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Speech disorders - children

Definition

A speech disorder is a condition in which a person has problems creating or forming the speech sounds needed to communicate with others. This can make the person's speech difficult to understand.

Common speech disorders are:

Speech disorders are different from language disorders in children. Language disorders refer to someone having difficulty with:

Alternative Names

Articulation deficiency; Articulation disorder; Phonological disorder; Voice disorders; Vocal disorders; Disfluency; Communication disorder - speech disorder; Speech disorder - stuttering; Cluttering; Stammering; Childhood onset fluency disorder

Causes

Speech is one of the main ways in which we communicate with those around us. It develops naturally, along with other signs of normal growth and development. Disorders of speech and language are common in preschool age children.

Disfluencies are disorders in which a person repeats a sound, word, or phrase. Stuttering may be the most serious disfluency. It may be caused by:

Articulation and phonological disorders may occur in other family members. Other causes include:

Voice disorders are caused by problems when air passes from the lungs, through the vocal cords, and then through the throat, nose, mouth, and lips. A voice disorder may be due to:

Symptoms

DISFLUENCY

Stuttering is the most common type of disfluency.

Symptoms of disfluency can include:

ARTICULATION DISORDER

The child is not able to produce speech sounds clearly, such as saying "coo" instead of "school."

PHONOLOGICAL DISORDER

The child does not use some or all of the speech sounds to form words as expected for their age.

VOICE DISORDERS

Other speech problems include:

Exams and Tests

Your health care provider will ask about your child's developmental and family history. The provider will do some neurological screening and check for:

Some other evaluation tools used to identify and diagnose speech disorders are:

A hearing test may also be done to check for hearing loss as a cause of the speech disorder.

Treatment

Children may outgrow milder forms of speech disorders. The type of treatment will depend on the severity of the speech disorder and its cause.

Speech therapy may help with more severe symptoms or any speech problems that do not improve.

In therapy, the therapist may teach your child how to use their tongue to create certain sounds.

If a child has a speech disorder, parents are encouraged to:

Support Groups

More information and support for people with stuttering and their families can be found at:

Outlook (Prognosis)

The outlook depends on the cause of the disorder. Speech can often be improved with speech therapy. Early treatment is likely to have better results.

Possible Complications

Speech disorders may lead to challenges with social interactions due to difficulty communicating.

When to Contact a Medical Professional

Contact your provider if:

Prevention

Hearing loss is a risk factor for speech disorders. At-risk infants should be referred to an audiologist for a hearing test. Hearing and speech therapy can then be started, if necessary.

As young children begin to speak, some disfluency is common, and most of the time, it goes away without treatment. If you place too much attention on the disfluency, a stuttering pattern may develop.

References

American Speech-Language-Hearing Association website. Voice disorders. www.asha.org/Practice-Portal/Clinical-Topics/Voice-Disorders/. Accessed February 22, 2024.

Driver LE, Nelson ME. Pediatric speech disorders. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 183.

Simms MD. Language development and communication disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 52.

Trauner DA, Nass RD. Developmental language disorders. In: Swaiman KF, Ashwal S, Ferriero DM, et al, eds. Swaiman's Pediatric Neurology: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 53.

Zajac DJ. Evaluation and management of speech disorders for the patient with cleft palate. In: Fonseca RJ, ed. Oral and Maxillofacial Surgery. 3rd ed. St Louis, MO: Elsevier; 2018:chap 32.