speech and language disorders in child

Language and Speech Disorders in Children

Helping children learn language, what to do if there are concerns.

Detecting problems

Children are born ready to learn a language, but they need to learn the language or languages that their family and environment use. Learning a language takes time, and children vary in how quickly they master milestones in language and speech development. Typically developing children may have trouble with some sounds, words, and sentences while they are learning. However, most children can use language easily around 5 years of age.

Parents and caregivers are the most important teachers during a child’s early years. Children learn language by listening to others speak and by practicing. Even young babies notice when others repeat and respond to the noises and sounds they make. Children’s language and brain skills get stronger if they hear many different words. Parents can help their child learn in many different ways, such as

Responding to the first sounds, gurgles, and gestures a baby makes.
Repeating what the child says and adding to it.
Talking about the things that a child sees.
Asking questions and listening to the answers.
Looking at or reading books.
Telling stories.
Singing songs and sharing rhymes.

This can happen both during playtime and during daily routines.

Parents can also observe the following:

How their child hears and talks and compare it with typical milestones for communication skills external icon .
How their child reacts to sounds and have their hearing tested if they have concerns .

Learn more about language milestones . Watch milestones in action.

Top of Page

Some languages are visual rather than spoken. American Sign Language uses visual signals, including gestures, facial expressions, and body movement to communicate.

Some children struggle with understanding and speaking and they need help. They may not master the language milestones at the same time as other children, and it may be a sign of a language or speech delay or disorder.

Language development has different parts, and children might have problems with one or more of the following:

Not hearing the words (hearing loss).
Not understanding the meaning of the words.
Not knowing the words to use.
Not knowing how to put words together.
Knowing the words to use but not being able to express them.

Language and speech disorders can exist together or by themselves. Examples of problems with language and speech development include the following:

Difficulty with forming specific words or sounds correctly.
Difficulty with making words or sentences flow smoothly, like stuttering or stammering.
Language delay – the ability to understand and speak develops more slowly than is typical
Aphasia (difficulty understanding or speaking parts of language due to a brain injury or how the brain works).
Auditory processing disorder (difficulty understanding the meaning of the sounds that the ear sends to the brain)

Learn more about language disorders external icon .

Language or speech disorders can occur with other learning disorders that affect reading and writing. Children with language disorders may feel frustrated that they cannot understand others or make themselves understood, and they may act out, act helpless, or withdraw. Language or speech disorders can also be present with emotional or behavioral disorders, such as attention-deficit/hyperactivity disorder (ADHD) or anxiety . Children with developmental disabilities including autism spectrum disorder may also have difficulties with speech and language. The combination of challenges can make it particularly hard for a child to succeed in school. Properly diagnosing a child’s disorder is crucial so that each child can get the right kind of help.

Detecting problems with language or speech

Doctor examining toddler's ear with mom smiling

If a child has a problem with language or speech development, talk to a healthcare provider about an evaluation. An important first step is to find out if the child may have a hearing loss. Hearing loss may be difficult to notice particularly if a child has hearing loss only in one ear or has partial hearing loss, which means they can hear some sounds but not others. Learn more about hearing loss, screening, evaluation, and treatment .

A language development specialist like a speech-language pathologist external icon will conduct a careful assessment to determine what type of problem with language or speech the child may have.

Overall, learning more than one language does not cause language disorders, but children may not follow exactly the same developmental milestones as those who learn only one language. Developing the ability to understand and speak in two languages depends on how much practice the child has using both languages, and the kind of practice. If a child who is learning more than one language has difficulty with language development, careful assessment by a specialist who understands development of skills in more than one language may be needed.

Treatment for language or speech disorders and delays

Children with language problems often need extra help and special instruction. Speech-language pathologists can work directly with children and their parents, caregivers, and teachers.

Having a language or speech delay or disorder can qualify a child for early intervention external icon (for children up to 3 years of age) and special education services (for children aged 3 years and older). Schools can do their own testing for language or speech disorders to see if a child needs intervention. An evaluation by a healthcare professional is needed if there are other concerns about the child’s hearing, behavior, or emotions. Parents, healthcare providers, and the school can work together to find the right referrals and treatment.

What every parent should know

Children with specific learning disabilities, including language or speech disorders, are eligible for special education services or accommodations at school under the Individuals with Disabilities in Education Act (IDEA) external icon and Section 504 external icon , an anti-discrimination law.

Get help from your state’s Parent Training and Information Center external icon

The role of healthcare providers

Healthcare providers can play an important part in collaborating with schools to help a child with speech or language disorders and delay or other disabilities get the special services they need. The American Academy of Pediatrics has created a report that describes the roles that healthcare providers can have in helping children with disabilities external icon , including language or speech disorders.

More information

CDC Information on Hearing Loss

National Institute on Deafness and Other Communication Disorders external icon

Birth to 5: Watch me thrive external icon

The American Speech-Language-Hearing Association external icon

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The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
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Second Opinion

Language Disorders in Children

What are language disorders in children?

Most infants or toddlers can understand what you’re saying well before they can clearly talk. As they get older and their communication skills develop, most children learn how to put their feelings into words.

But some children have language disorders. They may have:

Receptive language disorder. A child has trouble understanding words that he or she hears and reads.

Expressive language disorder. A child has trouble speaking with others and expressing thoughts and feelings.

A child will often have both disorders at the same time. Such disorders are often diagnosed in children between the ages of 3 and 5.

What causes language disorders in a child?

Language disorders can have many possible causes. A child’s language disorder is often linked to a health problem or disability such as:

A brain disorder such as autism

A brain injury or a brain tumor

Birth defects such as Down syndrome, fragile X syndrome, or cerebral palsy

Problems in pregnancy or birth, such as poor nutrition, fetal alcohol syndrome, early (premature) birth, or low birth weight

Sometimes language disorders have a family history. In many cases, the cause is not known.

It’s important to know that learning more than one language does not cause language disorders in children. But a child with language disorder will have the same problems in all languages.

Which children are at risk for language disorders?

The cause often is not known, but children at risk for a language disorder include those with:

A family history of language disorders

Premature birth

Low birth weight

Hearing loss

Thinking disabilities

Genetic disorders such as Down syndrome

Fetal alcohol spectrum disorder

Brain injury

Cerebral palsy

Poor nutrition

Failure to thrive

What are the symptoms of language disorders in a child?

Children with receptive language disorder have trouble understanding language. They have trouble grasping the meaning of words they hear and see. This includes people talking to them and words they read in books or on signs. It can cause problems with learning. It needs to be treated as early as possible.

A child with receptive language disorder may have trouble:

Understanding what people say

Understanding gestures

Understanding concepts and ideas

Understanding what he or she reads

Learning new words

Answering questions

Following directions

Identifying objects

A child with expressive language disorder has trouble using language. The child may be able to understand what other people say. But he or she has trouble when trying to talk, and often can’t express what he or she is feeling and thinking. The disorder can affect both written and spoken language. And children who use sign language can still have trouble expressing themselves.

A child with expressive language disorder may have trouble:

Using words correctly

Expressing thoughts and ideas

Telling stories

Using gestures

Asking questions

Singing songs or reciting poems

Naming objects

How are language disorders diagnosed in a child?

Your child’s healthcare provider will ask about your child’s language use. He or she will also look at your child’s health history. Your child may have a physical exam and hearing tests. Your child’s healthcare provider will likely refer your child to a speech-language pathologist (SLP). This specialist can help diagnose and treat your child.

An SLP will evaluate your child during play. This may be done in a group setting with other children. Or it may be done one-on-one with your child. The SLP will look at how your child:

Follows directions

Understands the names of things

Repeats phrases or rhymes

Does in other language activities

How are language disorders treated in a child?

To treat your child, the speech-language pathologist (SLP) will help him or her to learn to relax and enjoy communicating through play. The SLP will use different age-appropriate methods to help your child with language and communication. The SLP will talk with your child and may:

Use toys, books, objects, or pictures to help with language development

Have your child do activities, such as craft projects

Have your child practice asking and answering questions

The SLP will explain more about the methods that are best for your child’s condition.

How can I help my child live with a language disorder?

A language disorder can be frustrating for parents and teachers, and also for the child. Without diagnosis and treatment, children with such a disorder may not do well in school. They may also misbehave because of their frustration over not being able to communicate. But language disorders are a common problem in children. And they can be treated.

If you think your child might have a language disorder, talk with your child’s healthcare provider right away. Research has shown that children who start therapy early have the best outcome. Make sure that the SLP you choose is certified by the American Speech-Language-Hearing Association.

The SLP will guide your child’s treatment. But it’s important to know that parents play a critical role. You will likely need to work with your child to help him or her with language use and understanding. The SLP will also talk with caregivers and teachers to help them work with your child.

Ask the SLP what you should be doing at home to help the process. The SLP may advise simple activities such as:

Reading and talking to your child to help him or her learn words

Listening and responding when your child talks

Encouraging your child to ask and answer questions

Pointing out words on signs

When should I call my child’s healthcare provider?

Call your child’s healthcare provider if your child has:

Symptoms that don’t get better, or get worse

New symptoms

Key points about language disorders in children

Children who have a language disorder have trouble understanding language and communicating.

There are 2 kinds of language disorders: receptive and expressive. Children often have both at the same time.

A child with a receptive language disorder has trouble understanding words that they hear and read.

A child with an expressive language disorder has trouble speaking with others and expressing thoughts and feelings.

Language disorders can have many possible causes, such as a brain injury or birth defect.

A speech-language pathologist can help diagnose and treat a language disorder.

Parents can help their child with language use and understanding through simple activities.

Tips to help you get the most from a visit to your child’s healthcare provider:

Know the reason for the visit and what you want to happen.

Before your visit, write down questions you want answered.

At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

Ask if your child’s condition can be treated in other ways.

Know why a test or procedure is recommended and what the results could mean.

Know what to expect if your child does not take the medicine or have the test or procedure.

If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

Speech & Language Disorders

There are two main types of speech and language disorders your child may be experiencing. One type is when they have difficulty making correct speech sounds. The other type is when they have difficulty using and understanding language.

