The first three years
Every child develops at his or her own pace. Problems with a child’s height or weight are usually easy to recognize for parents but problems with speech or language may not be so easily detected. Nearly 1 in 12 children in the U.S. between the ages of 3 and 17 have a disorder related to speech or language, according to the National Institute on Deafness and Other Communications Disorders. Research has shown that the first the first 3 years of life, when the brain is developing and maturing, is the most intensive period for acquiring speech and language skills. These skills develop best in a world that is rich with sounds, sights, and consistent exposure to the speech and language of others. There appear to be critical periods for speech and language development in infants and young children when the brain is best able to absorb language. If these critical periods are allowed to pass without exposure to language, it will be more difficult to learn.
A distinct difference
Speech and language. The two communication skills are often confused, but there is a distinct difference between the two. Speech is the verbal expression of language and includes articulation, which is the way sounds and words are formed. Language is much broader and refers to the entire system of expressing and receiving information in a way that’s meaningful. It’s understanding and being understood through communication, whether it’s verbal, non-verbal or written. Children who have trouble understanding what others say or difficulty sharing their thoughts may have a language disorder. Specific language impairment is a language disorder that delays the mastery of language skills. Children who have trouble producing speech sounds correctly or who hesitate or stutter when talking may have a speech disorder. Apraxia of speech is a speech disorder that makes it difficult to put sounds and syllables together in the correct order to form words.
The Individuals with Disabilities Education Act, legislation enacted by the U.S. government to make sure that children with disabilities are provided with a proper education, defines a speech or language impairment as a communication disorder that adversely affects a child’s educational performance. There are many causes for such disorders. Speech delays in an otherwise normally developing child can sometimes be caused by oral impairments, like problems with the tongue or the roof of the mouth. Hearing problems are also commonly related to delayed speech, which is why a child’s hearing should be tested by an audiologist whenever there’s a speech concern. A child who has trouble hearing may have trouble articulating as well as understanding, imitating, and using language. Ear infections can affect hearing ability. Simple ear infections that have been adequately treated, though, should have no effect on speech.
Tests and scales
If you or your child’s pediatrician suspect that the child may have a problem with speech or language, an evaluation by a speech-language pathologist should be considered. During the evaluation, the specialist will look at a child’s speech and language skills within the context of total development. Besides observing your child, the speech-language pathologist will conduct standardized tests and scales, and look for milestones in speech and language development. The pathologist will also assess what your child understands, what your child can say and determine if your child is attempting to communicate in other ways, such as pointing, head shaking or gesturing. If the speech-language pathologist finds that your child needs speech therapy, your involvement will be very important. You can observe therapy sessions and learn to participate in the process. The speech therapist will show you how you can work with your child to improve their speech and language skills.
Help for parents
To encourage speech and language development in a child, the American Speech-Language-Hearing Association has some helpful hints for parents. With toddlers, it’s a good idea to use gestures, such as waving goodbye, to help convey meaning. And read to your child. Sometimes “reading” is simply describing the pictures in a book without following the written words. Choose books that have large colorful pictures that are not too detailed. Ask your child, “What’s this?” and encourage naming and pointing to familiar objects in the book. With a slightly older child, ask questions that require a choice, like “Do you want an apple or an orange?” And sing simple songs and recite nursery rhymes that show the rhythm and pattern of speech. With children of pre-school age, it is important to give your full attention when a child starts a conversation. Acknowledge all attempts to speak and show that you understand the word or phrase by fulfilling the request, if appropriate.
Trusted by thousands of listeners every week, T. Glenn Pait, M.D., began offering expert advice as the host of UAMS’ “Here’s to Your Health” program in 1996. Dr. Pait began working at UAMS in 1994 and has been practicing medicine for over 20 years.