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January 2011



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First Published Tuesday 2 June, 2009.

By Amanda Genge, Staff Writer, my OptumHealth

Parents delight in hearing their child’s first words blossom into full conversation. Some children, though, run into problems when learning to speak.  There are babies who don’t babble at all, and toddlers and preschoolers who have trouble forming words. These children may have speech or language disorders.

Some of these disorders are the result of oral-motor problems. This means a child has trouble using the parts of his mouth that form words and sounds. Others may be caused by broader developmental disorders like autism. Chronic ear infections or hearing loss could also be a factor.

It’s important for parents to understand that speech and language are not the same thing. Speech is how words are formed and spoken. Language is the meaningful exchange of information by expressing or understanding an idea, either through spoken or written words or gestures. A child may have trouble with one or both of these areas.

Speech and language disorders

These disorders are usually diagnosed by a speech-language pathologist (SLP) after a thorough evaluation. This specialist can also arrange sessions to work with your child to improve needed skills. Some speech and language disorders include:

*Expressive language disorder. This is marked by limited vocabulary for the child’s age, errors in tense or problems with recalling words. Using the wrong names for objects or people may occur.

* Mixed receptive-expressive language disorder. These symptoms tend to overlap with expressive language disorder. Also, the child may have trouble understanding words or phrases, or may just repeat words after hearing them. Answers to questions – especially those that ask “who, what or where” or “when, why or how” – may not make sense.

*Orofacial myofunctional disorders. A child with this problem may pronounce sounds incorrectly – “s” may come out sounding like “th”, for instance. The tongue moves too far forward while talking and swallowing. At other times, the tongue may stick out from between the teeth. Open-mouth posture is common.

*Speech sound disorders. These are problems with forming and articulating sounds and words. A young child who does not outgrow this speech pattern may need speech therapy.

*Stuttering.  Stutterers repeat whole words or parts of words, or prolong certain sounds in a word. This can make a child’s speech hard to understand. Stress may make the problem worse.

*Maturational delay. “Late bloomer” or “late talker” syndrome. Sometimes a child will be slow to start speaking, but will have no problems forming or understanding words. This occurs more often in boys than girls, and tends to run in families. Doctors and speech-language pathologists do not make this diagnosisunless they are certain that there are no other possible causes of the delay. Once the child does start to speak, he or she will typically continue to develop language skills in a normal way.

*Childhood apraxia of speech. This is a less common motor disorder in which children have trouble forming sounds and words. They know what they want to say, but the brain can’t coordinate the muscles needed to say it. Very early symptoms are lack of babbling during infancy, late first words with missing sounds, limited sound rang and problems combining sounds.  Older children may struggle to speak in general, especially with long words and phrases. They can also usually understand much more than they can say.

If you think your child has a speech or language problem, talk to a doctor about your concerns. He or she may suggest having your child evaluated by a speech-language pathologist. Check with your health insurance provider. This service may not be covered.

If your child is under age 3, you can also contact your state’s Early Intervention Program for an assessment. Studies have shown that the earlier speech or language therapy is started, the better the outcome for the child.


Simms MD.  Language disorders in children: classification and clinical syndromes. Pediatric Clinics of North America. 2007;54 (3):437-467.

American Speech-Language-Hearing Association.  Child speech and language.

National Institute on Deafness and Other Communication Disorders. Apraxia of speech.

Also on the web

A Head Start for Children With Autism
Baby Steps and Other Milestones: Developmental Goals and Signs of Delays
Q&A: Help for Stuttering Children
Signs of Dyslexia

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