The two common disorders of speech and language are speech sound (articulation) disorder and mixed receptive-expressive language disorder. These disorders are very different from each other in the symptoms they cause and how they are treated.

A speech-sound (articulation) disorder describes when a child says sounds and words incorrectly, even though they are past the expected age to be able to do this. Speech-sound disorder is also called articulation disorder. A child with a speech sound disorder may:

Substitute one sound for another
Leave sounds out of words
Add sounds to words
Change a sound in a word

A mixed receptive-expressive language disorder is when a child has difficulty in both speaking and understanding others. A child with mixed receptive-expressive language disorder may have trouble:

Following directions
Understanding what people say to them
Answering yes/no questions correctly and answering “WH- questions” correctly (“who,” “what,” “where,” “when,” “why,” “which,” “whose” and “how”)
Using grammatically correct sentences, such as using the correct verb tense (“I go” versus “I goes”)
Telling a clear, organized story
Using an age-appropriate vocabulary

A speech-language pathologist has several tools to evaluate your child’s speech and language skills. They include the following:

A detailed history from the child’s family to learn how the child has developed over time and any current communication challenges.
Standardized assessments to compare your child’s performance to same-aged children who are developing typically. The SLP may ask your child to name pictures and repeat sentences to listen to the way your child produces sounds in single words and sentences. They may also look at similar parts of language, such as following directions, grammar, vocabulary and figurative language.
An oral mechanism exam, which looks at the way the muscles are working in and around your child’s mouth. This exam helps rule out muscle weakness or physical abnormalities that may be contributing to your child’s challenges with making sounds.
A language sample, which involves listening to the child speak in natural way. For example, a child may tell a story from a wordless picture book or play with toys with the provider. The SLP writes down what the child says and reviews it to evaluate things such as the words the child uses (vocabulary), grammar and sentence length.

As you investigate your child’s speech challenges, it’s important to have your child’s hearing examined. Hearing loss can lead to speech sound errors when your child cannot hear the correct sounds of speech.

Speech and language therapy. If your child has trouble communicating with others, a speech pathologist will work with them to improve communication skills. Speech therapists also work on the social aspects of communication, such as back-and forth conversation, and nonverbal communication, like eye contact.
Augmentative and alternative communication (AAC) device. Augmentative and alternative communication (AAC) describes a form of communication other than talking. This often includes using gestures, like sign language, or using an app on a device like a tablet or iPad. Some children with spoken language disorders benefit from this approach. It is important to remember that AAC does not discourage spoken language – it’s only been proven to help language growth.

Support Services & Resources

Visit the trusted websites below for more information and support for voice and speech conditions.

Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.

Learn More About Riley Support Services

The American Speech-Language-Hearing Association (ASHA) offers information and resources on spoken language disorders.

ASHA also offers information on AAC systems.

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Developmental Language Disorder

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What is developmental language disorder (DLD)?

What causes dld, what are the symptoms of dld, how is dld diagnosed, is dld the same thing as a learning disability, is dld a lifelong condition, what treatments are available for dld, what research does nidcd support on dld, where can i find more information on dld.

A young boy playing with alphabet letter toys.

Developmental language disorder (DLD) is a communication disorder that interferes with learning, understanding, and using language. These language difficulties are not explained by other conditions, such as hearing loss or autism, or by extenuating circumstances, such as lack of exposure to language. DLD can affect a child’s speaking, listening, reading, and writing. DLD has also been called specific language impairment, language delay, or developmental dysphasia. It is one of the most common developmental disorders, affecting approximately 1 in 14 children in kindergarten. The impact of DLD persists into adulthood.

DLD is a neurodevelopmental disorder. Neurodevelopmental disorders are caused by complex interactions between genes and the environment that change brain development. The exact causes of the brain differences that lead to DLD are unknown.

Neurodevelopmental disorders tend to run in families. Children with DLD are more likely than those without DLD to have parents and siblings who have also had difficulties and delays in language development. In fact, 50 to 70 percent of children with DLD have at least one family member with the disorder. In addition, other potentially related neurodevelopmental disorders, such as dyslexia or autism, are more common in the family members of a child with DLD.

Learning more than one language at a time does not cause DLD. The disorder can, however, affect both multilingual children and children who speak only one language. For multilingual children, DLD will impact all languages spoken by a child. Importantly, learning multiple languages is not harmful for a child with DLD. A multilingual child with DLD will not struggle more than a child with DLD who speaks only one language.

A child with DLD often has a history of being a late talker (reaching spoken language milestones later than peers). Although some late talkers eventually catch up with peers, children with DLD have persistent language difficulties.

Younger children with DLD may:

Be late to put words together into sentences.
Struggle to learn new words and make conversation.
Have difficulty following directions, not because they are stubborn, but because they do not fully understand the words spoken to them.
Make frequent grammatical errors when speaking.

Symptoms common in older children and adults with DLD include:

Limited use of complex sentences.
Difficulty finding the right words.
Difficulty understanding figurative language.
Reading problems.
Disorganized storytelling and writing.
Frequent grammatical and spelling errors.

Language difficulties may be misinterpreted as a behavioral issue. For example, a child who struggles with language may avoid interactions, leading others to think that the child is shy. A child may not follow directions because they don’t understand the instructions, but others may interpret this as misbehavior. A child who struggles to communicate may become frustrated and act out. When a child is struggling at home or in school, it is important to determine if language difficulties may be part of the problem.

If a doctor, teacher, or parent suspects that a child has DLD, a speech-language pathologist (a professional trained to assess and treat people with speech or language problems) can evaluate the child’s language skills. The type of evaluation depends on the child's age and the concerns that led to the evaluation. In general, an evaluation includes:

Direct observation of the child.
Interviews and questionnaires completed by parents and/or teachers.
Assessments of the child’s learning ability.
Standardized tests of current language performance.

These tools allow the speech-language pathologist to compare the child's language skills to those of same-age peers, identify specific difficulties, and plan for potential treatment targets.

DLD is not the same thing as a learning disability . Instead, DLD is a risk factor for learning disabilities since problems with basic language skills affect classroom performance. This means that children with DLD are more likely to be diagnosed with a learning disability than children who do not have DLD. They may struggle with translating letters into sounds for reading. Their writing skills may be weakened by grammatical errors, limited vocabulary, and problems with comprehension and organizing thoughts into coherent sentences. Difficulties with language comprehension can make mathematical word problems challenging. Some children with DLD may show signs of dyslexia. By the time they reach adulthood, people with DLD are six times more likely to be diagnosed with reading and spelling disabilities and four times more likely to be diagnosed with math disabilities than those who do not have DLD.

DLD is a developmental disorder, which means that its symptoms first appear in childhood. This does not mean that, as children develop, they grow out of the problem. Instead, the condition is apparent in early childhood and will likely continue, but change, as they get older.

For instance, a young child with DLD might use ungrammatical sentences in conversation, while a young adult with DLD might avoid complex sentences in conversations and struggle to produce clear, concise, well-organized, and grammatically accurate writing.

Early treatment during the preschool years can improve the skills of many children with language delays, including those with DLD. Children who enter kindergarten with significant language delays are likely to continue having problems, but they and even older children can still benefit from treatment. Many adults develop strategies for managing DLD symptoms. This can improve their daily social, family, and work lives.

Treatment services for DLD are typically provided or overseen by a licensed speech-language pathologist. Treatment may be provided in homes, schools, university programs for speech-language pathology, private clinics, or outpatient hospital settings.

Identifying and treating children with DLD early in life is ideal, but people can benefit from treatment regardless of when it begins. Treatment depends on the age and needs of the person. Starting treatment early can help young children to:

Acquire missing elements of grammar.
Expand their understanding and use of words.
Develop social communication skills.

For school-age children, treatment may focus on understanding instruction in the classroom, including helping with issues such as:

Following directions.
Understanding the meaning of the words that teachers use.
Organizing information.
Improving speaking, reading, and writing skills.

Adults entering new jobs, vocational programs, or higher education may need help learning technical vocabulary or improving workplace writing skills.

The National Institute on Deafness and Other Communication Disorders (NIDCD) supports a wide variety of research on the causes, symptoms, diagnosis, and treatment of DLD. For example, NIDCD funds research that seeks to understand how brain and learning patterns differ for children with DLD compared to children with typical language development. Other research focuses on understanding why socioeconomic disparities increase the risk of DLD in children from low-income families. NIDCD-supported scientists are also determining how to accurately diagnose DLD, especially in culturally diverse children who speak a variety of dialects or languages. The institute also funds research to ascertain, at a highly practical and specific level, the best ways to teach language to children with DLD, including how many times a language structure (e.g., using proper tense) should be practiced, how instructional sessions should be organized, and how often teaching should occur. NIDCD-supported programs are also researching how to coach parents or peers of children with DLD to support language growth at home or school.

The NIDCD maintains a directory of organizations providing information on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language.

For more information, contact us at:

NIDCD Information Clearinghouse 1 Communication Avenue Bethesda, MD 20892-3456 Toll-free voice: (800) 241-1044 Toll-free TTY: (800) 241-1055 Email: [email protected]

NIH Pub. No. 22-DC-8194 October 2022

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Health Library Speech Disorders

What is a speech disorder.

Many children will experience a temporary delay in speech and language development. Most will eventually catch up. Others will continue to have difficulty with communication development. Communication disorders include speech disorders and language disorders. Speech disorders are discussed in this article and some general guidelines are also given.  This will help you decide if your child needs to be tested by a speech-language pathologist.

A child with a speech disorder may have difficulty with speech sound production, voice, resonance or fluency (the flow of speech).

Speech Sound Disorders

A child with a speech sound disorder is unable to say all of the speech sounds in words. This can make the child’s speech hard to understand. People may not understand the child in everyday situations. For most children, the cause of the speech sound disorder is unknown. Other speech sound disorders can be linked to things such as a cleft palate, problems with the teeth, hearing loss, or difficulty controlling the movements of the mouth.

