocabulary is not sufficient for the age, if he/she has difficulty speaking despite being around 3 years old, a possible language and speech disorder may be suspected. For a more comprehensive evaluation, it is absolutely necessary to get support from a professional who is specialized in language and speech disorders and, if necessary, to see a mental health specialist (psychiatrist).

Parents can benefit by responding to their children’s reactions (socially and vocally), talking to their children a lot, reading books, and encouraging them to socialize with other children (peers) in order to support speech and language development.

Can Speech Disorders Be Corrected?

As with any disorder, speech disorders can be treated with early intervention and special education programs. Family support is much more effective than all treatment and therapy processes in the treatment of speech disorders in children. You should approach your child with patience and a supportive attitude. You can encourage him by appreciating every step he takes and make him understand that he can overcome his speech disorder.

Treatment methods include language therapy, behavioral therapy, and voice therapy. Developmental follow-up is an important issue in improving speech disorders. You should not neglect your child’s neurological examination. Treatment methods applied as a result of the motivation and patience you provide him/her may yield easier results.

Your child’s developmental disorder level and whether the disorder will fully recover or not will indicate whether the speech disorder will fully recover. During the treatment process, you can help your child with different supports such as physical therapy, sports, massage, hobbies, music therapy, psychotherapy.

How to Understand Speech Delay in Children?

The most obvious indicator of speech delay in children is the child’s inability to produce proper sounds during speech. Avoiding speaking because he cannot speak well enough, and the lack of sufficient vocabulary development prevent speech development. Speech delay may be due to lack of attention. Speech disorders that are psychologically based can be cured through psychotherapy. An expert psychiatrist can decipher your child’s communication language and guide him in terms of social interaction.

Play therapy is one of the methods you can use to make communication with children more effective. Drawing the child’s attention to an activity they enjoy and ensuring that they put in maximum effort supports language and speech skills. Over time, the child can develop the ability to imitate the sounds they hear.

Speech Disorders According to Age

If the developmental stages do not progress as expected in a child, it is possible to suspect a neurological disorder. Expected language skills begin to manifest themselves in every child in the form of various sounds a few months after birth. In the following months, children can produce various sounds in the form of syllables.

After reaching the age of 18 and in the first few years, the child can start to say meaningful words and sentences. In terms of age group norms, the child’s communication skills develop with the sounds they gradually begin to produce. Although they may not say some words completely at first, as they continue to speak, they develop their communication skills by imitating the sounds they hear from their environment.

Speech development is at different levels in early childhood, preschool and school age. It would be beneficial for children who are not able to speak as expected despite reaching school age to be monitored by a specialist for development. Awareness of the difficulties your child is experiencing is one of the most important issues. You can offer your support for what your child can do with love and interest without forcing him/her.

Excitement-Induced Speech Disorders

Speech disorders in children can also be caused by excitement. While the child can speak normally with his/her parents and friends, he/she may get excited when the teacher asks a question in class. They may stutter due to excitement when speaking on stage or in front of people.

You can approach the child with a calming attitude against speech disorders caused by stress and emotional reactions. It is very normal for you to get excited in front of so many people! Did you know? Actually, I get very excited here too. After a while, you get used to it, you can help the child normalize this situation. These types of conversations help the child understand that you understand his feelings and that being excited is a normal feeling. You can also prevent the development of social anxiety and fear of speaking in front of a group.

Stuttering that occurs due to excitement during speech may return to normal after the excitement has passed. You can encourage your children who are excited during speech to control their excitement with breathing exercises. Your child may want to end the speech as soon as possible because they are excited. In this case, they may start talking faster than they should. This causes their speech to be unintelligible.

It is perfectly natural for a child to react this way when dealing with excitement. You can encourage him by telling him that the important thing is to have the courage to stand before a group. Over time, you can help him overcome his excitement on this issue. Supportive attitudes help to solve the problem of lack of self-confidence in children in a shorter period of time. You can encourage your precious children to take part in active communication so that they become healthier and more social individuals.

