If your child is two years old and up, and cannot be understood more than half the time, you may want to consider if she has possible speech problems. Here, we ask speech therapists for the telltale signs.
How do I tell if my child has a speech or language problem?
“When his speech is very unclear, words are incorrectly pronounced and he’s babbling a lot,” says speech therapist Tee Suat Chin of Little Chatterbox speech and language therapy centre. “For example, he leaves out or substitutes the sounds – ‘fish’ is ‘pish’, ‘ball’ becomes ‘all’ and ‘cup’ is ‘up’.”
If your child is still saying “pish” when he’s already 3½ years old, this is considered a delay. If he still says “boo” instead of “blue”, this is a common error in children until he is five. The “cup”/“up” error should be gone by around 2½ years, as this is not a “normal” error, whereas “fish”/“pish” is commonly heard.
(Also read: This could be why your toddler is not talking yet)
“Likewise, ‘ball’/‘all’ is not a common error. Both ‘b’ and ‘k’ are early developing sounds. Most children make ‘b’, ‘p’, ‘m’ and ‘k’ in their babbling stage. You’ll notice that words such as ‘ball’, ‘car’, ‘mama’ and ‘papa’ are some first words that a child can say,” explains Suat Chin.
A child with language disorders is still using one-word sentences and mostly gestures, even at three. He is also not able to answer when asked questions, and parrots back instead. “For instance, you ask, ‘How are you?’ and he answers back, ‘How are you?’” Suat Chin adds.
As a guideline, there is cause for concern if a child over two still “cannot use oral language to communicate more than his immediate needs, and is not understood more than 50 per cent of the time,” adds Kristl Alphonso, a speech therapist at Singapore General Hospital.
The most common causes include hearing loss, slow development or cognitive impairments (intellectual or mental impairments – for example, low IQ),” says Kristl.
Other causes may include psychosocial deprivation (the child does not spend enough time talking with adults), developmental disorders (for example, autism and Attention Deficit Hyperactivity Disorder) or elective mutism (the child just does not want to talk).
(Also read: 9 ways to get your toddler talking)
Speech problem #1
A common issue is general speech and language delay, where “language is developing in the correct sequence but at a slower rate,” says Kristl.
“For example, a child would normally say his first word around the age of 12 months. And by two years old, he should be putting words together. For a child who is delayed, he may only say his first word at 18 months and be able to put two words together at 30 months.”
Speech problem #2
Then there is phonological or articulation disorder, which is the “incorrect production of specific sounds that affects the intelligibility of the child’s speech,” she adds.
“A child may be substituting all his ‘d’ sounds with ‘g’ sounds. So, if he wants to say, “Mummy, look at the doggy at the door”, it would sound like “look at the goggy at the goor”.
If you just listened to that sentence without seeing what he was looking at, you wouldn’t know what he was talking about.”
(Also read: 3-year-old not talking: Should you worry?)
Speech problem #3
Stuttering is another common problem. “There are disruptions in the rhythm of the child’s speech, resulting in repetitions, dragging out or getting stuck on sounds, syllables or words,” Kristl elaborates.
Speech problem #4
Finally, there is Specific Language Impairment (SLI) or the difficulty in understanding and using language in the absence of any other difficulties (for instance, low IQ). “Children with SLI may have poor vocabulary and grammar skills across languages, and may have difficulty meeting academic demands,” says Kristl. “They may score within normal range in IQ tests but have difficulty grasping the rules of language, like grammar and narrative skills.”
SGH doesn’t have any statistics of children with speech problems in Singapore but, in general, speech and language delay occurs in up to 10 per cent of kids.