Reasons for Concern

The child doesn't babble using consonant sounds (particularly b, d, m, and n) by age 8 or 9 months.
The child uses mostly vowel sounds or gestures to communicate after 18 months.
The child’s speech cannot be understood by many people at age 3.
The child’s speech is difficult to understand at age 4 or older.

Voice Disorders

The voice is produced as air from the lungs moves up through and vibrates the vocal folds. This is called phonation. With voice disorders, the voice may be harsh, hoarse, raspy, cut in and out, or show sudden changes in pitch. Voice disorders can be due to vocal nodules, cysts, papillomas, paralysis or weakness of the vocal folds.

The voice is hoarse, harsh or breathy.
The voice is always too loud or too soft.
The pitch is inappropriate for the child's age or gender.
The voice often "breaks" or suddenly changes pitch.
Frequent loss of voice

Resonance Disorders

Resonance is the overall quality of the voice. A resonance disorder is when the quality of the voice changes as it travels through the different-shaped spaces of the throat, nose and mouth. Resonance disorders include the following:

Hyponasality (Denasality): This is when not enough sound comes through the nose, making the child sound “stopped up.” This might be caused by a blockage in the nose or by allergies.

Hypernasality : This happens when the movable, soft part of the palate (the velum) does not completely close off the nose from the back of the throat during speech. Because of this, too much sound escapes through the nose. This can be due to a history of cleft palate, a submucous cleft, a short palate, a wide nasopharynx, the removal of too much tissue during an adenoidectomy, or poor movement of the soft palate.

Cul-de-Sac Resonance: This is when there is a blockage of sound in the nose, mouth or throat. The voice sounds muffled or quiet as a result.

Reasons for Concern:

Speech sounds hyponasal or hypernasal
Air is heard coming out of the nose during speech

Fluency Disorders (Stuttering)

Fluency is the natural “flow” or forward movement of speech. Stuttering is the most common type of fluency disorder. Stuttering happens when there are an abnormal number of repetitions , hesitations, prolongations, or blocks in this rhythm or flow of speech. Tension may also be seen in the face, neck, shoulders or fists. There are many theories about why children stutter. At present, the cause is most likely linked to underlying neurological differences in speech and language processing. Internal reactions from the person talking, and external reactions from other listeners, may impact stuttering, but they do not cause stuttering.

The parents are concerned about stuttering.
The child has an abnormal number of repetitions, hesitations, prolongations or blocks in the natural flow of speech.
The child exhibits tension during speech.
The child avoids speaking due to a fear of stuttering.
The child considers themselves to be someone who stutters.

Treatment for Speech Disorders

Early intervention is very important for children with communication disorders. Treatment is best started during the toddler or preschool years. These years are a critical period of normal language learning. The early skills needed for normal speech and language development can be tested even in infants. At that age, the speech-language pathologist works with the parents on stimulating speech and language development in the home. Active treatment in the form of individual therapy usually starts between the ages of 2 and 4 years.

If you have concerns about your child’s communication skills, discuss them with your child’s doctor. The doctor will likely refer the child to a speech-language pathologist for evaluation and treatment.

All children with speech and language disorders should also have their hearing tested.

Helping Your Child

Children learn speech and language skills by listening to the speech of others, and practicing as they talk to others. Parents are the most important teachers for their child in their early years.

They can help the child by giving lots of opportunities to listen to speech and to talk. This can be done by frequently pointing out and naming important people, places, and things. They can also read and talk to the child throughout the day, especially during daily routines, interactive plays, and favorite activities. Parents can give the child models of words and sentences to repeat.

Parents can also set up opportunities for the child to answer questions and talk. Listening to music, singing songs and sharing nursery rhymes are also great ways to build speech and language skills while having fun with your child.

Last Updated 12/2023

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Quick guide to language disorder, what is language disorder.

Language disorder is a communication disorder that can affect kids. Children with language disorder have trouble understanding and speaking language. They may struggle with written language, spoken language or both. Kids with language disorder often use short or simple sentences, mix up the order of words, or say “um” a lot. These challenges can cause problems at home, at school and with other children.

Language disorder is different from speech sound disorder. In speech sound disorder, the child has problems making sounds. In language disorder, the child can make sounds but has trouble using them to communicate.

What are the symptoms of language disorder?

Signs that a child might have language disorder include:

Trouble learning and using spoken and written language
Struggling to learn and use gestures
Difficulty with vocabulary, sentence structure or having a conversation
Having a hard time following directions or organizing thoughts
Using short, simple sentences
Putting words in the wrong order
Using the wrong tense (like saying “I go to school” when they mean “I went to school”)
Leaving words out of sentences
Saying things like “um” a lot while trying to remember the right word
Repeating parts of questions or entire questions before answering them
Avoiding talking to people they don’t know well
Not knowing a lot of words

How is language disorder diagnosed?

To diagnose language disorder, speech and language therapists will give the child a few tests. These tests will show how well the child can understand and speak language. A child is diagnosed if they cannot communicate as well as other children their age and they struggle with:

Knowing a lot of words
Speaking or writing long sentences
Sharing information
Having a conversation

A doctor should also test for other issues that could affect their language skills, including deafness.

What are the risk factors for language disorder?

Language disorder often runs in families. A child is more likely to have language disorder if they have a parent or sibling who also has it.

How is language disorder treated?

Language disorder is best treated with speech and language therapy, where a specialist can help the child model correct vocabulary and grammar, and build language skills through repetition.

Language disorder can also lead to other challenges, such as depression or social anxiety. Cognitive behavioral therapy (CBT) can help children with language disorder who experience emotional or behavioral problems.

Risk for other disorders

Children with language disorder may have a hard time making friends. This can cause them to feel depressed or have social anxiety.

How can teachers support students with language disorder?

Let the child know in advance before calling on them
Let the child know it’s okay to ask you to repeat or rephrase what you say
Encourage them to take notes
Take time to break down directions for assignments with the student one-on-one
During a lesson, pause for a few minutes to allow them to process the information before moving on to the next topic
Choose reading material that uses simple sentence structures and language

How can parents support their kids?

Simplify your language when speaking
Be direct in your language
Have your child repeat back what you said to make sure they understand
Place them in a classroom that has two teachers or includes a special education teacher
Make sure your child’s teachers know about their disability and how to support them
Take your child to a speech pathologist

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Rearing a child with a language disorder: parents experiences with speech and language therapy services in 10 countries

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Published: 17 April 2024

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Sam Harding ORCID: orcid.org/0000-0002-5870-2094 1 ,
Maja Kelić ORCID: orcid.org/0000-0002-7253-1295 2 ,
Thora Ulfsdottir 3 ,
Sofia Baena ORCID: orcid.org/0000-0003-4736-9318 4 ,
Julie Feilberg ORCID: orcid.org/0000-0002-6748-2732 5 ,
Kristine M. Jensen de López ORCID: orcid.org/0000-0001-5799-8615 6 ,
Inge S. Klatte ORCID: orcid.org/0000-0002-7280-8960 7 ,
Rena Lyons ORCID: orcid.org/0000-0001-7294-9707 8 ,
Tina C. Mantel ORCID: orcid.org/0000-0001-9155-2190 9 ,
Rama Novogrodsky ORCID: orcid.org/0000-0002-9834-2388 10 ,
Isabel R. Rodriguez-Ortiz ORCID: orcid.org/0000-0002-2623-4310 11 &
Krisztina Zajdó ORCID: orcid.org/0000-0002-6047-2275 12

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Collaboration between speech and language therapists and parents to help children with language disorders has always been important. The majority of published work is from the perspective of the therapist and what they think and feel parents need to help their children. However, less is known about (1) the processes parents try to access and receive services; (2) how they perceive the journey; and (3) what they think about the service provided to their child. This paper describes an exploration of how parents experience identification and access of services for their children living with language disorders.

Subjects and methods

Parents from ten countries, with a child who had received services for speech language disorder participated in semi-structured qualitative interviews. Thematic analysis was used to interpret the data.

Two main themes were constructed: (1) Parental recognition of the need for services; and (2) difficulties accessing services. Parents detailed how they recognised that their children needed services and how they went about securing them. Parents recounted the process they undertook; from their initial concerns about their child’s development, the feelings this engendered, and how they tried to get support and treatment. Parents talked about the factors that made them decide they had to fight to gain access to services for their children.

Conclusions

Across countries, parents encounter similar experiences. The major obstacles identified by parents lead to the perception of delay in obtaining access to services. Identifying the services that children required was the first hurdle, even before getting a referral to them.

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Boosting speech language practitioner—parent collaboration remains a key goal in the field. While we know a lot about how therapists understand parents’ needs (Davies et al. 2017 ; Klatte et al. 2019 ), there is less information available on the flip side (Klatte et al. 2023 ). Specifically, we lack data on parents’ challenges navigating support services for their children with language disorders (Davies et al. 2017 ). The 1989 Convention on the Rights of the Child established child development as a fundamental right (UNICEF 1989 ). However, the World Health Organization emphasised integrating children with communication difficulties into healthcare, ensuring timely access to early intervention only since 2020 (World Health Organization 2020 ).

Early speech and language issues can have lasting impacts, affecting literacy, social-emotional well-being and even employment (Beitchman et al. 2003 ; Berkman et al. 2015 ). Early identification allows for timely intervention, potentially reducing long-term negative consequences. The effectiveness of intervention is well-documented (Ebbels et al. 2019 ). The challenge lies in pinpointing who needs help and how services can be provided to lead to effective treatment. ICAN, a UK children’s communication charity, observed that while some children improve with support, others face persistent needs (ICAN 2009 ). Up to two-thirds of children with diagnosed language needs will not show spontaneous improvement (Broomfield and Dodd 2011 ; Roulstone et al. 2003 ). Previous reviews, citing the complexity of language development and lack of robust evidence, did not recommended universal screening (Law et al. 1998 ; Berkman et al. 2015 ); however, recent and ongoing work is establishing screening of a UK population (Law et al. 2023 ) and bilingual Welsh children (Baker et al. 2022 ). Even so, this work is in its infancy and under-diagnosis may therefore obstruct service access for children with developmental language disorders (McGregor 2020 ).

