Speech disorders - children
Definition
Speech disorders refer to several conditions in which a person has problems creating or forming the speech sounds needed to communicate with others.
Three common speech disorders are:
Articulation disorders
Disfluency
Voice disorders
See also: Language disorder - children
Alternative Names
Articulation deficiency; Voice disorders; Vocal disorders; Disfluency; Communication disorder - speech disorder
Causes, incidence, and risk factors
Speech is one of the main ways in which we communicate with those around us. It develops naturally, along with other signs of normal growth and development.
Disfluencies are disorders in which a person repeats a sound, word, or phrase. Stuttering may be the most serious disfluency.
Articulation disorders may have no clear cause. They may also occur in other family members. Other causes include:
Problems or changes in the structure or shape of the muscles and bones used to make speech sounds. These changes may include
cleft palate and tooth problems.
Damage to parts of the brain or the nerves (such as from
cerebral palsy) that control how the muscles work together to create speech.
See also: Phonological disorders
Voice disorders are caused by problems when air passes from the lungs, through the vocal cords, and then through the throat, nose, mouth, and lips. A voice disorder may be due to:
Acid from the stomach moving upward
Cleft palate or other problems with the palate
Laryngeal webs or clefts (a birth defect in whcih a thin layer of tissue is between the vocal cords)
Noncancerous growths (polyps, nodules, cysts, granulomas, papillomas, or ulcers) on the vocal cords
Overuse of the vocal cords from screaming, constantly clearing the throat, or singing
References
Friedman O, Wang TD, Milczuk HA. Cleft lip and palate. In: Flint PW, Haughey BH, Lund VJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010: chap 188.
Choi SS, Zalzal GH. Voice disorders. In: Flint PW, Haughey BH, Lund VJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010: chap 203.
Sharp HM, Hillenbrand K. Speech and language development and disorders in children. Pediatr Clin North Am. 2008;55:1159-1173.
Simms MD. Language disorders in children: classification and clinical syndromes. Pediatr Clin North Am. 2007;54:437-467.
Specific language and learning disabilities. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 32.
Review Date: 9/28/2010
Reviewed By: Sumana Jothi, MD, Clinical Instructor, UCSF Otolaryngology, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Articulation deficiency; Voice disorders; Vocal disorders; Disfluency; Communication disorder - speech disorder
Symptoms
Disfluency (stuttering is the most common type of disfluency):
- Repetition of sounds, words, or parts of words or phrases after age 4 (I want...I want my doll. I...I see you.)
- Putting in (interjecting) extra sounds or words (We went to the...uh...store.)
- Making words longer (I am Boooobbby Jones.)
- Pausing during a sentence or words, often with the lips together
- Tension in the voice or sounds
- Frustration with attempts to communicate
- Head jerking while talking
- Eye blinking while talking
- Embarrassment with speech
Articulation disorder:
- Sounds may be distorted (changed)
- Sounds (most often consonants) will be substituted, left off, added, or changed
- Errors may make it hard for people to understand the person (only family members may be able to understand a child)
See also: Phonological disorders
Voice disorders:
- Hoarseness or raspiness to the voice
- Voice may break in or out
- Pitch of the voice may change suddenly
- Voice may be too loud or too soft
- May run out of air during a sentence
- Speech may sound odd because too much air is escaping through the hose (hypernasality) or too little air is coming out through the nose (hyponasality)
Signs and tests
The following tests can help diagnose speech disorders:
- Denver Articulation Screening Examination
- Early Language Milestone Scale
- Denver II
- Peabody Picture Test Revised
A hearing test may also be done.
References
Friedman O, Wang TD, Milczuk HA. Cleft lip and palate. In: Flint PW, Haughey BH, Lund VJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010: chap 188.
Choi SS, Zalzal GH. Voice disorders. In: Flint PW, Haughey BH, Lund VJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010: chap 203.
Sharp HM, Hillenbrand K. Speech and language development and disorders in children. Pediatr Clin North Am. 2008;55:1159-1173.
Simms MD. Language disorders in children: classification and clinical syndromes. Pediatr Clin North Am. 2007;54:437-467.
Specific language and learning disabilities. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 32.
Review Date: 9/28/2010
Reviewed By: Sumana Jothi, MD, Clinical Instructor, UCSF Otolaryngology, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Articulation deficiency; Voice disorders; Vocal disorders; Disfluency; Communication disorder - speech disorder
Treatment
Milder forms of speech disorders may disappear on their own.
Speech therapy may help with more severe symptoms or speech problems that do not improve.
In therapy, the child will learn how to create certain sounds.
Expectations (prognosis)
The prognosis depends on the cause of the disorder. Usually, speech can be improved with speech therapy. Prognosis improves with early intervention.
Complications
Speech disorders may lead to psychosocial problems associated with ineffective communication.
Calling your health care provider
Call your health care provider if:
Your child's speech is not developing according to normal milestones
You think your child is in a high-risk group
Your child is showing signs of a speech disorder
References
Friedman O, Wang TD, Milczuk HA. Cleft lip and palate. In: Flint PW, Haughey BH, Lund VJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010: chap 188.
Choi SS, Zalzal GH. Voice disorders. In: Flint PW, Haughey BH, Lund VJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010: chap 203.
Sharp HM, Hillenbrand K. Speech and language development and disorders in children. Pediatr Clin North Am. 2008;55:1159-1173.
Simms MD. Language disorders in children: classification and clinical syndromes. Pediatr Clin North Am. 2007;54:437-467.
Specific language and learning disabilities. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 32.
Review Date: 9/28/2010
Reviewed By: Sumana Jothi, MD, Clinical Instructor, UCSF Otolaryngology, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Articulation deficiency; Voice disorders; Vocal disorders; Disfluency; Communication disorder - speech disorder
Prevention
Mental retardation and hearing loss make children more likely to develop speech disorders. At-risk infants should be referred to an audiologist for an audiology exam. Audiological and speech therapy can then be started, if necessary.
As young children begin to speak, some disfluency is common. Children lack a large vocabulary and have difficulty expressing themselves. This results in broken speech. If you place excessive attention on the disfluency, a stuttering pattern may develop. The best way to prevent stuttering, therefore, is to avoid paying too much attention to the disfluency.
References
Friedman O, Wang TD, Milczuk HA. Cleft lip and palate. In: Flint PW, Haughey BH, Lund VJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010: chap 188.
Choi SS, Zalzal GH. Voice disorders. In: Flint PW, Haughey BH, Lund VJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010: chap 203.
Sharp HM, Hillenbrand K. Speech and language development and disorders in children. Pediatr Clin North Am. 2008;55:1159-1173.
Simms MD. Language disorders in children: classification and clinical syndromes. Pediatr Clin North Am. 2007;54:437-467.
Specific language and learning disabilities. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 32.
Review Date: 9/28/2010
Reviewed By: Sumana Jothi, MD, Clinical Instructor, UCSF Otolaryngology, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 9/28/2010
Reviewed By: Sumana Jothi, MD, Clinical Instructor, UCSF Otolaryngology, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.