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Children who Benefit from Speech Pathology Services

A child may benefit from speech pathology services if he or she cannot communicate as well as other children at the same age, or if the child has difficulty with any aspects of  feeding or swallowing. Speech pathology services should be considered if the child demonstrates any of the symptoms described in the following sections:

LANGUAGE DISORDER

A child with a language disorder may have difficulty understanding language, following directions or choosing appropriate words and combining them correctly in sentences. Language disorders can affect the child’s ability to interact with others and to learn. Some characteristics of a language disorder at different ages include the following:

  • 4 months: Has poor eye contact or is inattentive to the speech of others 
  • 6–8 months: Doesn’t use gestures
  • 12 months: Has difficulty understanding speech or following simple directions 
  • 16–18 months: Uses no words or has a limited vocabulary
  • 24–26 months: Does not combine words for short sentences
  • 3 years: Echoes words or phrases or has many grammar errors in sentences 
  • 3–4 years: Cannot retell stories or talk about past events
  • 6 years: Has trouble with attention, memorization of facts, learning or reading

ARTICULATION (SPEECH SOUND) DISORDER

A child with an articulation (speech sound) disorder may have difficulty producing individual sounds. As a result, the child may substitute an easy sound for a harder one (i.e., tun for sun), omit sounds (i.e., ool for school) or distort sounds (i.e., shlun for sun). In some cases (i.e., apraxia of speech), the child may have difficulty combining the movements of speech sounds in sequences, as required for words and sentences. Articulation errors often make speech very hard to understand. Some characteristics of an articulation disorder at different ages include the following: 

  • 8–9 months: Does not babble in a repetitive manner
  • 18 months: Uses primarily vowels or only a few consonants
  • 3 years: Leaves out consonants or has unclear speech
  • 4 years: Has distorted speech that is often hard to understand
  • 6 years: Cannot produce some speech sounds

FLUENCY DISORDER (STUTTERING)

A child with a fluency disorder (stuttering) has frequent abnormal disruptions in the flow of speech. Characteristics of a fluency disorder include the following:

  • Involuntary repetitions, hesitations, prolongations, blocks, or disruptions during speech
  • Tension during speech or abnormal movements such as jerking or forceful eye blinking
  • Refusal to talk to strangers due to a fear of stuttering
  • Embarrassment during speaking.

Feeding and Swallowing Problems (Dysphagia)

A child with a feeding or swallowing disorder may have one or more of the following signs or symptoms:

  • Difficulty swallowing liquids and/or solids
  • Difficulty sucking or drinking from a cup
  • Difficulty taking foods from a spoon or chewing foods
  • Avoidance of certain types of foods or certain food textures
  • Gagging, choking, or coughing during feeding

Resonance Disorders

A child with a resonance disorder will have either velopharyngeal (a problem with the valve that closes off the nose from the mouth during speech) or blockage in the nose, throat or back of the mouth. Types of resonance disorders include the following:

  • Hypernasality due to too much sound in the nasal cavity during speech
  • Hyponasality due to a blockage in the nasal cavity
  • Cul-de-sac resonance due to blockage in one or more areas of the vocal tract

Voice Disorder

A child with a voice disorder has either abnormal vocal cord structure or abnormal function. Characteristics of a voice disorder include one or more of the following symptoms:

  • A chronically hoarse, harsh, breathy, or raspy voice quality
  • An inappropriate vocal pitch for the child's age or sex
  • Frequent pitch breaks
  • A voice that is consistently too soft

Causes of Communication and Feeding/ Swallowing Disorders

The exact cause of a communication disorder is not always known. However, common causes include abnormal structures (oral, pharyngeal, or laryngeal), neurological problems, and hearing loss. Causes of feeding and swallowing disorders include structural abnormalities and neurological problems.

 

 

 

 

 

 

 

 

 

INFORMATION FOR FAMILIES

 

 

THE IMPORTANCE OF EARLY INTERVENTION

Communication skills are critical for a normal, productive life. Left untreated, a communication disorder can have a life-long effect on social development, interpersonal relationships, the ability to learn, and on ultimate independence. Swallowing disorders can affect nutrition, health, and even relationships that develop within the context of social eating.

Young children develop the majority of their speech and language skills in the first three years of life. During this time, this learning influences how the brain develops. Early intervention is critically important because infants, toddlers, and preschoolers have developing brains that are designed to learn communication and swallowing skills. If there is a problem with that development, therapy should be started as soon as possible to take advantage of this period of normal brain development.

Early intervention for a communication or swallowing disorder will greatly improve the child’s ultimate outcome. Of course, speech-language pathologists are able to determine what problems the child will “grow out of” and what problems will require treatment.