While some countries explore universal language screening (Public Health England 2020 ), currently, the onus often falls on parents and their network to suspect a language delay. Mothers, friends, neighbours and religious leaders are often the first to voice concerns and suggest strategies before parents approach healthcare professionals (Marshall et al. 2017 ; Roulstone et al. 2015 ). However, we know less about parents’ specific experiences when navigating speech and language therapy services for children suspected of having a language disorder.

In Western societies, patient and caregiver voices are often overlooked, rarely influencing clinical practice or, even less frequently, policy making (Roulstone et al. 2015 ). Integrating parental perspectives and expectations into evidence-based practices is crucial (Davies et al. 2017 ; Dollaghan 2007 ). Difficulty accessing services risks hindering therapist–parent collaboration, as negative initial experiences can breed frustration and misunderstandings.

This current study is explorative and inductive, with the aim of understanding the lived experiences of parents who are seeking access to speech and language therapy services. It was believed that this can lead to the discovery of fresh themes and surprising connections that can help construct more comprehensive, context-specific theories that can be of use to therapists working collaboratively with parents (Charmaz 2006 ).

This paper report’s themes from an explorative, rather than theory driven research exploring parental perspective of speech and language disorders. In the current paper we explore how parents talk about their experiences of identification and access to speech and language therapy services for their language impaired children.

This research extends the exploration of the services provided for the children with language disorder started within the COST Action IS1406 ‘Enhancing children’s oral language skills across Europe and beyond’ in which the authors of the paper participated.

Cross-national differences existed in relation to the procedures for applying for ethics. Five countries required and obtained ethical approval to carry out the study (Supplementary Material S1).

Interviews were conducted in the authors’ respective countries and native language. All members of the research team held a minimum of a master’s degree in speech and language pathology, developmental or health psychology, and had experience conducting qualitative research. The authors followed the Consolidated Criteria for Reporting Qualitative Research (COREQ; Tong et al. 2007 ). Nine interviewers did not know the participants prior to the interview. One interviewer knew the parent because she had provided a speech and language therapy service to the child.

Participants

The inclusion criteria for parental participation were parents of a monolingual child aged 6 to 12 years who had a speech and/or language disorder as the primary presenting difficulty; and that their child had been in receipt of services for speech and language disorders within the past 4 months.

An opportunistic purposive sampling was used to recruit parents from ten countries: Croatia, Denmark, England, Hungary, Iceland, Ireland, Israel, the Netherlands, Norway and Spain. Ten interviews were conducted, one for each participating country. In nine interviews, data were given by mothers, while in one country, a mother and father pair participated together in the interview (Table 1 ).

Reflexivity

This study is multinational qualitative research which poses several challenges in different stages of the research: developing the unique interview schedule for different countries and cultural contexts; analysis of the data obtained in different languages; multiple researchers/data analysts. We used a consensus approach where each step was discussed via teleconferencing platforms, in-person or a combination.

An interview schedule was developed to ensure that data collection was conducted with cultural sensitivity, whilst collecting comparable data. During the data analysis, multiple meetings facilitated modification and refinement of interpretation as well as generation of new codes, using the analyst triangulation (Patton 2002 ). Data were shared in English in online spreadsheets to ensure that every researcher had access to all the excerpts from different countries. In this way, codes and themes could be cross-checked and discussion stimulated.

Data were collected in nine different languages. Analyses were undertaken in the original language to keep the nuances in the meanings, cultural context and the voice of the participants. The research team consisted of multiple researchers who could analyse the data in the native language of the participants. Excerpts illustrating the codes were translated into English for the shared spreadsheets, with the comments for the translation and further explanations where needed.

Procedure and data collection

Semi-structured interviews were used. The interview schedule was inspired by a topic guide applied at Aalborg University’s Clinic for Developmental Communication Disorders and adapted in English by K.J.L. and R.L. (Supplementary Material S2). The interview guide was then translated by the researchers into each of the participating nations’ official languages. Independent scholars performed back translations to make sure the meaning of the words and phrases were intact following the translation.

Each of the authors carried out the interview at a convenient location, such as the home of the parent or in the clinic (Supplemental Material S3). Interviews were audio-recorded and transcribed verbatim by a local member of the research team. Duration of the interview was on average 54 min (35 to 77 min; median = 52 min). There is disagreement over when data from cross-cultural and cross-linguistic qualitative research should be translated into English (Chapple and Ziebland 2017 ). One worry is that the data’s richness might be reduced if it were translated before the analyses. For this reason, the nation’s primary language was used for the interviews and analysis and only in the latter stages of the study, after the team had decided on the codes and themes, were segments translated into English.

Data analysis

Thematic analysis following the procedure of Horwitt ( 2010 ) and Braun and Clarke ( 2006 ) was undertaken. The first step of the analysis was familiarisation with the data where every researcher reread the transcript from her country to get the main ideas that parents were communicating. To establish the common coding, initially one member of the team coded her interview and shared the codes and the respective transcript with the full research team. For this step, one of the interviews undertaken in English was chosen, to ensure that all the members of the team could reflect on the initial coding with the entire interview available. These initial codes were discussed, and revised, new codes were added, and the initial ‘codebook’ was applied for all the interviews. This process was repeated with a second round of discussion (now with the coding from all countries) where the final codebook was developed and then used for each country. The excerpts of the interviews mapped to the specific codes were translated to English.

The second step in the analysis was the identification of themes which took place in a two-day meeting where seven authors participated face-to-face and other researchers joined them online in specifically planned sessions where data was discussed and cross-checked against codes. Codes were grouped into broad themes. Themes were further refined during multiple online meetings. In light of these conversations, we made changes to the data and came up with fresh interpretations. A shared Excel spreadsheet that enabled cross-checking of extracted excerpts and subsequent themes by each researcher was created to improve transparency and reliability (Supplemental Material S4).

In the interview texts, parents provided descriptions of how they recognised the need for services for their children and how they went about accessing and securing these services. Parents recounted explicitly the process they went through; watching their children grow and develop, the feelings that arose in them when they either thought or were made aware that their child needed some help with their language development. Parents report on how they decided to fight for services for their children and the rationale for these decisions.

Two main themes are reported in this article. The first main theme is ‘parental recognition of the need for services’ which included two codes: (1) ‘observing a difference’, referring to the parents’ observation and recognition of the difference in their child’s behaviour compared to that of other children or their impressions of their child’s behaviour in comparison to others and, (2) ‘unmet needs of their child’, specified as the parent’s beliefs/impressions about the child’s existent but so far unsatisfied needs. These are presented in turn, and the codes within them discussed (Table 2 ).

Theme 1: Parental recognition of the need for services

Code 1.1 – Observing a difference, referring to the parents’ observation and recognition of the difference in their child’s behaviour compared to that of other children or their impressions of their child’s speech, language behaviours in comparison to others, including siblings.

Parental reports of speech, language behaviour represented their experiences and observations of their child’s behaviours and skills. Parents reported noticing differences in their children’s past and present behaviour and this experience was typically coupled with being aware of their own feelings relating to their belief that their child was not developing as they expected. Specifically, parents’ first sense was that their child’s development was slow when compared to their own expectations, or experience of other children.

so when she came close to being 3 years-old, that I tried to say to the day care person, that it seemed strange to me that she still doesn’t have better language, and what should be done about it… in relation to if they understand what Klara says (Denmark) I saw when he was two months old that he does not have a firm hand. I said to my husband, we should not wait. Let’s go immediately to [name of city]” . (Croatia)

Parental worries led them to seek help from professionals, reporting the changes they perceive in their child’s behaviour as evidence of therapeutic need, e.g. We noticed that the child needed something more (in addition to medication) so we started with speech therapy. (Spain).

Code 1.2 – Unmet needs of their child, represented the parent’s reports about the needs of their child in relation to speech and language and how these had not been met by health care services.

When parents felt that their child was different from other children of the same age, they were quick to discuss the needs of their child with friends and family, and then healthcare professionals. These parental concerns sometimes lead to formal assessment of unmet needs to be addressed or to parents being asked to wait and watch for further development.

We had the impression that he understood everything that we said, because he responded adequately… but around the age of 3, he still did not really talk, and then we wondered a bit… the results of the test really surprised us, because we thought he understood everything (Norway)

Other parents noted that their child had communication difficulties but there was a reticence from the preschool to acknowledge a need.

Soon as we started preschool there, I start to talk about his language development, but they didn’t feel it was very serious and talked about that he was a good boy. They said that he used his own methods to cope with it. I can tell you that at this time he could not express himself clearly and his sentences were all jumbled. He was not able to communicate with others . (Iceland)

Theme 2: Obstacles to accessing services

This second theme has three codes: ‘identifying pathways to services’, ‘ready to fight for my child’ and ‘finding the right person’. The three codes are interwoven as parents described them as part of an unfolding journey to services. In essence they might be viewed as way points or viewing platforms on the treatment pathway.

Code 2.1 – Identifying pathways to services

Pathways to the needed services that are available for these families are often unclear. Parents reported that they didn’t know what services they needed to help their child, and the information they readily accessed did not provide information on who to talk to.

Well it’s frustrating because we are no means the experts. Like we are depending on other people who are working in these areas to tell you where you’re supposed to be going and then when you get sent off to this place and you’re kind of feeling like this is definitely not where he needs to go (Ireland)

Consequently, parents related how they felt confused and frustrated trying to navigate the system in order to find relevant services for their child.

… now we are in the service system and we know who the healthcare professionals are and their special area(s) of expertise and to whom I need to ask my questions. But at the beginning it was unclear … (Netherlands)

Importantly, parents recounted how vital other parents were as a source of information about the available services in their community and the routes to get access and make use of services.

I was always talking if I heard that somebody has a child with some difficulties, you say, you hear from others, there is this thing there, that thing in that place . (Croatia)

There appeared to be common agreement across parents of the importance of access to speech and language therapy services. However, parents voiced that knowing your and your child’s rights are important.

