Toddler Speech Problems
How to know what's normal development, and when to be concerned about delays in your child's speech
Orofacial Myology as a Cause
When babies are born, they are routinely given a screening that tests their hearing; yet as some of them begin to grow, they may experience progressive hearing loss. This is just one reason of many that may contribute to a toddler’s difficulty speaking. For parents to help their child and to get him or her the attention needed for a speech problem, they need to know what speech problems are, what causes them, and what to do if they believe their child has one.
“It is important first of all to distinguish between speech and language,” says Erin Harrison, a speech and language pathologist. Harrison explains that speech refers to the movement of the articulators (tongue, teeth, etc.), or what most people perceive as how clear the words and sounds are. “Speech problems are usually related to coordination and/or strength of the muscles that serve the lips, tongue, jaw, soft palate, and cheeks,” says Harrison. Language is something that includes vocabulary and grammar, and those problems have their root in the brain itself. A child can have a problem with one and not the other.
Harrison reports that the most common referrals that she receives include:
- Speech/language delay: The child isn’t talking enough for his age.
- Poor articulation: The parent feels the child doesn’t speak as clearly as other children the same age.
- Stuttering: Most children cycle in and out of this normal developmental speech during the toddler years.
- Regression of speech: A child that has a large vocabulary begins to lose that vocabulary instead of continuing the growth.
Sandra Coulson, president of the International Association of Orofacial Myology (IAOM), is one such specialist who gets referrals from pediatricians and speech therapists suspecting a child has a muscle problem. An orofacial myologist, Coulson specializes in working with the muscles of the face and tongue; proper movement of these muscles is needed for children to create specific speech sounds.
According to IAOM, recent research has found a prevalence of orofacial myofunctional disorders in 81 percent of children that show speech or articulation problems. The disorder involves incorrect habits of using the tongue, jaws, lips, and face. Several things can cause such disorders, including:
- Developmental abnormalities
- Improper oral habits (e.g., thumb sucking, teeth grinding, nail biting)
- Enlarged tonsils or allergies that are restricting nasal airway
“I find quite often that the length of the lingual frenum, the attachment under the tongue, is extremely short or tight, which limits a child’s ability to elevate the tongue for certain sounds,” explains Coulson. “This is often overlooked by the pediatrician, dentist, or speech pathologist.”
There are many reasons for speech delays beyond those involving the muscles of the face and tongue. Some of these reasons include cleft palate, accidents, mental retardation, and psychosocial deprivation. The treatment method varies depending on what the problem is. Some of the more common speech delays and concerns can be caused by such things as:
- Hearing problems: Even if your child passed a newborn screening, it’s important to test again to rule out a hearing impairment.
- Stuttering: According to the Stuttering Foundation of America, around 60 percent of those that stutter have a family member that does as well, suggesting a genetic link. The SFA also reports that around 20 percent of children go through a stuttering period.
- Siblings: “Sometimes if the child has an older sibling who speaks for him, he has no need to produce articulate sounds,” says Coulson. Encourage your child to speak for himself instead.
- Tonsils: Having large tonsils can cause a delay in speech because the tongue is pushed forward, making it difficult to make sounds.
- Allergies: Frequent allergy problems can play a role in speech delay. “If a child is often congested, hearing can be affected, the mouth rests open, the tongue rests forward and can become quite flaccid,” says Coulson.
- Injury or Environment: There are many speech problems that can be caused by injury. “Trauma to the brain (head injury, anoxia, tumor, meningitis) can result in speech/language difficulties,” says Harrison. Some of these injuries can be caused by car accidents and other such incidents.
“There are also environmental causes of speech/language problems because they impact the nervous system, such as lead poisoning,” says Harrison.
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