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Introduction to Speech Problems

Kathryn Patricelli, MA

serious young girlSpeech problems are known as Communication Disorders. Speech problems are often caused by problems with the body's nervous system. The problems between the brain and the nervous system affect the use of language, speech or communication.

  • Language is the words people speak, the signs they make, the words they write or pictures they use to share their thoughts and feelings with each other. These forms each have rules that allow people to share information in a way that makes sense to others that know that language. Language includes:
    • What words mean (for example, friend is someone you get along with and are close to, and enemy is the opposite)
    • How to make new words using different endings and beginnings (for example - help, helpful, unhelpful)
    • How to put words together in the right order (for example, "Alex played a new game yesterday" not "Alex play game new yesterday)
  • Speech is how a person makes the sounds that form words said out loud. This involves:
    • Learning to make the sounds of each letter. For example, children have to learn how to make the "r" sound (often a tricky one) so that they can say "rock" instead of "wock").
    • How to use your vocal cords and breath to make sounds
    • the correct rhythm of speech so that you don't pause or stutter in between or while saying words.
  • Communication is the use of language and speech to share thoughts, ideas or feelings with someone else. Examples include:
    • someone speaking English or Spanish or using sign language to ask someone for directions
    • writing a letter to a family member or friend to discuss plans for something they are doing together
    • posting on the Internet to talk to friends about a hobby or interest that you all share.

Disorders in this category include:

  • Language Disorder - involves problems with understanding or with putting words together to make sentences that share thoughts.
  • Speech Sound Disorder - involves trouble making the sounds needed to speak to others.
  • Childhood-Onset Fluency Disorder (better known as Stuttering) - involves problems in the timing of words that are said.
  • Social (Pragmatic) Communication Disorder - involves problems communicating with others. This might include not knowing how to greet others or talk to them, not taking turns when talking to someone, or not asking questions to understand what someone has said.
  • Unspecified Communication Disorders - the person has speech issues that cause them stress or that cause issues in school, work or relationships with others. But, their problems don't completely match any of the four speech and language disorders.

The following checklist, adapted from the National Institute on Deafness and Other Communication Disorders, describes typical hearing and communication skills from birth through the preschool years:

Birth to 3 Months

  • Reacts to loud sounds
  • Calms down or smiles when spoken to
  • Recognizes your voice and calms down if crying
  • When feeding, starts or stops sucking in response to sound
  • Coos and makes pleasure sounds
  • Has a special way of crying for different needs
  • Smiles when he or she sees you

4 to 6 Months

  • Follows sounds with his or her eyes
  • Responds to changes in the tone of your voice
  • Notices toys that make sounds
  • Pays attention to music
  • Babbles in a speech-like way and uses many different sounds, including sounds that begin with p, b, and m
  • Laughs
  • Babbles when excited or unhappy
  • Makes gurgling sounds when alone or playing with you

7 Months to 1 Year

  • Enjoys playing peek-a-boo and pat-a-cake
  • Turns and looks in the direction of sounds
  • Listens when spoken to
  • Understands words for common items such as “cup,” “shoe,” or “juice”
  • Responds to requests (“Come here”)
  • Babbles using long and short groups of sounds (“tata, upup, bibibi”)
  • Babbles to get and keep attention
  • Communicates using gestures such as waving or holding up arms
  • Imitates different speech sounds
  • Has one or two words (“Hi,” “dog,” “Dada,” or “Mama”) by first birthday

1 to 2 Years

  • Knows a few parts of the body and can point to them when asked
  • Follows simple commands (“Roll the ball”) and understands simple questions (“Where’s your shoe?”)
  • Enjoys simple stories, songs, and rhymes
  • Points to pictures, when named, in books
  • Acquires new words on a regular basis
  • Uses some one- or two-word questions (“Where kitty?” or “Go bye-bye?”)
  • Puts two words together (“More cookie”)
  • Uses many different consonant sounds at the beginning of words

2 to 3 Years

  • Has a word for almost everything
  • Uses two- or three-word phrases to talk about and ask for things
  • Uses k, g, f, t, d, and n sounds
  • Speaks in a way that is understood by family members and friends
  • Names objects to ask for them or to direct attention to them

3 to 4 Years

  • Hears you when you call from another room
  • Hears the television or radio at the same sound level as other family members
  • Answers simple “Who?” “What?” “Where?” and “Why?” questions
  • Talks about activities at daycare, preschool, or friends’ homes
  • Uses sentences with four or more words
  • Speaks easily without having to repeat syllables or words

4 to 5 Years

  • Pays attention to a short story and answers simple questions about it
  • Hears and understands most of what is said at home and in school
  • Uses sentences that give many details
  • Tells stories that stay on topic
  • Communicates easily with other children and adults
  • Says most sounds correctly except for a few (l, s, r, v, z, ch, sh, and th)
  • Uses rhyming words
  • Names some letters and numbers
  • Uses adult grammar