… it took us a few months until someone also told me “Go get private, get refunds”. And then we actually started some kind of a process … (Israel)

Parents conveyed that knowing that there are services their child has a right to access was not always sufficient. Their experience was that even when the need for referral was recognised, there were often delays between this and having an initial appointment with a speech language therapist.

Everything started. Only 4 months until summer vacation and then the school would start. There was no time to lose. He had the right to professional support, but it was too late to hire a person to support him. So the preschool teachers took on the treatment. They worked on his self-confidence and helped him to make friends . (Iceland)

Code 2.2 – Ready to fight for my child

Concerns were raised by some parents that they needed to fight for recognition that their child needed referral or intervention; with many commenting that they had to keep pushing or fighting to be seen.

You have to push, you just have to push for everything. You have to find and speak to different services out there….…as a parent, you have to fight for everything that you want.….I always sort of think that I have been quite lucky because I have pushed, and I know the right people to push . (England) when she was 3, I contacted the municipal again to tell them I felt it [her speech development] was developing too slow … (Croatia)

In some cases, when parents turn to a person or an institution they believe could provide the services they feel their child may benefit from, they get rejected without even being heard or the child being assessed.

So I asked her if it [the service at the speech institute] could be offered to Klara, and she says no, they can’t take her, the children there are all children with diagnoses, and Klara, she is a normal child, and I can’t imagine in any way that it would give Klara anything to go sit with other children that have big articulation problems and this and that . (Denmark)

Parents report that, once they knew that the child needed to be seen by an SLT they were unable to get access to treatment due to no service availability (Ireland). In other cases, the lack of government-funded services forced the parents to seek out a private provider (Croatia, Israel) while waiting on the government-funded services waiting list, sometimes even for a rather extended period of time (Israel).

… at the time when they were referring her for speech and language we couldn’t get, I couldn’t get any help for her. I couldn’t find anyone at the time. There was a lack of speech therapists in [name of city] at the time when she was going through and I was trying to say, when the paediatrician said oh she is going to need help with speech or she wasn’t talking or whatever, I said oh it’s fine I’ll bring her private and he kind of laughed at me and was like, there isn’t anybody. (Ireland)

Code 2.3 – Finding the right person

Once parents found the right person, they evaluated therapists and valued the relationships they built with them.

I knew that they will only help him… I noticed how kind and dedicated they are and that they have a positive attitude towards things, Peter and all the children… the kindness and the hard work they put in… it is easy to see that they are really helping the children. This is what I noticed. And I was so glad… (Hungary) If she [the Speech and Language Therapist] had not turned up, I would perhaps still be lost . (Iceland)

However, frequent frustration is reported resulting from high staff turnover.

One of the barriers was the turn around of staff in the speech and language was really high, so he would get a relationship with one person, then 3 weeks later you would be seeing another speech and language person… so that would be a real barrier so it was almost like building those relationship right again… (England)

As well as some parents reporting a breakdown in the therapeutic partnership, due to the feeling that therapists are expecting them to deliver the therapies to their child, and the fear that they are not knowledgeable enough, and that they may do more harm than good.

… in the end I was so frustrated, I could read this and read and read, but I am not a speech pedagogue, so I can’t find out on my own, in the end, find out what it is I should do… to support it… (Denmark)

This paper explored how parents experienced the identification and access of speech and language therapy services for their language impaired children. It is clear from the parents’ views collected in this research that they believe they have an important role to play in their child’s language development. However, they also recognised that there is a lack of access to health care professionals, in this case specifically speech and language therapy.

Parents can identify that their children have speech and language difficulties at an early stage (Johnson and Bountziouka 2020 ), but navigating healthcare systems to access the best services for their child’s needs appears to be a challenge across countries. Mancilla-Martinez et al. ( 2016 ) argued that parent report is a valuable tool for assessment, as well as being cost-effective for a service it avoids task and context bias. There is a body of research that validates parents’ ability to assess language development (Feldman et al. 2000 , 2005 ; Johnson and Bountziouka 2020 ; Mancilla-Martinez et al. 2016 ; Nayeb et al. 2021 ). Studies using versions of the Child Development Inventories (CDI) have found significant correlations between children’s productive vocabulary as reported by parents and when directly assessed or observed (Mancilla-Martinez et al. 2016 ; Marchman and Martinez-Sussman 2002 ). There are even stronger associations between parent report and productive vocabulary than receptive vocabulary, suggesting that parents may be better able to report on the words their child uses than those they only understand (Mancilla-Martinez et al. 2016 ).

Parents have a meaningful role to play in recognising their child’s development needs, to a level which should be recognised by health care professionals, to warrant clinical assessment of need.

Most European countries have a Universal Public Health Care System in place where accessibility to health service is secured (Law et al. 2019 ). Since 2015, 53 European member states have been working towards a strategy for child and adolescent health, which includes organising services and policy making to support child development (Alemán-Díaz et al. 2018 ). The European countries participating in the current study have different methods of delivering their health systems. Many countries have a well-developed health system for the diagnosis and treatment of different health issues, including neurodevelopmental conditions. However, as parents voice in the current paper, the systems are seldom transparent, so are inherently hard to navigate, and are often perceived to be insufficiently funded/organised when the conditions of concern are psychological and/or neurodevelopmental in origin.

Parents frequently reported that there was a shortage of speech and language therapy services, and that there was a need to fight to ensure their child had access to them. Health professionals are aware of this situation and that long waiting lists discourage them from referral to speech and language therapy services (Ruggeroet al. 2012 ). This practice results in late diagnosis and late treatment, with the potential to lead to extensive life-long negative consequences for the child’s development and, understandably, parent’s discontentment.

Melvin et al. ( 2019 ) noted the value of two–way communication through listening to parents, giving them a voice in the therapeutic journey and sharing information in order to facilitate their engagement with intervention. There is a body of literature that indicates that parents’ perceptions of therapy are heavily influenced by their relationship and partnership with the therapists (Davies et al. 2017 ; Klatteet al. 2019 ). In the current study, the building of this relationship was part of the code ‘finding the right person’.

The parental relationship with the therapist, can influence how engaged they are in therapy. Parents’ underlying knowledge, skills and confidence related to the management of their child’s language, has only recently been attempted to be measured with a modified version of the Parent Activation Measure—SLT (PAM-SLT-UK; Gibbard et al. 2021 , 2024 ; Insignia Health 2014 ). Further research into both, parent partnership and parent activation and their role in causing change for children’s speech and language, will be critical in the development of speech and language therapists’ understanding of how parents can most beneficially (for themselves and their child) collaborate with therapists.

There may also be value in further understanding the knowledge and attitudes of the wider social networks identified as being important to parents (Marshall et al. 2017 ; Roulstone et al. 2015 ). Their role in helping parents to find the right person and providing support to parents is important and could be enhanced through improved service signposting. Klatte et al. ( 2020 ) provide a realist framework of ‘context’, ‘mechanism’ and ‘outcomes’, which they suggest is a first step to opening the ‘black box’ of collaborative practice between parents and speech and language therapists. The researchers argued that it is important that we make the process of collaborative practice explicit so that it can be debated and tested, both within the profession and with the families with which we work.

Strengths and limitations

This study acknowledges several limitations that shape the scope and generalisability of the findings. Firstly, concerns around language, translation and potential inter-coder variability in analysis led us to include only one family per country (n = 10). Though these interviews were extensive (35–77 min, median 52 min) and yielded rich qualitative data, the sample homogeneity in terms of educational and socioeconomic background restricts the generalizability of our conclusions. We recognise the inherent diversity within and across parental populations and emphasise the need for future research to incorporate the voices of parents from broader socioeconomic strata, including underserved communities and those with multilingual children.

Secondly, this study did not directly link parental experiences to health and service provision within each country. However, other work within the European COST Action compiled data on health and service provision across the participating countries (Law et al. 2019 ). This resource lays the groundwork for future research to conduct a more in-depth analysis and explore how our findings resonate with the specific healthcare and service landscapes in each nation.

Across countries, parents recount similar experiences in accessing speech and language therapy services. Major obstacles were identified that lead to the perception of delay in obtaining timely access to services. Often, the link between language difficulties and the right proficiency, identifying that it is speech and language therapy services that children required, was the first hurdle, even before trying to get a referral to them.

The analysis of data from a qualitative research project identified obstacles parents perceived to knowing which services were needed, as well as getting timely access to speech and language therapy services. Collaborative working with parents and therapists could mitigate negative feelings towards services and improve relationships between therapists and parents.

Data availability

Due to the multi-national nature of the qualitative data, it is not available to share outside that of the research team and their host organisations.

Code availability

Not applicable.

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Acknowledgements

We thank the parents for participating in our study and the gatekeepers that facilitated the participation. The COST Action IS1406 entitled ‘Enhancing children’s oral language skills across Europe and beyond: a collaboration focusing on interventions for children with difficulties learning their first language’ funded by the European Union facilitated meetings and made this large international collaboration possible.

The COST Action IS1406 entitled ‘Enhancing children’s oral language skills across Europe and beyond: a collaboration focusing on interventions for children with difficulties learning their first language’ funded by the European Union facilitated meetings and made this large international collaboration possible.

