Hi, my name is Carol Edgel, and I’m a certified speech-language pathologist. During my years of teaching, I’ve noticed that parents often can see that their child is struggling with communication, but they don’t know exactly what to call it, or how to help. Even the child’s teachers might not know how to label it. In this video, I’m going to walk you through the different types of speech-language disorders and how to recognize them.
- SPEECH SOUND DISORDERS: First there are Speech-Sound disorders. These involve the child mispronouncing sounds. We can divide speech-sound disorders into 2 general types:
- Articulation Disorder – this is when the child has only a few errors. For example, the child may say, “free” instead of “three”. F/TH is a fairly common error among young children.
Depending on the child’s age and how hard he is to understand, the child might need to be evaluated by a speech-language pathologist. It is always better to begin treatment while the child is young, before he has had time to build up incorrect speech habits.
- Phonological Disorder – this is when the child has many errors and is very hard to understand. The child is unable to understand the rules of sounds (phonology). Here is an example of how a child with a phonological disorder would speak.
If the teacher says, “Tell me what you did last summer,” the child might respond, “We went to Talifonnia an wen to Ditneywan, an we wen to da beats an went surpin. Den we wen to Wedo Wan an Sea Wood an I saw sarts an pendins. Den we tame home adin an dat’s all.”
The child exhibited many substitution errors, as well as deletion and distortion of other sounds.
Rare condition — Childhood Apraxia of Speech (CAS) — this is when the child cannot coordinate signals between his brain and his speech articulators in order to form words correctly. His errors will be inconsistent, and he may exhibit groping behaviors. The cause of CAS is usually unknown, and it is different than apraxia in adults.
Because a child with CAS or a phonological disorder will probably have many errors that make the child hard to understand, he should be evaluated by a speech-language pathologist.
- LANGUAGE DISORDERS: There are many facets of a language disorder. A child may have difficulties in one area or several.
- Syntax/Grammar – this is when the child struggles with the rules of language and can’t put together a complete sentence correctly. He may struggle to use the right verb form or pronoun when he speaks or writes.
Using the same vacation story above, a child with a grammar problem might say it this way:
“I go California, go see Disneyland, go at beach and do surfing. Then us see Lego Land and Sea World, I see sharks and penguins. Then us go home, go home again and that’s all.”
Notice how the child is pronouncing his sounds correctly, but is using the wrong verb tenses and pronouns, among other things.
- Language Processing – this is when children are slower to interpret and respond to the language signals they receive. It can take them longer to answer questions, follow directions, write a paper, or do anything involving language. It’s not that they don’t want to listen, or respond, or follow directions, it’s just that they can’t keep up with the rest of the class. This is different than an attention disorder like ADD/ADDHD, although they can occur together.
An example would be a child who struggles to follow multi-step directions at home or at school. Imagine if a first grade teachers is telling the class, “Take out your math book and turn to chapter 2, exercise 1. That should be on page 54.” Already the child will be struggling to follow the directions but the teacher will continue, “Now get out a piece of paper and write your name on the top right corner and number the paper from 1-10 down the left-hand side.” By now the child will probably be asking the teacher, “What? What do we do again?” or turning to his neighbor and saying, “What page? What do I put on the paper?”
- Language Comprehension – this is where the child just doesn’t understand the language input. Even if they understand the meaning of words, they may not understand the subtleties of how changing the order of words in a sentence can change the meaning. Or they may hear the words of a story but not understand the underlying message or theme of the story.
For example, you may read your child the story of The 3 Little Pigs, and ask her, “What was the main idea of this story?” She may answer, “Pigs!” If you push her by saying, “Yes, there were pigs in the story, but what was the problem?” she may give up and say, “Umm… I don’t know.”
- Language – Vocabulary – this is when children do not know the amount of words that they should know by their age. It interferes with their ability to understand others and to communicate what they want to say. It may take them longer than average to learn and store the meaning of words, and so they might need help catching up. This can be a particular problem if they don’t know ‘academic’ language, or language that is used in the classroom frequently, such as: title, author, absent, conclusion, community, arrive, exit, and many more.
If you suspect your child has a language disorder, she might need to be evaluated by a speech-language pathologist, depending on your child’s age and performance at school.
As with speech-sound disorders, it is best to catch language disorders early and begin treatment when the child is young. The child’s problems with language can become more evident as they get older and try to keep up with the increased demands of the upper elementary grades and beyond.
- FLUENCY DISORDERS – this is when the child stutters or clutters.
It is not related to what your child’s teacher might call fluency of reading, or how fast and accurately they can read. Here we are talking about how smoothly your child can speak without multiple repetitions of sounds and words.
- Stuttering – this is when the child is repeating sounds and words so frequently that it interferes with communication. It may often cause stress and tension behaviors while the child is trying to get his words out – blinking, licking lips, fidgeting, groping mouth movements – anything to ease stress or postpone having to get the words out.
Most of us are familiar with what stuttering sounds like. And most of us repeat our words or sounds on occasion. When the amount of stuttering reaches a certain point, it becomes an issue.
For example, using the vacation story from earlier, the child who stutters might respond this way, “I–I-I – I went to Ca-Ca-Ca-Ca- California………….. We-We-, you know, we- went to D- d- d- Disneyland. To Disneyland. ……And and and we went to Sssssss Sea World.”
- Cluttering – this is when the child speaks unusually fast and in a somewhat disorganized way. It may sound as though they are speaking in rapid spurts, and the syllables in a word may blend together. We see cluttering less commonly, but it is worth mentioning here. It can co-occur with stuttering.
It is not uncommon for children 3-4 years old to exhibit some stuttering behaviors. Often, they will grow out of it, but it’s hard to know who will and who won’t. If your child has fluency symptoms that make it hard for family, friends and teachers to understand him, it may be time to have him evaluated by a speech-language pathologist.
- OTHER DISORDERS – You may not be aware that there are other disorders that speech-language pathologists work with that may first occur in children or adults.
- Voice Disorders – this is when there is an issue with the vocal cords. Symptoms may include a very hoarse voice for an extended period with no known illness, or a voice having an unusual pitch or sound.
- Swallowing Disorders (dysphagia) – this may be a problem for newborns, or older patients who may have suffered a stroke. The patient is unable to use their tongue and other swallowing mechanisms correctly.
- TBI-related (traumatic brain injury) cognitive or speech disorders: A stroke, injury or illness might cause memory, executive functioning, or speech/language disorders in children or adults. Aphasia, Apraxia, and Dysarthria are some speech conditions that might result.
I hope this mini-course was helpful to you. Please check out our other courses at clarityspeechandlanguage.com. Thanks and have a great day!