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Speech Disorders and Language Disorders
What are speech/language delays and disorders?
What causes speech and language problems?
Causes of speech and language disorders
There are a variety of causes of speech and language disorders.

•Congenital syndromes
•Disorders of the prenatal environment
•Syndromes acquired after birth
•Factors that may contribute to a speech-language disorder

Speech Disorders and Language Disorders

A speech disorder refers to a problem with the actual production of sounds, whereas a language disorder refers to a difficulty understanding or putting words together to communicate ideas.

Speech disorders include:
•Articulation disorders: difficulties producing sounds in syllables or saying words incorrectly to the point that listeners can't understand what's being said.
•Fluency disorders: problems such as stuttering, in which the flow of speech is interrupted by abnormal stoppages, repetitions (st-st-stuttering), or prolonging sounds and syllables (ssssstuttering).
•Resonance or voice disorders: problems with the pitch, volume, or quality of the voice that distract listeners from what's being said. These types of disorders may also cause pain or discomfort for a child when speaking.
•Dysphagia/oral feeding disorders: these include difficulties with drooling, eating, and swallowing.
Language disorders can be either receptive or expressive:
•Receptive disorders: difficulties understanding or processing language.
•Expressive disorders: difficulty putting words together, limited vocabulary, or inability to use language in a socially appropriate way.
Where can I get more information?
The functions, skills, and abilities of voice, speech, and language are related. Some dictionaries and textbooks use the terms almost interchangeably. But for scientists and medical professionals, it is important to distinguish among them.
Voice
Voice (or vocalization) is the sound produced by humans and other vertebrates using the lungs and the vocal folds in the larynx, or voice box. Voice is not always produced as speech, however. Infants babble and coo; animals bark, moo, whinny, growl, and meow; and adult humans laugh, sing, and cry. Voice is generated by airflow from the lungs as the vocal folds are brought close together. When air is pushed past the vocal folds with sufficient pressure, the vocal folds vibrate. If the vocal folds in the larynx did not vibrate normally, speech could only be produced as a whisper. Your voice is as unique as your fingerprint. It helps define your personality, mood, and health.

Approximately 7.5 million people in the United States have trouble using their voices. Disorders of the voice involve problems with pitch, loudness, and quality. Pitch is the highness or lowness of a sound based on the frequency of the sound waves. Loudness is the perceived volume (or amplitude) of the sound, while quality refers to the character or distinctive attributes of a sound. Many people who have normal speaking skills have great difficulty communicating when their vocal apparatus fails. This can occur if the nerves controlling the larynx are impaired because of an accident, a surgical procedure, a viral infection, or cancer.

Speech

Humans express thoughts, feelings, and ideas orally to one another through a series of complex movements that alter and mold the basic tone created by voice into specific, decodable sounds. Speech is produced by precisely coordinated muscle actions in the head, neck, chest, and abdomen. Speech development is a gradual process that requires years of practice. During this process, a child learns how to regulate these muscles to produce understandable speech.

However, by the first grade, roughly 5 percent of children have noticeable speech disorders; the majority of these speech disorders have no known cause. One category of speech disorder is fluency disorder, or stuttering, which is characterized by a disruption in the flow of speech. It includes repetitions of speech sounds, hesitations before and during speaking, and the prolonged emphasis of speech sounds. More than 15 million individuals in the world stutter, most of whom began stuttering at a very early age. The majority of speech sound disorders in the preschool years occur in children who are developing normally in all other areas. Speech disorders also may occur in children who have developmental disabilities.

Language

Language is the expression of human communication through which knowledge, belief, and behavior can be experienced, explained, and shared. This sharing is based on systematic, conventionally used signs, sounds, gestures, or marks that convey understood meanings within a group or community. Recent research identifies “windows of opportunity” for acquiring language—written, spoken, or signed—that exist within the first few years of life.

Between 6 and 8 million individuals in the United States have some form of language impairment. Disorders of language affect children and adults differently. For children who do not use language normally from birth, or who acquire an impairment during childhood, language may not be fully developed or acquired. Many children who are deaf in the United States use a natural sign language known as American Sign Language (ASL). ASL shares an underlying organization with spoken language and has its own syntax and grammar. Many adults acquire disorders of language because of stroke, head injury, dementia, or brain tumors. Language disorders also are found in adults who have failed to develop normal language skills because of mental retardation, autism, hearing impairment, or other congenital or acquired disorders of brain development.