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Bristol Speech and Language Therapy Research Unit, Pines and Steps, Southmead Hospital, Bristol, BS10 5NB, UK

Sam Harding

University of Rijeka, Rijeka, Croatia

Department of School and Leisure, Centre for Language and Literacy at Reykjavik City, Reykjavik, Iceland

Thora Ulfsdottir

Universidad Loyola Andalucía, Seville, Spain

Sofia Baena

Department of Language and Literature, Norwegian University of Science and Technology, No-7491, Trondheim, Norway

Julie Feilberg

Clinic for Developmental Communication Disorders, Institute of Communication and Psychology, Aalborg University, Teglgaardsvej 1, Office 12-01, 9000, Aalborg, Denmark

Kristine M. Jensen de López

HU University of Applied Sciences Utrecht, Utrecht, The Netherlands

Inge S. Klatte

School of Health Sciences, National University of Ireland, Galway, Ireland

UMCU Department of Education, University Medical Centre Utrecht, Utrecht, The Netherlands

Tina C. Mantel

University of Haifa, Haifa, Israel

Rama Novogrodsky

Universidad de Sevilla, Seville, Spain

Isabel R. Rodriguez-Ortiz

Department of Special Education/Speech-Language Therapy, Széchenyi István University/University of Győr, Győr, Hungary

Krisztina Zajdó

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• Conceptualization: Kristine M. Jensen de López and Rena Lyons. • Methodology: Sam Harding, Maja Kelić, Thora Ulfsdottir, Sofia Baena, Julie Feilberg, Kristine M. Jensen de López, Inge S. Klatte, Rena Lyons, Tina C. Mantel, Rama Novogrodsky, Isabel R. Rodriguez-Ortiz and Krisztina Zajdó. • Formal analysis and investigation: Sam Harding, Maja Kelić, Thora Ulfsdottir, Sofia Baena, Julie Feilberg, Kristine M. Jensen de López, Inge S. Klatte, Rena Lyons, Tina C. Mantel, Rama Novogrodsky, Isabel R. Rodriguez-Ortiz and Krisztina Zajdó. • Writing—original draft preparation: Sam Harding, • Writing—review and editing: Sam Harding, Maja Kelić, Thora Ulfsdottir, Sofia Baena, Julie Feilberg, Kristine M. Jensen de López, Inge S. Klatte, Rena Lyons, Tina C. Mantel, Rama Novogrodsky, Isabel R. Rodriguez-Ortiz and Krisztina Zajdó. • Funding acquisition: Kristine M. Jensen de López.

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Harding, S., Kelić, M., Ulfsdottir, T. et al. Rearing a child with a language disorder: parents experiences with speech and language therapy services in 10 countries. J Public Health (Berl.) (2024). https://doi.org/10.1007/s10389-024-02264-5

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Committee on the Evaluation of the Supplemental Security Income (SSI) Disability Program for Children with Speech Disorders and Language Disorders; Board on the Health of Select Populations; Board on Children, Youth, and Families; Institute of Medicine; Division of Behavioral and Social Sciences and Education; National Academies of Sciences, Engineering, and Medicine; Rosenbaum S, Simon P, editors. Speech and Language Disorders in Children: Implications for the Social Security Administration's Supplemental Security Income Program. Washington (DC): National Academies Press (US); 2016 Apr 6.

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Speech and Language Disorders in Children: Implications for the Social Security Administration's Supplemental Security Income Program.

Hardcopy Version at National Academies Press

Speech and language are central to the human experience, and their acquisition is a seemingly automatic process that continues from birth through adolescence. The identification of speech and language disorders often occurs when a child does not achieve expected or normative developmental milestones. Such disorders impair a child's functioning, and when they are severe enough to disrupt a child's ability to communicate, they have especially serious consequences. In their most severe forms, moreover, such conditions can be expected to persist over a lifetime. When combined with other risks, such as poverty, severe speech and language disorders can increase risk for a wide variety of adverse outcomes, including social isolation and mental health disorders, learning disabilities, behavior disorders, poor academic achievement, and chronic underemployment. These outcomes—some of which can be mitigated through early identification and intervention—point to the array of needs children with speech and language disorders are likely to have and to the kinds of ongoing support they may require.

The Supplemental Security Income (SSI) program for children provides financial assistance to children from low-income, resource-limited families who have been determined to have conditions that meet the disability standard required under law. When sufficiently severe, speech and language disorders can qualify children for SSI disability assistance. Over the past several decades, the number of children receiving SSI has risen overall, and the number receiving SSI on the basis of speech and language disorders also has risen. A 2010 report issued by the U.S. Government Accountability Office (GAO) found an increase between 2000 and 2010 in both applications and allowances (applicants determined to meet the disability criteria) for children with speech and language impairments. During this period, the number of applications for speech and language impairments increased from 21,615 to 49,664, while the number of children found to meet the disability criteria increased from 11,565 to 29,147.

Based on the GAO's findings, the Social Security Administration (SSA) determined that additional research was needed to understand the increases in the number of children applying for and receiving SSI benefits on the basis of speech and language disorders. It is in the context of the changes observed in the SSI program for children that the SSA requested this study.

STUDY CHARGE

In 2014, the SSA Office of Disability Policy requested that the Institute of Medicine of the National Academies of Sciences, Engineering, and Medicine convene a consensus committee to identify past and current trends in the prevalence and persistence of speech and language disorders among the general U.S. population under age 18 and compare those trends with trends among the SSI childhood disability population, and to provide an overview of the current status of the diagnosis and treatment of speech and language disorders and the levels of impairment due to these disorders in the U.S. population under age 18. (See Box S-1 for the committee's full statement of task.)

Statement of Task.

OVERALL CONCLUSIONS

The committee reviewed a range of sources to respond to its charge, including published research on the etiology, epidemiology, and treatment of childhood speech and language disorders; expert testimony; data from clinical studies; data from nationally representative surveys; and data from federal programs. Collectively, the findings and conclusions presented in this report represent the committee's responses to the objectives, goals, and activities specified in its statement of task. The findings are statements of the evidence; the conclusions are inferences, interpretations, or generalizations drawn from the evidence and supported by the committee's findings.

After reviewing the evidence, the committee arrived at seven overall conclusions. Each of these is described in detail in the sections that follow.

Impact of Severe Speech and Language Disorders

Severe speech and language disorders in children are associated with significant impairment in functioning. Children with severe speech and language disorders—those whose functioning is considered to be two or more standard deviations from the norm—may lack the ability to communicate effectively. The committee found that these disorders can have a lasting and profound impact on the children and families they affect. Specifically, the committee concluded that

1. Severe speech and language disorders in children are conditions that interfere with communication and learning and represent serious lifelong threats to social, emotional, educational, and employment outcomes.

The functional requirements for language and communication increase continually throughout childhood. For children with moderate to severe speech and language disorders, these requirements often outpace their development. Thus, even if a child with such a disorder is able to make at least some developmental progress through treatment, the gap between his or her abilities and functional expectations may nonetheless continue to widen.

Prevalence and Comorbidity

The committee was asked to identify past and current trends in the prevalence of speech and language disorders in the general population under age 18. As a first step to this end, the committee sought to arrive at a current estimate of the overall prevalence of speech and language disorders in children. In addition, the committee was asked to identify common comorbidities (or co-occurring conditions) of childhood speech and language disorders. To do so, the committee consulted numerous sources of data, including clinical data from small treatment studies, population-based data from large national surveys, and administrative data from large federal programs. From this review, the committee concluded that

2. Speech and language disorders affect between 3 and 16 percent of U.S. children. Approximately 40 percent of children with speech and language disorders in nationally representative studies have serious comorbidities such as intellectual disabilities, autism spectrum disorder, and other neurodevelopmental and behavioral disorders.

This range is based on the best evidence available: prevalence estimates of speech and language disorders from peer-reviewed studies of U.S. children (between 3.8 and 15.6 percent) and prevalence estimates of speech and language disorders from three national surveys (between 3.2 and 7.7 percent). However, the available data regarding the prevalence of childhood speech and language disorders within the general population are limited in several ways. Specifically, the sources of data considered by the committee vary markedly in how speech and language impairments are defined and identified, the degree to which the level of severity is documented, the reporting sources, and the characteristics of the populations within each dataset. For example, many of the sources of data include information reported by a parent or a caregiver but include no corroborating information from clinical assessment.

The few but varied data collection strategies used to estimate the prevalence of speech and language disorders in children leave room for both undercounts and overcounts. For example, conditions that commonly co-occur with speech and language disorders, such as autism spectrum disorder and attention deficit hyperactivity disorder, may initially be identified as speech and language disorders, thereby inflating the number of speech and language disorders reported. Conversely, speech and language disorders may be included in other reported categories, such as “development delays” or “multiple disabilities,” or reported as impairments secondary to primary conditions such as autism spectrum disorder or primary disorders of hearing, thereby effectively deflating the number of speech and language disorders reported.

Although the committee encountered challenges, it found sufficient evidence to estimate that 3 to 16 percent of the general population of children from birth through age 21 experience problems with speech or language. 1 For example, studies on childhood speech sound disorders show overall prevalence rates ranging from 3 to 16 percent. Research on childhood language disorders shows overall prevalence rates of 6 to 15 percent. And one population-based study of specific language impairment found a prevalence rate of 7.4 percent among children in kindergarten. In addition, data from the National Survey of Children with Special Health Care Needs and the National Survey of Children's Health show reported prevalence of speech and language disorders between 3 and 5 percent. And one recent national survey on voice, swallowing, speech, and language problems in children found that 7.7 percent had such problems according to parent or guardian reports. Finally, National Health Interview Survey data from 2000 to 2012 indicate that more than 40 percent of children with speech and language problems experienced comorbidities such as developmental delay (estimated at 32 percent), autism (estimated at 12 percent), and intellectual disability (estimated at 10 percent).

Within the population of all children with speech and language disorders, a small group will have disorders severe enough to meet the standard of disability for the SSI program. Within that latter population, even fewer children will both meet the SSI financial eligibility standard and actually enroll in the program (see Figure S-1 ).

The number of children receiving SSI for speech and language disorders is a small subpopulation among the general population of U.S. children. NOTES: FPL = federal poverty level; SSI = Supplemental Security Income. All data are from 2013. Scale = 1 symbol (more...)

Supplemental Security Income

Childhood poverty and the accompanying deprivations have significant adverse implications for children with disabilities. Research has established that childhood poverty can exacerbate disabilities and their effects and lead to deleterious outcomes across a range of indicators, including emotional, social, and mental development; academic achievement; and employment during adulthood. The converse is true as well: the consequences of poverty are likely to be especially serious for children with disabilities because of their heightened vulnerabilities, elevated needs for health care, and overall poor health.

