Frequently Asked Questions

Below is a list of answers to questions that are frequently asked about our clinic, services, ideas, etcetera. If you have a question that is not answered on this page, feel free to contact us via the form in the sidebar.

Questions about Normal Speech and Language Development:

Is my child’s speech or language developing normally?

“Speech” and “language” are often used interchangeably by parents to describe their children’s communication skills. However, “speech” is used by speech pathologists and other experts working within the field of pediatrics to describe the acts of communicative intent that includes pre-speech sounds such as, cooing and babbling, variegated babbling, and sounds in words and sentences.

“Language” describes not only speech, but listening comprehension, and expressive communication acts; it includes visual communication means such as sign language and gestures. Language and speech development begins at birth. Infants learn early on that they must communicate in order to have their needs met. Although, infants do not express their needs through spoken words, they are still successful at communicating their needs. From the moment children are born, they are absorbing every spoken word. This is evidenced by their ability to engage in turn-taking games such as cooing and babbling with parents and caregiver, turning to look when a caregiver enters and exits the room. They smile and laugh when played with. Some of the things the speech pathologist often examines are:

• Awareness of sounds: Hearing, listening, and meaning
• Discrimination of sounds: Hear the sounds; the ability to interpret the sounds as having different meaning from other sounds, e.g., “Moo” sounds differently from “Boo.” “Moo” can be associated to the sound a cow makes and “Boo” a ghost.
• Understand the words and ideas from the language spoken: Receptive language-hearing and interpreting meaning for the words and ideas heard.
• Respond vocally/verbally by sharing thoughts and ideas with another person: Expressive language.
• Spontaneous communication with gestures, body language and initiation of communication acts and intent: Pragmatics Language. Pragmatic language begins to take shape as early as infancy. As the child’s cognition matures, relationship becomes “dyadic” in nature. Dyadic means the child’s attention remains intently on the social partner during face to face interaction.
• Syntactical structures: Grammar and rules of how the child uses language
• Articulation of speech sounds: How speech sounds are made. It must be the same as that of the child’s community. For Ages and Stages of developmental sequence checkout the following websites:

  www.asha.org/speech/deve/opment/language_speech.htm
  www.borninglearning.org
  www.asha.org/public/speechdevelopment/chart.htm

My child was talking normally and then one day he stopped talking, is that normal?

No! It is not normal for a child to suddenly stop talking. Common causes for sudden change in communication acts or intent/acts ranges from trauma, anxiety, neurological speech or language delays such as, Autism Spectrum Disorder, degenerative Disorders and selective mutism and hearing impairment.

Autism Spectrum Disorder (ASD). In this case the child may have developed prototype speech, but often times does not have social relationship for age, and may have limited conventional gestures. Speech difficulties are often the first-cited concern for these children. However, depending on the subtype the severity can range from mild social deficits to severe distinct deficit. Children with higher functioning autistic disorder and Asperger’s have more subtle symptoms, in all of these children pragmatic language must also be evaluated.

• In selective mutism the child is able to speak and comprehend language, but refuses to speak in certain situations or places such as school or outside of the home. Selective mutism usually happens before the age of five and up to school age. Sometimes parents do not notice the problem until the child begins school. To read more on selective mutism and recommended treatment visit: www.asha.or/public/speech/disorder/selectivemustim.htm
• In the case involving other neurological speech disorders such as, Childhood Apraxia of Speech (CAS), the child often does not coo or babble as infant, may have feeding related issues. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. Thebrain has problemsplanning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, buthis/her brain has difficulty coordinating the muscle movements necessary to say those words.
• A child may stop talking as a result of a hearing loss. The hearing impaired child has both delayed speech and impaired auditory comprehension, but retains normal visual communication skills.

Why is my child not talking clearly?

Just because a child is not talking clearly does not mean the child has a developmental speech or language delays. To be sure that your child does not have communication delays visit. If you are still concern write down your concerns and contact your pediatrician and discuss your concerns to make a proper referral. If your child was premature, it is a given your child at first may show some developmental milestone delays, however, it does not often mean a life time delay. It is important to get your child screen or evaluated if they are six months or more behind their peers in communication skills. If your child has had frequent ear infections, it could also impact their speech, so therefore discuss with your pediatricians your concerns about your child’s ear infections. If you have further questions please contact our office directly and speak to one of our therapists, you may also want to visit www.asha.org/public/speechdevelopment/chart.htm.

What can I do to help my child talk?

You can help your child’s speech and language skills by slowing down your speech rate when talking to your child. Use simple phrases to encourage relationship and language building skills versus playing 20 questions with your child. Use words and phrases that promote more of (“joint + actions,” ) shared skills. For example, let’s share about… Lets play I spy. Read stories that repeat words, for example, “Brown bear…,” “Goodnight moon,” most books by Eric Carle will work and other authors that use similar style. Play listening games, such as pausing a familiar song and having your child finish part of the song. Play repetitive nursery rhymes and having your child exaggerate parts of the words.

Will my child out grow his delays?

It is very difficult to tell from early on which child will out grow delays. The most important thing is getting the child the right help and making sure your child is healthy physically and emotionally. Making sure your child is showing continuous progress and is developing and achieving all the expected milestones within your child’s ability. Depending on the type of delays, some children do overcome their delays for example, some speech delays are overcome. Other children develop compensations for their delays to the point that people cannot distinguish them from their typical peers.