Problems involving speech

There are several organic and psychological factors that can affect speech. Among these are:

1.Diseases and disorders of the lungs or the vocal cords, including paralysis, respiratory infections (bronchitis), vocal fold nodules and cancers of the lungs and throat.
2.Diseases and disorders of the brain, including alogia, aphasias, dysarthria, dystonia and speech processing disorders, where impaired motor planning, nerve transmission, phonological processing or perception of the message (as opposed to the actual sound) leads to poor speech production.
3.Hearing problems, such as otitis media with effusion, and listening problems, auditory processing disorders, can lead to phonological problems.
4.Articulatory problems, such as stuttering, lisping, cleft palate, ataxia, or nerve damage leading to problems in articulation. Tourette syndrome and tics can also affect speech. Many speakers also have a slur in their voice
5.In addition to dysphasia, anomia and auditory processing disorder can impede the quality of auditory perception, and therefore, expression. Those who are Hard of Hearing or deaf may be considered to fall into this category. What are speech/language delays and disorders? Speech is the sound that comes out of our mouths. When it is not understood by others there is a problem. Speech problems, such as stuttering and mispronunciation can be very frustrating. Language has to do with meanings, rather than sounds. Language is a measure of intelligence and language delays are more serious than speech problems. Language delay is when a child’s language is developing in the right sequence, but at a slower rate. Speech and language disorder describes abnormal language development. Delayed speech or language development is the most common developmental problem. It affects five to ten percent of preschool kids. Find out exactly What is Language? What is Speech? Here’s more about Children with Communication Disorders. How can I tell if my child’s speech and language development is on track? If your child is not on track with the following speech/language development milestones, you should talk to your pediatrician. Here are the milestones to look for in normal speech development:
Age Language Level

Birth

Cries

2-3 months

Cries differently in different circumstances; coos in response = to=20 you

3-4 months

Babbles randomly

5-6 months

Babbles rhythmically

6-11 months

Babbles in imitation of real speech, with = expression

12 months

Says 1-2 words; recognizes name; imitates familiar sounds; = understands=20 simple instructions

18 months

Uses 5-20 words, including names

Between 1 and 2 years

Says 2-word sentences; vocabulary is growing; waves goodbye; = makes=20 =93sounds=94 of familiar animals; uses words (like =93more=94) to = make wants=20 known; understands =93no=94

Between 2 and 3 years

Identifies body parts; calls self =93me=94 instead of name; = combines nouns=20 and verbs; has a 450 word vocabulary; uses short sentences; = matches 3-4=20 colors, knows big and little; likes to hear same story repeated; = forms=20 some plurals

Between 3 and 4 years

Can tell a story; sentence length of 4-5 words; vocabulary of = about=20 1000 words; knows last name, name of street, several nursery=20 rhymes

Between 4 and 5 years

Sentence length of 4-5 words; uses past tense; vocabulary of = about 1500=20 words; identifies colors, shapes; asks many questions like = =93why?=94 and=20 =93who?=94

Between 5 and 6 years

Sentence length of 5-6 words; vocabulary of about 2000 words; = can tell=20 you what objects are made of; knows spatial relations (like =93on = top=94 and=20 =93far=94); knows address; understands same and different; = identifies a penny,=20 nickel and dime; counts ten things; knows right and left hand; = uses all=20 types of sentences

What are speech/language delays and disorders?

What causes speech and language problems?

Developmental speech and language disorder is a common reason for speech/language problems in kids. This is a learning disability that is caused by the brain working differently. These kids may have trouble producing speech sounds, using spoken language to communicate, or understanding what other people say. Speech and language problems are often the earliest sign of a learning disability. Find out more about language-based learning disabilities. Hearing loss is often overlooked, and easily identified. If your child is speech/language delayed, their hearing should be tested.

Intellectual disabililtyis a common cause of speech and language delay.

Extreme environmental deprivation can cause speech delay. If a child is neglected or abused and does not hear others speaking, they will not learn to speak. Prematurity can lead to many kinds of developmental delays, including speech/language problems. Auditory Processing Disorder describes a problem with decoding speech sounds. These kids can improve with speech and language therapy.

Neurological problems like cerebral palsy, muscular dystrophy, and traumatic brain injury can affect the muscles needed for speaking.