The SSI program for children was established to address the needs of children with disabilities living in low-income households because they were determined to be “among the most disadvantaged of all Americans and are deserving of special assistance.” SSI recipients include children whose health conditions or disabilities are severe enough to meet the program's disability eligibility criteria and whose family income and assets are within limits specified by the SSA. The committee concluded that

3. Children of families with low incomes are more likely than the general population to have disabilities, including speech and language disorders. The Supplemental Security Income (SSI) program is designed to award benefits to the most severely impaired children from low-income, resource-limited families. Currently, 0.31 percent of U.S. children receive SSI benefits for speech and language disorders.

In December 2014, 213,688 children were receiving SSI benefits as the result of a primary speech or language impairment (16 percent of all children receiving SSI benefits). Figure S-1 shows that these children represent a small subpopulation among the general population of U.S. children. The majority of children who receive SSI benefits are from families with a household income less than 200 percent of the federal poverty level (FPL). The number of families with incomes less than 200 percent of the FPL changes over time. That is, as economic conditions deteriorate, more families join the ranks of those with incomes at or below a defined poverty level. This occurred most recently following the 2008-2009 recession in the United States. As a result, more children would have met the financial eligibility criteria for SSI benefits. This means that an increase in the number of children with speech and language disorders receiving SSI may not reflect an increase in these disorders, but instead may arise from an increased number of children with these disorders who meet the poverty threshold for SSI eligibility ( NASEM, 2015 ). However, there are no reliable estimates of the number of children living in poverty who also have speech and language disorders.

Assessment, Evaluation, and Standards of Care

The committee reviewed standards of care, including diagnostic evaluation and assessment, treatments and protocols, and educational interventions, for children with speech and language disorders. The committee reviewed the literature and invited speech, language, and special education experts to provide additional insights into current standards of care and practices for children with speech and language disorders, including evidence on the efficacy of treatments and interventions, when available.

In addition, the committee was asked to identify the kinds of care documented or reported to be received by children in the SSI disability program. The committee requested a review of a random sample of case files of children who receive SSI benefits for speech and language disorders. The results of this review helped demonstrate the kinds of evidence the SSA considers when making a disability determination for a child. Based on its review of professional standards of care and the documentation included in a random sample of case files, the committee concluded that

4. To determine the severity of speech and language disorders in children, the Social Security Administration employs the results of professionally administered assessments and also takes into account other clinical evidence that would be consistent with severe speech and language disorders.

To qualify for SSI benefits, children must meet a complex and detailed set of eligibility criteria that are income- and resource-related, work-related, and disability-related. The evidence required to document severity of disability is extensive and includes both medical evidence—such as formal testing to provide developmental and functional information, signs, symptoms, and laboratory findings—and parental and teacher reports. Under the SSA's standards, observations and information from a single source—such as a parent or caregiver—are an insufficient basis for a finding of disability. For example, the majority of the cases in the random sample included evidence of standardized testing (143 of 152 files), and virtually all of the case files included information from speech-language pathologists regarding the child's speech and language status (150 of 152 files). While these findings cannot be considered representative of the entire SSI child population with speech and language disorders, the review offered valuable information that is consistent with other sources of evidence considered by the committee.

Trends in the General U.S. Population Compared with Trends in the Supplemental Security Income Program

One of the committee's primary objectives was to consider past and current trends in the prevalence of speech and language disorders among the general U.S. population under age 18 and to compare those trends with trends observed among participants in the SSI childhood disability program. To this end, the committee analyzed clinical studies, nationally representative survey data, and administrative or service data from a range of sources. These data, however, are primarily serial cross-sections as opposed to longitudinal data. Thus, these data reflect changes in the prevalence of speech and language disorders observed within populations of respondents (in the case of survey data) or beneficiaries (in the case of SSI data) over successive years and do not follow individual children over time. Without longitudinal data, it is not possible to describe the natural course of these disorders. Moreover, because children observed in one year may not be the same as those observed in another, the composition of the populations reflected in the data changes from year to year. Not only may changes in population composition over time affect rates of observed occurrence; changes in programs that provide supports for children with severe disabilities also will affect the size and characteristics of the population of children who receive benefits based on a severe disability in any given year. Thus, over time, SSI eligibility standards and the eligibility determination process itself, along with broader economic factors such as the recession of 2008-2009, may influence the rate at which speech and language disorders are observed among any given population of children at any given point in time.

Despite the above limitations, the committee was able to draw conclusions from the evidence regarding the extent to which speech and language disorders are documented in specific populations of children over time.

Trends in the General U.S. Population

The committee used the best evidence available to assess trends in the prevalence of speech and language disorders in the general U.S. child population. Several sources that collect data on speech and language disorders in children suggest that over the past decade, the prevalence of these conditions has increased. Although there have been no studies describing why the prevalence of speech and language disorders has increased over time, available epidemiologic literature related to children with autism spectrum disorder and attention deficit hyperactivity disorder may provide insight. Factors identified as causes for these increases include increased awareness of developmental disorders, increased availability of early intervention and special education services, and changes in the definition of certain conditions (e.g., autism spectrum disorder). The two nationally representative surveys that include measures of speech and language disorders in children at multiple points in time are the National Survey of Children's Health and the National Survey of Children with Special Health Care Needs. The National Survey of Children's Health showed an increase in prevalence of speech and language disorders from 3.8 percent in 2007 to 4.8 percent in 2011, a 26 percent increase. The National Survey of Children with Special Health Care Needs showed an increase in prevalence from 3.2 percent in 2005-2006 to 5.0 percent in 2009-2010, an increase of 56 percent. Although not a direct comparison, the committee reviewed data on initial SSI allowances for speech and language disorders for two points in time to determine the percent increase in those initial allowances. 2 The number of initial allowances for speech and language disorders increased by nearly 40 percent between 2007 and 2011 (from 21,135 to 29,309). Therefore, the committee concluded that

5. The best available evidence shows an increase in the prevalence of speech and language disorders over the past decade in the U.S. child population. Trends in annual Supplemental Security Income initial allowances parallel this overall increase.

Causes, Treatment, and Persistence

The committee was asked to identify causes of speech and language disorders and to determine how often those causes are known. The evidence shows a variety of known etiologies (e.g., cleft palate, congenital brain tumors, and genetic disorders) and potential risk factors (e.g., toxic exposures, nutritional deficiencies, and injuries), as well as the common comorbidities noted earlier (e.g., autism spectrum disorder and attention deficit hyperactivity disorder). In some cases, the cause may not be known.

A range of strategies are used to treat mild, moderate, and severe speech and language disorders in children. In its review of the evidence, the committee found that with treatment, mild speech and language disorders may completely resolve or be limited to relatively minor impairments; moderate speech and language disorders may substantially diminish, with residual impairments in an associated domain, such as reading and literacy. In the most severe cases, however—even with treatment—core speech and language deficits will likely continue into adolescence and may be lifelong. Therefore, the committee concluded that

6. Children with mild to moderate speech and language disorders will benefit from a variety of treatments. For children with severe speech and language disorders, treatment improves function; with few exceptions, however, substantial functional limitations will persist.

An implication of this conclusion is that a severe disorder will persist over time, thereby necessitating ongoing educational, social, and health supports and, in the case of children from low-income families, continuing eligibility for financial assistance through the SSI program.

Trends Among Participants in the Supplemental Security Income Program

To identify trends among participants in the SSI program, the committee reviewed administrative data collected by the SSA on initial allowances and recipients 3 for primary speech and language impairments. Between 2004 and 2014, the total number of children receiving benefits for speech and language disorders increased from 90,281 to 315,523, a 249 percent increase. The committee reviewed older data to help explain this substantial growth in the total number of recipients. At the committee's request, the SSA provided supplemental data for review beginning in 1994, the year in which the primary impairment code for speech and language impairments (3153) was introduced. From this review, the committee concluded that

7. The total number of children receiving Supplemental Security Income for speech and language disorders more than tripled in the past decade. In addition to an increase in prevalence of these disorders in the general U.S. child population, this growth is explained primarily by two factors: the introduction of a new impairment code for speech and language disorders in 1994, and the continuing eligibility of children whose severe speech and language disorders persist throughout childhood.

Prior to 1994, there were zero initial allowances for the impairment code for speech and language disorders in children (3153). The current total number of recipients reflects both the accumulation over time of new individuals in this impairment category and the very low attrition from the program due to the persistence of severe speech and language disorders. Thus, the increase in the number of annual initial allowances leads to a much larger percent increase in the total number of recipients over time, because once qualified for SSI, few children with severe speech and language disorders subsequently become ineligible for the program.

Several additional factors contribute to the changes observed in the number of children receiving SSI benefits for speech and language disorders. For example, the total number of child SSI recipients fluctuates depending on the number of initial allowances, terminations, suspensions, and reentries from suspension. When the number of allowances exceeds the number of terminations and suspensions in 1 year, the total number of recipients increases for that year. Overall growth in the population of children would be expected to contribute some growth in the program as well. In addition to severity, a statutory condition of eligibility for SSI is either duration or death. Therefore, children with speech and language disorders who qualify for SSI will continue to have a severe speech and language disorder, and unless their eligibility changes for some other reason, they will not exit the program before they reach 18 years of age. Finally, allowances are affected by macroeconomic conditions. During a period of economic expansion, as family income increases and joblessness decreases, fewer children are likely to meet the SSA's financial eligibility criteria. By contrast, during periods of economic downturn—for example, during the recent recession—more children will meet the financial eligibility criteria of the program because of relatively higher unemployment.

The evidence presented in this report underscores the long-term and profound impact of severe speech and language disorders on children and their families. It also helps explain the degree to which children with such disorders can be expected to be a significant presence in a program such as SSI, whose purpose is to provide financial assistance to families of children with the severest disabilities. It is the committee's hope that this report will make a substantial contribution to understanding the nature of severe speech and language disorders in children and provide a strong foundation for future efforts in policy, practice, and research.