You should not forget that in order for the child to develop speaking skills, their listening skills must also be good. Listening is as important as speaking, and you should encourage them to focus on the listener during a conversation. One of the best ways to prevent possible social phobias is to be aware of the child’s feelings. When they understand that the situation they are experiencing is normal and that they should not worry, communicating and talking may become easier for them after a while.

Until What Age Is It Normal for a Child Not to Talk?

Your child’s speech process does not occur all at once, but as a developmental journey. Children with normal language development gradually begin to make sounds during infancy and begin to say first single-syllable sounds and then two- and three-syllable words as they grow. If your child is not making sounds as desired from infancy onwards, signs of developmental delay should be monitored by a specialist.

Children with developmental disorders or delays can gain the ability to speak like their friends thanks to early diagnosis. The earlier the treatment process begins, the faster your beloved child’s speaking skills will develop. The child’s development process varies according to the severity of the developmental disorder. You can encourage him/her to make the right sounds starting from the 2-4 month period, which is considered the beginning of communication skills. You can talk to him/her to support his/her speaking skills. Babies gain speaking skills by hearing and imitating others.

The effect of family and environment on the normal speech development of a child cannot be denied. If your child has hearing loss or hearing impairment, this prevents him/her from speaking as he/she should. You can understand whether your child has a hearing impairment through hearing tests.

The examination you will have by applying to the pediatric ENT unit will help you understand in a short time whether there is any discomfort in this area. Early intervention is of utmost importance for hearing disorders that can be improved with treatment.

Your children’s healthy physical and mental development is closely related to good parental observation. You should follow them with great devotion from the moment they are born, and do not hesitate to consult an expert in cases where you have doubts.

What is Late Speech and How is it Related to Autism?

Late speech; It is a condition that occurs when the skills expected from the child in the field of language and speech do not develop within the appropriate age range. It is observed in young children between 18-30 months. The child has skills appropriate for his age in terms of motor skills and social skills, although he understands what is said (receptive language) his vocabulary and speaking skills (expressive language) are not compatible with his age. The presence of a late-talking parent in the family is also one of the determining factors, the rate of observation is higher in boys. It can also be observed in premature birth and births below normal weight.

There are important points that distinguish late talking from autism. In autism, there are cases where language and speech skills are acquired late or not acquired at all. In autism, the child has difficulty perceiving social messages and responding accordingly. Instead of speaking, “pointing” or “taking the parent’s hand and taking him/her away” to reach what he/she wants is frequently observed. The most important difference from late talking is that children who talk late understand language and can respond to social messages even if they cannot speak at the time. In both cases, support should be sought from a professional in the field of child mental health (psychiatrist/psychologist) and an intervention area should be established without delay as a result of guidance.

Causes of Speech and Language Disorders

Although the main cause of speech and language disorders is unknown, the factors that lead to them are as follows:

The primary cause of speech disorders is hearing problems. It is known that in addition to hearing loss, neurological problems (such as brain damage, mental retardation) and problems with the lip and tongue structure (such as tongue tie, cleft lip or cleft palate) also accompany hearing loss.

In areas related to language, low birth weight, premature birth, inadequate nutrition in the womb, exposure to toxic substances, and fetal alcohol syndrome are mentioned. The presence of genetic factors in language problems (delayed speech in the family, language problems, etc.) is another known reason.

Interventions for Children and Adolescents with Speech and Language Disorders

In speech and language disorders; the problem area experienced, the intervention and therapy technique to be applied also differ according to the age of the child. After a comprehensive evaluation, the problem area is determined and the appropriate treatment protocol is implemented. Applications are usually made from the ear, nose and throat departments of hospitals; for a more comprehensive evaluation, it is directed to the audiology department. It is very important for the effectiveness of the treatment that the specialist in the unit from which support will be received has training in the field of “audiology and speech disorders”. In the treatment protocol, an appropriate treatment plan is prepared according to the child’s needs. For example; children who have receptive language skills (understanding what is said) but limited or no expressive language skills (speaking) benefit greatly from speech and language therapy.