Nowadays speech and hearing issues are very common among children. So it really needs to be discussed in detail.
SPEECH PROBLEMS
Speech problems can be of any type. It can be a speech delay or problems with the word output either qualitative or quantitative.
Normal development of Speech:
By 6 months of age- monosyllables like ma..,da…
By 9 months of age- Babbling, Bisyllables like mama,dada…
By 1 year- small words like amma, acha, papa…
By 15 months- Jargon’s speech
By 2 years of age- 20 to 30 words, small sentence with 2 to 3 words
By 3 years of age- exponential increase in the vocabulary , increases to 300 to 400 words, a complex sentence with at least 3 words
RED FLAGS!
- Baby is not responding to sound by 6 months
- No babbling by 10 months
- No word output by 15 months
If any of these are noticed, need to consult a doctor
- Speech delay- causes
- Hearing defects
Nowadays hearing screening is recommended for all newborn babies. This is done by OAE after first 48 hours of life. If either ear fails, it needs to be repeated after 2 weeks. If again failed, then BERA needs to be performed. OAE is done to assess the functioning of outer hair cells of cochlea. 90% hearing loss is due to problems between external meatus and outer hair cells of cochlea. That’s why we do OAE as the screening test. Rest 10% can be due to the defect in the transmission of signals from cochlea to brain. This is detected only with BERA. These tests should be completed by maximum of 6 months of age. Otherwise the speech will be delayed. The correction of hearing loss is done with either hearing aid or cochlear implant based on the type of defect.
- Mental retardation
- Family history of speech delay- Familial
- Multilingualism – Exposure to multiple languages
- Learning disability
- Autism
- Lack of stimulation-
Nowadays this is the commonest cause! Parents don’t have enough time to spend with their children. In these cases they have nothing much to listen, then speech also will be delayed. Please try to avoid overuse of mobile, TV and laptops.
SPEECH DEFECTS: CAUSES
Here children will have a defective speech where the letters are not clearly spelt or told. Most of the times, they will have issues with some specific letters.
- Tongue tie- Here they will have restrictive movement of the tip of the tongue and they won’t be able to spell some sounds properly. It can easily repaired surgically.
- Adenoiditis, Tonsillar enlargement, Nasal polyposis – In these cases they will have a nasal tone of voice.
- Cleft lip and cleft palate
In this type of defective speech, always try to find out the reason and then try to correct. If all causes are ruled out, better to consult a speech therapist and start therapy.
STUTTERING/STAMMERING:
Usually this is seen by the age of two. Most of the time this is not associated with any defects. As there is an exponential growth in the vocabulary at this age, they will have a word output block sometimes. Mainly it is due to the over enthusiasm to speak more and increased speed of talk. Sometimes all the family members will be talking very fast, so child also tries to imitate and ends in stammering. Sometimes it is associated with mental stress of any reason. So in such cases, we can wait for next 6 months. If it is not resolving, then only consult a speech therapist. We need to do a counseling also to know whether anything is bothering the child. One thing need to be kept in mind, not to discuss this defects in front of others which will result in anxiety of the child and this will worsen the situation. Just ignore the issue and give them mental support. It will resolve by its own.