Autism affects communication.

Speech/language/communication problems are often an early sign of autism. Find out more: Autism and Communication.

Structural problems like cleft lip or cleft palate can interfere with normal speech. More on speech development and cleft palate.

Apraxia of speech is a specific speech disorder in which the child has difficulty in sequencing and executing speech movements.

Selective mutism is when a child will not talk at all in certain situations, often school.

How can my child communicate, if not verbally?

Children who are nonverbal, or not communicating well enough due to hearing loss, autism, apraxia, or similar problems, can use other methods. These include sign language, the Picture Exchange Communication System (PECS), and Augmentative and Alternative Communication.

The American Sign Language Browser can help you look up signs for words you need. At the bottom of the screen, just click on the first letter of the word you want to look up, then scroll down the right hand side and click on the word you want. A video will appear to demonstrate the sign, along with a written description.

How can I help my child with language development?

It is important to identify speech/language problems early, so your child can begin treatment. Many people believe that speech and language treatment cannot begin until a child starts talking. This is not true. Treatment can and should begin as soon as possible. Research shows that children know a lot about language long before the first word is ever said. If your child has any risk factors (for example low birth weight) or any of the problems listed above, they should be tested early and periodically for speech/language problems. If your child needs treatment, it should be developmentally appropriate and individualized. Your child’s treatment team might include a doctor, an audiologist, a speech-language pathologist, an occupational therapist, and/or a social worker.

Be sure to read YourChild: Learning Disabilities or Developmental Delay for information about how the school system can help your baby, preschooler, or school-age child if you have speech or language concerns.

For more about how schools can help: FAQ: Speech and Language Disorders in the School Setting Here are some parenting tips for helping along your child’s speech and language:
Start talking to your child at birth. Even newborns benefit from hearing speech.

Respond to your baby’s coos and babbling.

Play simple games with your baby like peek-a-boo and patty-cake.

Listen to your child. Look at them when they talk to you. Give them time to respond. (It feels like an eternity, but count to 5—or even 10—before filling the silence).

Describe for your child what they are doing, feeling and hearing in the course of the day.

Encourage storytelling and sharing information.

Don’t try to force your child to speak.
Read books aloud. Ask a librarian for books appropriate to your child’s age. If your baby loses interest in the text, just talk about the pictures. Sing to your child and provide them with music. Learning new songs helps your child learn new words, and uses memory skills, listening skills, and expression of ideas with words.

Expand on what your child says. (For example, if your child says, “Elmo!”, you can say, “You want Elmo!”) Talk a lot to your child. Tell them what you are doing as you do it.

Plan family trips and outings. Your new experiences give you something interesting to talk about before, during, and after the outing.

Look at family photos and talk about them. Answer your child every time they speak—this rewards them for talking.

Ask your child lots of questions.
Use gestures along with words.
Don’t criticize grammar mistakes. Instead, just model good grammar.
Play with your child one-on-one, and talk about the toys and games you are playing.
Follow your child’s lead, so you are doing activities that hold their interest as you talk.
Have your child play with kids whose language is a little better than theirs.

What about stuttering, and how can parents help?

Stuttering (sometimes called stammering) is a speech disorder. In stuttering, the normal flow of speech is broken up by repeating or lengthening the sounds, syllables, or words. A person may also have trouble getting a word started. Most kids outgrow stuttering. Parents can help by:

Once in a while, talk about the stuttering in an accepting, encouraging way.
Find out how to communicate with someone who stutters.
Talk to your child in a slow, relaxed way.
Take time each day to spend some relaxed, one-on-one time with your child. Follow their lead, and let them be the center of attention.
Take turns speaking in the family, such as at dinner time—make sure family members aren’t competing for time to talk.
Slow the pace of life in the home, especially conversations.
If your child is getting treatment for stuttering, don’t set perfect speech as the goal. Rather, expect treatment to help your child to arrive at more natural speech, with less struggle and work.
The Stuttering Foundation has a helpful video called Stuttering and Your Child: Help for Parents

Where can I find more information and support?

Information and organizations:
Delayed speech or language development —basic information from KidsHealth.org, including normal development, warning signs, causes, how Speech-Language Pathologists (SLPs) can help, and what parents can do.

Speech Clarity

The ability to speak clearly so that it is understandable to a listener