Does My Child Need Speech Therapy?

Maybe, you noticed some difficulty as your child speaks, or a teacher expressed concern that your child could have a problem with certain speech or language skills.


What should you do? Is Speech Therapy needed? What does Speech Therapy mean?


This article tries to answer these questions in simple terms.


Should I wait? Or should I start early intervention?

Early intervention gives best results. It is important that parents take the child for a speech evaluation and then start the required intervention as soon as possible. Also, parents and caretakers should educate themselves regarding their child’s problems.


Children enrolled in therapy early (before they're 5 years old) tend to have better outcomes than those who begin therapy later.


Children above 5 can also make significant progress in therapy; but they progress at a slower rate because they often have learned patterns that need to be changed.


What are the early signs that the child has a speech difficulty?

Here are some early signs

  • Not responding to name call

  • Not maintaining appropriate eye contact

  • Not following simple instructions

  • Not saying words by 14 to 16 months of age

  • Not putting two words together by 2 yrs.

  • Not answering basic “wh” questions (what, where, who) by age 3

  • Not being easily understood by people outside the family after age 3

  • Has trouble playing with other children

  • Has noticeable hesitations or repetitions in speech past age 5

  • Can’t tell a sequential story (a story with a beginning, middle and end) by age 5

  • Shows limited development of vocabulary


What is Speech?

Speech is a verbal means of communication to express thoughts and feelings. Speech uses muscles of the tongue, lips, jaw and vocal cords in a very precise and coordinated way to produce meaningful sounds that make up language.


What is Language?

Language is a system of communication which refers to words and symbols that can be written or spoken. It also includes gestures and body language which can be used for meaningful communication.


The terms speech and language are often used with the same meaning in casual conversation. But as medical terms, they are clearly different.


What are Speech Disorders?

A speech disorder usually indicates that someone has trouble producing certain sounds accurately.


What are the types of Speech Disorder?

The types of speech disorders are as follows

  1. Articulation disorders: difficulties producing sounds in syllables or saying words incorrectly to the point that listeners can't understand what's being said.

  2. Fluency disorders: (commonly called stuttering), in which the flow of speech is interrupted by abnormal stoppages, partial-word repetitions ("Ka-Ka-car"), or prolonging sounds and syllables (“nnnn-nice”).

  3. 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.


What are Language Disorders?

Language deals with meaning. A child with a language disorder may have difficulty understanding the meaning of what’s being said (receptive language issues). Or, he may have trouble expressing his own thoughts (expressive language issues).


So, language disorders can be either receptive or expressive:

  1. Receptive disorders: difficulties understanding or processing language.

  2. Expressive disorders: difficulty putting words together, limited vocabulary, or inability to use language in a socially appropriate way.

  3. Cognitive-communication disorders: difficulty with communication skills that involve memory, attention, perception, organization, regulation, and problem solving.

Speech disorders and language disorders may occur separately. Or an individual may have both kinds of disorders at the same time.


How does Speech develop with Age? Are there Speech Milestones?

There are milestones that can guide you when considering whether your child’s speech and language are developing typically. Most children, by their second birthday, have a vocabulary of about 50 words. By age 2 to 3 years, a typical child starts understanding a lot more language than he can express.


Developing children simplify speech as they are learning to talk. This is because coordination of lips, tongue, teeth, palate and jaw is yet to be developed fully for clear speech to be produced. So, they simplify complex words into an easier form to speak. This is considered normal unless it persists beyond the age when normally children have stopped using it. For example, a 4-yr. old still using “wawa” for water or “dudu” for milk would be considered delayed since most children stop this process by the age off 3.


Children develop speech and language skills at their own individual pace. But if your child has problem, it’s a good idea to talk to your pediatrician. He can refer you to a speech-language specialist to find out if a speech or language problem exists. Treatment options can be different for each child, so getting the right diagnosis is key.


What are feeding disorders?

Speech and Language Pathologists also handle feeding disorders. These are disorders in the way someone eats or drinks, including problems with chewing, swallowing, coughing, gagging, and refusing foods.


Who is a Speech Language Pathologist (SLP)?

Often informally known as speech therapists, they are professionals trained to assess and manage disorders of speech, language and swallowing.


What is Remediation?

In speech-language therapy, an SLP will work with a child one-on-one or in a small group, to overcome difficulties involved with a specific disorder.


Therapists use a variety of strategies, including:

  1. Language intervention activities: The SLP will interact with a child by playing and talking, using pictures, books, objects, or ongoing events to stimulate language development. The therapist may also model correct vocabulary and grammar and use repetition exercises to build language skills.

  2. Articulation therapy: Articulation therapy target the speech sounds in isolation (sound by itself), syllables, words, sentences, conversation and generalization. The aim is to produce the correct production of speech sound by physically showing the child how to make certain sounds(or modelling)

  3. Oral-motor/feeding and swallowing therapy: The SLP may use a variety of oral exercises — including facial massage and various tongue, lip, and jaw exercises — to strengthen the muscles of the mouth for eating, drinking, and swallowing. The SLP may also introduce different food textures and temperatures to increase a child's oral awareness during eating and swallowing.


When is Speech Therapy needed?

Children might need speech-language therapy for a variety of reasons, including, but not limited to:

  1. hearing impairments

  2. cognitive (intellectual, thinking) or other developmental delays

  3. weak oral muscles

  4. chronic hoarseness

  5. birth defects such as cleft lip or cleft palate

  6. autism spectrum disorder

  7. motor planning problems (Apraxia)

  8. articulation problems (Misarticulation)

  9. fluency disorders (Stuttering)

  10. respiratory problems (breathing disorders)

  11. feeding and swallowing disorders

  12. traumatic brain injury


What is your role in helping the child?

Parental involvement is critical to the success of a child's progress in speech or language therapy. Best and lasting results happen when parents involve actively.


Ask the speech therapist for suggestions. They will suggest homework and stimulation activities to ensure continued progress and carry-over of newly learned skills.


The process of overcoming a speech or language disorder takes time and effort, so it's important that the family is patient and understanding with the child.

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