Speech-Language Pathology

Language disorders can include difficulty understanding language, following directions or choosing appropriate words and combining them correctly in sentences. Language disorders can affect a child’s ability to interact with others and to learn. Some characteristics of a language disorder at different ages include:

• 4 months: Has poor eye contact or is inattentive to the speech of others 
• 6-8 months: Doesn’t use gestures
• 12 months: Has difficulty understanding speech or following simple directions 
• 16-18 months: Uses no words or has a limited vocabulary
• 24-26 months: Does not combine words for short sentences
• 3 years: Echoes words or phrases or has many grammar errors in sentences 
• 3-4 years: Cannot retell stories or talk about past events
• 6 years: Has trouble with attention, memorization of facts, learning or reading

Difficulty producing individual sounds. As a result, a child may substitute an easy sound for a harder one (e.g., “tun” for sun), omit sounds (e.g., “ool” for school) or distort sounds (e.g., “shlun” for sun). In some cases (e.g., apraxia of speech), a child may have difficulty combining the movements of speech sounds in sequences, as required for words and sentences. Articulation errors often make speech very hard to understand. Some characteristics of an articulation disorder at different ages include: 

• 8-9 months: Does not babble in a repetitive manner
• 18 months: Uses primarily vowels or only a few consonants
• 3 years: Leaves out consonants or has unclear speech
• 4 years: Has distorted speech that is often hard to understand
• 6 years: Cannot produce some speech sounds

Frequent abnormal disruptions in the flow of speech. Characteristics of a fluency disorder include:

• Involuntary repetitions, hesitations, prolongations, blocks, or disruptions during speech
• Tension during speech or abnormal movements such as jerking or forceful eye blinking
• Refusal to talk to strangers due to a fear of stuttering
• Embarrassment during speaking

• Difficulty swallowing liquids or solids
• Difficulty sucking or drinking from a cup
• Difficulty taking foods from a spoon or chewing foods
• Avoidance of certain types of foods or certain food textures
• Gagging, choking or coughing during feeding

Resonance disorders can include velopharyngeal dysfunction, a problem with the valve that closes off the nose from the mouth during speech, or blockage in the nose, throat or back of the mouth. Types of resonance disorders include:

• Hypernasality due to too much sound in the nasal cavity during speech
• Hyponasality due to a blockage in the nasal cavity
• Cul-de-sac resonance due to blockage in one or more areas of the vocal tract

Either abnormal vocal cord structure or abnormal function. Characteristics of a voice disorder include:

• A chronically hoarse, harsh, breathy or raspy voice quality
• An inappropriate vocal pitch for the child’s age or sex
• Frequent pitch breaks
• A voice that is consistently too soft