WHAT ARE THE CAUSES OF DELAYED SPEECH?
- Hearing impairment should always be considered as a cause of speech delay, since early detection leads to early intervention with the application of hearing aids, placement in special education and training in other methods of communication such as sign language. Hearing impairment may result from a number of genetic and acquired disorders.
- Intellectual disability, previously referred to as mental retardation, is the commonest cause of delayed speech development. It may be the result of abnormal brain development or a variety of insults to the brain during the prenatal period, birth or infancy.
- Developmental speech delay, which is an uncommon disorder due to delayed maturation of the areas of the brain concerned with the processing of sound.
- Autism, a disorder characterized by abnormal social interaction, poor communication skills and stereotyped behaviours (restricted, repetitive movements), usually presents with delayed speech. Autism, the incidence of which has markedly increased in recent years, may result from a number of recognized genetic and acquired brain diseases, but the underlying cause remains undetermined in many instances.
DETERMINING THE CAUSE OF SPEECH DELAY
- Obtaining a thorough clinical history, doing a detailed general and neurological examination and ordering appropriate laboratory tests e.g. genetic testing; brain imaging
- Formal assessment of hearing ability
- Developmental assessment
- Behavioural assessment
- Psychometric assessment
MANAGING SPEECH DELAY
Early intervention is key. The type of intervention is partially determined by the cause of the speech delay e.g. hearing aids for the hearing impaired
Language stimulation at home and in preschool
Special education for the hearing impaired and intellectually disabled
Behavioural therapy for the autistic child
WHAT IS SPEECH THERAPY?
Speech therapy is a method of training persons with speech delay or difficulty to communicate more effectively. It also helps to improve comprehension of spoken language, fluency of speech, and pronunciation of words. Speech therapy is not a cure but a means by which the child will be able to function at the maximum of his or her potential. The exercises that are applied in speech therapy sessions need to be continued at home on a daily basis. The length of the period of therapy will depend on the severity and cause of the speech delay or difficulty. Speech therapy also helps with problems like drooling and difficulty with swallowing that sometimes accompany delayed speech.
STIMULATING LANGUAGE WITH PLAY
Play with a toy car or airplane and repeatedly say “car drive”, “airplane fly”. Use other phrases like “dog bark”, “baby cry”.
Stack blocks then push them over and keep repeating “blocks up” and “blocks fall”
Using stones, bottle caps, coins, and a cup, have your child imitate you playing “in the cup”, “on the cup”, and “under the cup”. Then have the child place the object where you name. Finally have the child name the action. Engage in the same activity by standing in front of, behind and beside a chair.
EVERY CHILD IS DIFFERENT
Some children are very quick in learning to speak while others are somewhat slower in doing so. Speech, along with gesture and writing, represent the expressive component of language while oral comprehension and reading form the receptive component. The development of comprehension e.g. clapping hands on request and waving goodbye, precedes that of speech.
WHEN SHOULD A PARENT BECOME CONCERNED ABOUT SPEECH?
IF YOUR CHILD
- is not pointing or using gestures by age 12 months
- still prefers gestures to oral communication at age 18 months
- is still having trouble imitating sounds or having difficulty understanding simple verbal requests at age 18 months
- is not using words to communicate more than his or her immediate needs; has no spontaneous words or phrases, and can’t follow simple directions by age 2 years.
THE BEGINNINGS OF LANGUAGE
6-8 weeks: vowel sounds (cooing)
6 months: babbling (ba-ba; da-da); responding to name being called; understanding “no”
9 months: imitating actions and sounds
12 months: pointing & indicating needs by gesture; saying specific mama & dada; 1-2 words with meaning
DEVELOPMENT OF VOCABULARY
15 months: 2-6 words
18 months: 2-20 words
21 months: 2-3 word phrases
24 months: 50 or more words; asks what, where & who
30 months: Uses pronouns & prepositions. Sings nursery rhymes
36 months: 250 words; asks why, how & when
48 months: Tells stories; describes experiences; asks meaning of words, especially abstract ones
STIMULATING ACTIVITIES AT HOME
Imitating gross motor movements: Run, jump, clap, hop, touch your head, while you name the activity and have the child imitate the action. Do two such activities in a row, naming them and having the child imitate the actions in the same order. Then do three activitites in a row...
Following commands: Give the child a simple command such as stand, sit, clap, or others for him to follow. Increase the length of the command to two and three and have the child follow them in the correct order.
Finding: After showing the child two items or pictures e.g. animals, body parts, foods, furniture and other things in the environment, have the child point to the one you name. Gradually increase the number of items and pictures your child must choose from.
Naming: After the child can point to various objects and pictures have her start naming those same objects and pictures.
Reading stories: Get into the habit of reading to the child from as early as the first year e.g. bed-time stories.
Putting words together: Action concepts can be taught using known objects, remembering to keep speech short.
Making animal sounds: Show your child animals and animal pictures, and make the appropriate animal sounds for your child to imitate.
Imitating speech sounds: Make prolonged vowel sounds (A, E, I, O, U) for your child to imitate. Then have your child imitate consonant sounds such as Z, SH, K, R, L, M, and S. Make a game out of the activity surrounding the types of sound.
WITH YOUR CHILD...
Recite nursery rhymes
Say the alphabet
Talk a lot to your child
Keep your speech short
Allow your child to point to things before expecting him to name them
Be patient!! Praise her a lot for understanding and speak to her rather than punish her when she does not.
Create a need for using language
Limit television viewing. Recent research shows that excessive TV viewing in childhood delays the development of speech
Ignore negative behaviour as this is only reinforced by paying attention to it!