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Speech and Language (Pathology) for Kids


Speech Difficulties

♣︎   Articulation/ Pronunciation
♣︎   Stuttering (Stammering)
♣︎   Dyspraxia (Apraxia of Speech)

Articulation/ Pronunciation
Articulation difficulties relate to a child’s ability to correctly enunciate specific sounds in words when talking.Literature shows that children who have articulation difficulties or fail to acquire their sounds at the expected ages are more likely to develop difficulties with reading/ spelling at school unless they receive intervention by a speech therapist.

Your child would benefit from therapy if:
                   
- Familiar people to the child find it difficult to understand the child at age 2 years.

- Strangers to the child find it difficult to understand the child at age 3 years or beyond.

- The child leaves off or substitutes sounds (from the beginning, middle or endings).

- The child has difficulty saying sounds expected for their age (see below)

- The child has a ‘lisp’ when talking (i.e. substituting ‘s’, ‘z’ or ‘ch’, ‘dge’ with ‘th’)

Intelligibility Expectations (How well you should be able to understand a child)

                               
♣︎ 18 months - 25%
♣︎ 24 months - 50% to 75%
♣︎ 36 months - 75% to 100%

This basically means that at 3 years, you should be able to understand at least 7.5 to 10 words out of every 10 words you child says. Reference Lynch, Brookshire & Fox, 1980
 
Consonant Sounds Expectations (when a child should have mastered the sound)
         
♣︎ 3 years - h, y, w, ng, m, n, p, k, t, b, g, d, f
♣︎ 4 years - l, sh, ch, j, s, z
♣︎ 5 years - r, v
♣︎ 7 to 8 years - th

Reference: Bowen, C. (1998). Developmental phonological disorders. A practical guide for families and teachers. Melbourne: ACER Press 
              
Stuttering (Stammering)
Stuttering is considered a disorder affecting the fluency of speech. It begins in childhood, and in some cases, lasts throughout life.

As children experience a rapid growth in their language skills (typically between the ages of 2 ½ yrs and 3 ½ yrs), some children can develop what is referred to as ‘normal dysfluency’. This however should spontaneously resolve.
Whilst some children have also been known to spontaneously stop stuttering, most do require therapy, which if not given early (below age 6 years) can result in the stutter becoming established, severe and subsequently difficult to treat.
 
Signs of Stuttering
Stuttered speech often includes repetitions of sounds, parts of words or parts of sentences. A child who stutters may also prolong the initial sounds and/or experience a complete disruption to their flow of speech referred to as ‘blocking’. A block occurs when the child is about to say a word and finds themselves with their mouth open, but no sound actually coming out for several seconds. Some people who stutter may also experience tenseness during speaking situations and may produce unwanted behaviours when talking such as face grimaces, twitching, etc.

Stuttering is characterized by one or more of the following behaviours:

♣︎ Repeating sounds, words and/or phrases
(e.g. s s s- sun; sun sun sun- sun; I will I will I will- I will go)
♣︎ Prolongation (e.g. ssssssun- sun)
♣︎ Blocking
♣︎ Superfluous movements whilst talking
(e.g. twitching, blinking, nodding, facial grimaces or irregular breathing)    
 
Ideally, children should receive therapy as early as possible as best outcomes are realized when children who stutter receive intervention before their stutter has progressed on significantly.

Dyspraxia
This is a relatively unknown (not commonly diagnosed) disorder impacting a number of children. Dyspraxia is a motor planning disorder present from birth and very much a ‘hidden handicap’ due to the fact that a child afflicted with the disorder appears the same as any other child until a specific skills (eating, speaking, playing, etc.) that the disability is noticeable.

There are 3 types of Developmental Dyspraxia:

a. Oral
b. Verbal
c. Motor
 
Oral Dyspraxia
Oral Dyspraxia is a difficulty with planning and execution of non-speech movements e.g. chewing particular textured foods, licking, blowing, sucking, etc. All these movements require motor coordination and planning and can also indirectly affect speech and/or swallowing skills.

Verbal Dyspraxia
Verbal Dyspraxia or Developmental Verbal Dyspraxia is a speech related disorder affecting the programming, sequencing and initiating of movements required to make speech sounds. A skill such as speaking, unbeknown to many, requires a combination of sophisticated motor (muscle) movements, a breakdown of which may result in one or more of the following characteristics:

- Delayed expressive (talking) skills
- Simplications of words (e.g. ‘tapu’ for ‘kikapu’)
- Inconsistent speech errors (e.g. a child may say ‘tapu’ today and ‘apu’ another time)
- Highly unintelligible (not well understood) speech

Motor Dyspraxia
Motor Dyspraxia is a difficulty in planning, sequencing and then executing the right movement to perform age appropriate motor skills in a smooth and coordinated manner at will or when asked to. A child who has motor dyspraxia may have
difficulty with:

- Coordinated movements (e.g. playing sport, running)
- Handwriting
- Timing and rhythm
- Age appropriate skills
(e.g. a 2 year old may find it difficult to master walking up steps unassisted, etc.)
                           
- Motor problem solving (e.g. knowing to put on shoes after putting on pants, etc.)
- Consistent performance
- Responding quickly to motor commands
(e.g. close your eyes, touch your elbow, stand on one foot, etc.)

Reference: www.dyspraxia.com.au

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