Understanding Toddler Speech Problems

If you’re like most parents, you are probably always checking to see if your growing child is meeting the milestones set forth by the experts. And when they don’t seem to be, you get worried. When it comes to toddler speech problems, the situation can be a little frustrating, to say the least. There are many different things that can cause speech delays. By having an idea of what some of those are, you will be better-equipped to address the problem.

What are speech problems?

“It is important, first of all, to distinguish between speech and language,” says Erin Harrison, a speech and language pathologist. “Speech problems are usually related to coordination and/or strength of the muscles that serve the lips, tongue, jaw, soft palate and cheeks.”

Harrison explains that speech refers to the movement of the articulators (tongue, teeth, etc.). Language, by contrast, includes vocabulary and grammar, and those problems have their root in the brain itself. She reports that the most common referrals that she receives include speech and language delay, poor articulation, stuttering, and regression of speech.

What causes them?

Sandra Coulson, president of the International Association of Orofacial Myology (IAOM), specializes in working with the muscles of the face and tongue. These muscles facilitate proper movement of the facial muscles to create specific speech sounds.

According to IAOM, an orofacial myofunctional disorder is believed to be prevalent in 81% of children who show speech or articulation problems. The disorder involves incorrect habits when using the tongue, jaws, lips and face. There are several things that can cause such disorders, including developmental abnormalities, improper oral habits (thumb sucking, etc.), and enlarged tonsils or allergies.

“I find quite often that the length of the lingual frenum, the attachment under the tongue, is extremely short or tight, which limits a child’s ability to elevate the tongue for certain sounds,” explains Coulson. “This is often overlooked by the pediatrician, dentist or speech pathologist.”

There are many reasons for speech delays, and treatment methods vary, depending on what the problem is. Some of the more common causes are:

Hearing problems. Even if your child passed a newborn screening, it’s important to test again to rule out a hearing impairment.

Stuttering. According to the Stuttering Foundation of America, around 60 percent of those who stutter have a family member who does, as well, suggesting a genetic link. They also report that around 20 percent of children go through a stuttering period.

Siblings. “Sometimes, if the child has an older sibling who speaks for him, he has no need to produce articulate sounds,” says Coulson. Encourage your child to speak for himself instead.

Tonsils. Having large tonsils can cause a delay in speech because the tongue is pushed forward, making it difficult to make sounds.

Allergies. Frequent allergy problems can play a role in speech delay. “If a child is often congested, hearing can be affected, the mouth rests open, and the tongue rests forward and can become quite flaccid,” says Coulson.

Other problems. There are many speech problems that can be caused by cleft palate, mental retardation, injury or environmental impacts, such as lead poisoning.

Speech Milestones

According to the American Speech-Language-Hearing Association, it’s important to understand the common guidelines considered to be speech milestones in order to determine if a child is having a speech delay. These milestones suggest that, at the following ages, a child should be able to:

7 months – 1 year

Turn and look in the direction of a sound

Listen when spoken to

Recognize words for common items like “cup” and “juice”

Babble with long and short groups of sounds

Imitate different speech sounds

Have one or two words, although they may not be clear

1 – 2 years

Pont to a few body parts when asked

Follow simple commands and understand simple questions

Point to pictures in a book when named

Say more words every month

Use some one-to-two-word questions (e.g., “go bye-bye?”)

Put two words together (e.g., “no juice)

Use many different consonants and sounds of the beginnings of words

2 – 3 years

Understand differences in meaning (go/stop, up/down, etc.)

Follow two requests (get the book and put it on the table)

Have a word for almost everything

Use two-to-three-word “sentences” to ask for things and talk about things

Often name objects

3 – 4 years

Hear you when you call from another room

Hear television or the radio at the same loudness level as other family members

Understand simple questions (who, what, where, etc.)

Talk about activities at school or a friend’s house

Usually talk without repeating syllables or words

People outside the family can understand the child’s speech

What to do

“Children with marked expressive speech/language impairments commonly develop behavior problems in preschool or other settings, including hitting and biting,” says Harrison. “They resort to physical means to control the environment.”

If your child is having speech problems, those problems should be addressed sooner rather than later. Left unaddressed, they can lead to a child not feeling confident, which can hamper emotional growth. If you have a toddler whose speech development isn’t progressing, seek advice from your pediatrician.

“If the child’s physician doesn’t seem receptive to the parents’ concerns, most speech and language pathologists offer free screenings,” says Harrison. “I always tell parents to trust their instincts.”

Jacqueline Bodnar is a freelance writer living in Las Vegas with her husband and daughter.