My child does not do most of the things on the developmental chart that got from my pediatrician, what can I do to help my child?

I would contact a professional in the area depending on the types of delays your child is showing. For example, if your child is not crawling contacting a physical or occupational therapist will assist you in developing your child’s motor skills. If your child is having difficulty with speech or feeding related issues, contacting a speech pathologist will help answer your questions.

 

What is Articulation Disorder?

Childhood articulation disorder is defined as "a child having difficulty producing or pronouncing age appropriate speech sounds." A child at age three is expected to correctly pronounce sounds such as /b/, /t/, and /p/. Childhood articulation disorder is characterized by difficulty articulating age appropriate sounds. These errors are also not typical of errors seen with children around that child's age. A child is considered to have articulation disorder if most people cannot understand what the child says. A child with articulation disorder cannot correctly pronounce age appropriate sounds or the child completely deletes the sounds. Articulation disorder is not caused by the parents. There are different reasons why some children have articulation disorders.
 

What causes articulation disorder?

• Chronic Ear Infections: Children that have chronic ear infections are more inclined to misarticulate speech sounds because of the fluid collecting in the ear drums making it difficult for the child to attend to the adult model of correct speech sound productions.
• Hearing Loss: Depending on the type of hearing loss, the child will not hear how certain sounds are produced and may not recognize that they are not correctly pronouncing these sounds.
• Neuromuscular disorders: If a child has some neuromuscular disorder (depending on the severity) the child may present with articulation disorder due to muscle weakness.
• Syndromes: (Cranio-facial anomalies, Downs syndrome, Cleft lip/palate) Children with certain types of syndromes are more inclined to present with articulation related disorders.
• Unknown: Sometimes the causes are unknown.

Are all articulation disorders the same?

There are different types of articulation disorders. The term "articulation disorder" is generally used to indicate that the child is not pronouncing the sound (s) correctly (as typically heard in that child's community).

Types of Articulation Disorders

• Phonological Processing Disorders: This term is used when a child has a severe articulation disorder with a pattern to their errors (omissions, addition of extra vowels, simplification of sounds etc.). Phonological processing disorder is used to describe the patterns the child is using when talking.
• Childhood Apraxia of Speech CAS: (also known as developmental apraxia of speech). A child with dyspraxia has difficulty purposefully (despite having normal muscle tone) moving the muscles that assist with speech productions to produce intelligible speech (verbal apraxia). Non-verbal dsypraxia describes the inability to volitionally coordinate muscle movements. Children that have CAS struggle with correctly saying the sounds or words they at times can correctly say. For example, a child may say a word very clearly one -minute and the next minute the child gropes and struggles with how to say that same word. Some children are not able to produce words or sounds.

I just had my child tested and the therapist informed me my child has a language disorder. What does language disorder mean?

A child is considered to have a language disorder if the child's language skills are not developing according to expected developmental norms for the child’s age. Typically we look at the child’s receptive (understanding of the spoken language) or expressive (being able to use words to express self) skills to determine language delays or disorders. This disorder may be developmental or acquired.

 I keep thinking maybe I did something wrong form my child to have language problems. There is no history of a language disorder in our family. Where did my child get this problem from?

• Chronic Ear Infections: Children that have had a history of chronic ear infections are more inclined to have language delays. 
• Hearing Loss: Depending on the type of hearing loss, a child may have problems with understanding the spoken words or with expressive language.
• Neuromuscular Disorders and Syndromes: (Cranio-facial anomalies, Downs syndrome, Cleft lip/palate) Children with certain types of syndromes are more inclined to present with language disorders.
• Autism Spectrum Disorder (ASD) 
•  Attention Deficit Disorder/ Attention Deficit Hyperactivity Disorder (ADD/ADHD)
• Unknown: Sometimes the causes are unknown.
  
   

I am told my child needs language assessment, I can tell my child has a language difficulty, why is it necessary to perform standardized testing?

There are different types of language delays or disorders. To determine what type of language difficulties your child may have, standardized testing will be administered along with a language sample and teacher or parental input. Below are a list of language areas often assessed by a licensed speech-pathologist.
 

• Expressive Language delays: This is when a child is using only limited words to communicate. Has difficulty expressing what she wants. 
• Receptive Language delays: This is when a child has problems following simple commands, acquiring new concepts and does not seem to understand what is said.
• Auditory Processing Disorders: 
•  Pragmatic Language Disorders: Some children have problems understanding the social functions of language. These children may have problems reading body-language, social cues, and understanding the rules of verbal turn-taking (ASD, Non-verbal learning disabilities -NVLD and ADHD).
• Problems with Language Structures: Some children have problems acquiring the rules of the language structure. Children that have problems with constructing sentences most likely have problems presenting information or stories in an organized manner.
• Vocabulary: Vocabulary is made up of words that the child stores in his or memory bank. Learning vocabulary is like creating a web. The child has to create a chain (associate) the new word to words he or she already knows. If a child has difficulty mastering new vocabulary skills he or she may run into problems acquiring new concepts. Memory and Word Finding Problems: Some children with language difficulties have problems recalling specific names so they talk around words. They sometimes give you general information versus specific information. The problem may be due to how they organize and store information into long term memory.

For more information please visit
www.asha.org/speech/deve/opment/language_speech.htm
www.borninglearning.org
www.asha.org/public/speechdevelopment/chart.htm