The committee's findings and conclusions characterize the current state of knowledge. Its findings also highlight the challenges that arise in undertaking a close examination of children's health status in the area of speech and language because of deficiencies in the evidence both across the general population and, in this case, the specific population of children enrolled in the SSI program. Despite its limitations, the evidence presented in this report offers valuable insight into the relationship between children with speech and language disorders in the general population and those participating in the SSI program. Furthermore, the evidence presented here can assist policy makers, health and education professionals, and SSI program administrators in understanding the extent to which the SSI program's basic design and administrative process operate together to connect the nation's most severely impaired and disadvantaged children with speech and language disorders to the benefits that program offers.

NASEM (National Academies of Sciences, Engineering, and Medicine). Mental disorders and disabilities among low-income children. Washington, DC: The National Academies Press; 2015. [ PubMed : 26632628 ]

While the primary population of focus for this study is children under age 18, the committee reviewed and has included here relevant Individuals with Disabilities Education Act (IDEA) data (which include children from birth to age 21).

Initial allowances are the total number of new cases within any given period of time of children found to be eligible for disability benefits based on both the financial and the disability criteria.

Recipients refer to the current number of children receiving SSI benefits.

Cite this Page Committee on the Evaluation of the Supplemental Security Income (SSI) Disability Program for Children with Speech Disorders and Language Disorders; Board on the Health of Select Populations; Board on Children, Youth, and Families; Institute of Medicine; Division of Behavioral and Social Sciences and Education; National Academies of Sciences, Engineering, and Medicine; Rosenbaum S, Simon P, editors. Speech and Language Disorders in Children: Implications for the Social Security Administration's Supplemental Security Income Program. Washington (DC): National Academies Press (US); 2016 Apr 6. Summary.
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Speech & sound disorders in children
Top 10 Causes of Child Speech Delays and Language Problems
Speech and Language Disorders
Advice for Helping Children with Speech and Language Disorders
What is a Speech Disorder?

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Speech-Language Disorders
Characteristics of Speech/Language Disorders
Unlock Your Child's Potential through Suffolk Speech Therapy
Speech/language disorders in children-مشاكل تاخر الكلام و االنطق لدى الأطفال-1-White Coat-Alkarmatv
Speech disorder
How do you overcome speech and language disorders?

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Child Speech and Language
Most children develop speech and language skills within a specific age range. A child who takes longer to learn a skill may have a problem. Learn more about what to expect from your child from birth to 5 years old. Speech-language pathologists, or SLPs, can help your child. To find an SLP near you, visit ProFind.
Language and Speech Disorders in Children
Having a language or speech delay or disorder can qualify a child for early intervention (for children up to 3 years of age) and special education services (for children aged 3 years and older). Schools can do their own testing for language or speech disorders to see if a child needs intervention. An evaluation by a healthcare professional is ...
Language Disorders in Children
A child's language disorder is often linked to a health problem or disability such as: A brain disorder such as autism. A brain injury or a brain tumor. Birth defects such as Down syndrome, fragile X syndrome, or cerebral palsy. Problems in pregnancy or birth, such as poor nutrition, fetal alcohol syndrome, early (premature) birth, or low ...
Common Speech and Language Disorders
Fluency: Your child may have problems with how their words and sentences flow. Stuttering is a fluency disorder. That's when your child repeats words, parts of words, or uses odd pauses. It's ...
Childhood Speech and Language Disorders in the General U.S. Population
Speech and language disorders in children include a variety of conditions that disrupt children's ability to communicate. Severe speech and language disorders are particularly serious, preventing or impeding children's participation in family and community, school achievement, and eventual employment. This chapter begins by providing an overview of speech and language development and disorders ...
Speech and Language Disorders
Speech and Language Disorders. Speech is how we say sounds and words. People with speech problems may: not say sounds clearly. have a hoarse or raspy voice. repeat sounds or pause when speaking, called stuttering. Language is the words we use to share ideas and get what we want. A person with a language disorder may have problems:
Speech & Language Disorders
Speech-sound disorder is also called articulation disorder. A child with a speech sound disorder may: Substitute one sound for another. Leave sounds out of words. Add sounds to words. Change a sound in a word. A mixed receptive-expressive language disorder is when a child has difficulty in both speaking and understanding others.
Speech and Language Developmental Milestones
Developmental language disorder (DLD) is a language disorder that delays the mastery of language skills. Some children with DLD may not begin to talk until their third or fourth year. Children who have trouble producing speech sounds correctly or who hesitate or stutter when talking may have a speech disorder.
Evaluation and treatment of speech and language disorders in children
Developmental language disorder is the most common developmental disability of childhood, occurring in 5 to 10 percent of children . Children learn language in early childhood; later they use language to learn. Children with language disorders are at increased risk for difficulty with reading and written language when they enter school . These ...
Developmental Language Disorder
Developmental language disorder (DLD) is a communication disorder that interferes with learning, understanding, and using language. These language difficulties are not explained by other conditions, such as hearing loss or autism, or by extenuating circumstances, such as lack of exposure to language. DLD can affect a child's speaking, listening, reading, and writing.
Speech and Language Disorders
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: Genetic abnormalities. Emotional stress. Any trauma to brain or infection.
Speech & Language Disorders in Children
A child with a speech sound disorder is unable to say all of the speech sounds in words. This can make the child's speech hard to understand. People may not understand the child in everyday situations. For most children, the cause of the speech sound disorder is unknown. Other speech sound disorders can be linked to things such as a cleft ...
Speech and Language Disorders in Children
Speech and language are central to the human experience; they are the vital means by which people convey and receive knowledge, thoughts, feelings, and other internal experiences. Acquisition of communication skills begins early in childhood and is foundational to the ability to gain access to culturally transmitted knowledge, organize and share thoughts and feelings, and participate in social ...
Language Disorder in Children: A Quick Guide
Kids with language disorder often use short or simple sentences, mix up the order of words, or say "um" a lot. These challenges can cause problems at home, at school and with other children. Language disorder is different from speech sound disorder. In speech sound disorder, the child has problems making sounds. In language disorder, the ...
Introduction
Speech and language are central to the human experience; they are the vital means by which people convey and receive knowledge, thoughts, feelings, and other internal experiences. Acquisition of communication skills begins early in childhood and is foundational to the ability to gain access to culturally transmitted knowledge, to organize and share thoughts and feelings, and to participate in ...
Speech disorders: Types, symptoms, causes, and treatment
Types of speech disorder include stuttering, apraxia, and dysarthria. There are many possible causes of speech disorders, including muscles weakness, brain injuries, degenerative diseases, autism ...
Speech Therapy
What is Pediatric Speech Language Pathology? Some children are born with a disorder that affects normal speech, such as a cleft palate or cerebral palsy (CP). Other children might have disorders that affect the brain, nerves or muscles, which can cause problems with how the brain and body control speech or swallowing actions.
Rearing a child with a language disorder: parents ...
Aim Collaboration between speech and language therapists and parents to help children with language disorders has always been important. The majority of published work is from the perspective of the therapist and what they think and feel parents need to help their children. However, less is known about (1) the processes parents try to access and receive services; (2) how they perceive the ...
Autism Spectrum Disorder
The most severely affected children never learn to speak. Those who learn may do so much later than normal and use words in an unusual way. They often repeat words spoken to them (echolalia), use memorized scripted speech in place of more spontaneous language, or reverse the normal use of pronouns, particularly using you instead of I or me when referring to themselves.
(PDF) LANGUAGE AND SPEECH DISORDERS IN CHILDREN
Childhood speech disorders are one of the most frequent types of communication problem that Speech and. Language Therapists (SLTs) are li kely to enco unter ( Enderby & P hilipp, 1986) and it is ...
Spoken Language Disorders
Incidence of spoken language disorders refers to the number of new cases identified in a specified time period. No reliable data on the incidence of spoken language disorders in children were located. Prevalence of spoken language disorders refers to the number of people who are living with a spoken language disorder in a given time period. The variability in prevalence estimates below is ...
Beyond Sounds: Decoding Speech Errors and Phonological Awareness in
Purpose:The purpose of this clinical focus article is to describe the phonological awareness (PA) skills of children with speech sound disorders ... Implementing speech perception and phonological awareness intervention for children with speech sound disorders. Language, Speech, and Hearing Services in Schools, 53(3), 646-658. https://doi.org ...
Acoustic Analyses of Tone Productions in Sequencing Contexts Among
Method: Six children with CAS, six children with non-CAS speech sound disorder plus language disorder (S&LD), 22 children with speech sound disorder only (SSD), and 63 children with typical speech-language development (TD) performed the tone sequencing task (TST).
Speech-Language Pathology Graduate Program Rises in Rankings
The speech-language pathology graduate program in the School of Communication Science and Disorders ranked No. 14 among all public and private institutions and No. 10 among publics according to U.S. News & World Report. "The school's position as the top-ranked speech-language pathology program in Florida, and its rank of No. 14 nationwide, are well deserved,"…
Summary
Speech and language are central to the human experience, and their acquisition is a seemingly automatic process that continues from birth through adolescence. The identification of speech and language disorders often occurs when a child does not achieve expected or normative developmental milestones. Such disorders impair a child's functioning, and when they are severe enough to disrupt a ...
Aphasia and Stroke
Aphasia is a language disorder that affects your ability to communicate. It's most often caused by strokes in the left side of the brain that control speech and language. People with aphasia may struggle with communicating in daily activities at home, socially or at work.
Autism diagnostic criteria: DSM-5
The American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by health care professionals in the United States and much of the world as the authoritative guide to the diagnosis of mental disorders. In 2013, the APA released the fifth edition of DSM (DSM-5). It stated that an autism diagnosis requires persistent deficits in social ...
Pedagogical Approaches to Cultural and Linguistic Diversity in
Kentucky speech-language pathologists' confidence and education in providing services to Spanish-English bilingual children in the public schools ... pathologists' preparation, practices, and perspectives on serving culturally and linguistically diverse children. Communication Disorders Quarterly, 33(3), 169-180.
Early Identification of Speech, Language, Swallowing, and Hearing Disorders
Having your child play with other children. Speech Sound Disorders. Speech is how we say sounds and words. It is normal for young children to say some sounds the wrong way. Some sounds do not develop until a child is 4, 5, or 6 years old. Signs of a speech sound disorder in young children include: