What is speech and language problems in children?

Speech and language problems mean your child has trouble speaking or saying words. Or your child may find it hard to understand or explain ideas.

Hearing problems can cause speech and language delays in children. All children with speech and language delays should have their hearing tested. Certain disorders, such as autism spectrum disorder, can also cause a delay. Speech and language problems may also run in families.

A child can overcome many speech and language problems with treatment such as speech therapy. Treatment works best when problems are caught early. Speech therapy helps your child learn speech and language skills.

Children with speech sound disorders can be very frustrated when others don't understand them. They can also become shy about speaking.

You may hear your child make errors that other children the same age don't make. For example, your child may leave out sounds. Your child might say "cu" instead of "cup" or "poon" instead of "spoon." Or your child may use one sound instead of another sound. They might say "dood" instead of "good." Another mistake is leaving a syllable out of a word. An example of this is saying "tephone" for "telephone."

Children may have other speech sound problems. One of these is a lisp. With one type of lisp, the child makes a "th" sound instead of "s," "sh," "ch" and "j" sounds. Another type of lisp makes these sounds very slushy. Some children have problems making the "r" sound. For example, a child may say "teachuh" instead of "teacher" or "wabbit" instead of "rabbit."

No one expects that strangers will understand a 2-year-old child all of the time. But a 4-year-old who can't be understood most of the time may have a speech sound disorder.

Children may show signs of speech and language problems at a young age. For example, there may be a delay if children don't:

• Babble by 9 months.
• Say their first words by 15 months.
• Use word combinations by age 2.
• Speak in complete sentences by age 3.

A child's speech can often improve with treatment such as speech therapy. To help your child speak better, the speech-language pathologist (SLP) may:

• Help your child learn to make the right speech sounds and combination of sounds. The SLP does this by correcting certain movements of your child's mouth and tongue. This can make your child's speech more clear.
• Help your child to learn when sounds are right or wrong so they can correct themselves.

Treatment works best when problems are caught early. Your child's health care team will help you decide on the best schedule for treatment.

The SLP may suggest that your child practice every day between treatment sessions. If so, the SLP will teach you how to help your child do this at home.

The doctor will do a physical exam and ask questions about your child's medical history. The doctor will also ask you questions about whether your child has reached speech milestones for their age.

If it looks like your child has a speech problem, the doctor will refer your child to a speech-language pathologist (SLP). SLPs diagnose and treat speech and language problems. They are also called speech therapists.

Your doctor or SLP may suggest other tests to:

• Look for other conditions. For example, your child may get a hearing test to rule out hearing loss.
• Find out what speech sounds your child can say and how well they put speech sounds together to form words and sentences.
• Review how your child is developing speech, language, and motor skills.
• Find out if your child is having other problems. These could include having behavior problems or being clumsy. It could also include having trouble doing some of the common skills for your child's age, such as sucking, chewing, or swallowing.

To test your child's speech, the SLP will listen to and watch your child talk. The SLP will ask your child to say certain sounds, words, and sentences

The following health professionals can diagnose speech and language problems and may work with other health professionals to treat them:

• Family medicine physician
• Pediatrician
• Nurse practitioner
• Physician assistant
• Speech-language pathologist

Other professionals may be involved in the care of children with speech and language delays:

• Hearing specialist (audiologist)
• Ear specialist (otolaryngologist)
• Mental health professional (psychologist, psychiatric nurse, social worker, licensed mental health counselor)
• Occupational therapist and physical therapist
• Teacher

Try doing activities with your child that help the brain develop. For example, talk, play, sing, and read together. Ask your child to point to familiar items and make the sounds that go with them. Involve your child in conversations. Gently encourage them to talk to others. Have your child attend speech therapy appointments.

Speech disorders can make it frustrating to talk with others. But there are some things you can do to make it easier.

• Give yourself time to get the words out. Be patient with yourself.
• Try to slow down how fast you speak.
• Be patient with others. If they have trouble understanding you, try again.
• Use other methods to help listeners understand you. For example, you can use an alphabet board. Point to the first letter of each word as you say it. Or you can try adding gestures or drawing. You might also use special apps on devices such as smartphones or tablets.

Children learn to make speech sounds as they grow. By 6 months, they may be able to make "b," "m," "d," and "n" sounds. It may take until age 6 to make "r" and "l" sounds. But if they can't make sounds expected for their age, they might have a speech sound disorder.

Your family and friends can help you communicate better. Share these simple tips with them. Encourage them to:

• Be patient, understanding, and supportive.
• Speak directly to you and give you enough time to talk.
• Limit background and other noises like screens and music.
• Not correct your pronunciation.
• Ask you to repeat something if they don't understand. Or make sure you understand what they said by asking you "yes" or "no" questions.
• Now and then, repeat back what you said. This helps confirm that they understand the message.