Some children struggle with understanding and using language and they need help in communicating with others. They may not master the language milestones at the same time and in the same order as other children, and it may be a sign of a language delay/disorder. On the other hand, some children may have age-appropriate language skills, yet have difficulties in social communication and need professional support.
Fluency is the aspect of speech production that refers to continuity, smoothness, rate, and effort. Two fluency disorders are stuttering and cluttering. Stuttering, the most common fluency disorder, is an interruption in the flow of speaking characterized by repetitions, sound prolongations, blocks, interjections, and revisions, which may affect the rate and rhythm of speech. It begins during childhood and can continue right through a person’s life. Most people produce disfluencies in their speech. However, these are usually brief and generally do not cause a problem. If dysfluencies are becoming a barrier in academic and professional success, seek professional guidance.
Attention-Deficit/Hyperactivity Disorder (ADHD)
ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviours (may act without thinking about what the result will be), or be overly active. These behaviours and characteristics are more frequent and severe than typically observed in individuals at a comparable level of development. This vastly impacts speech-language development and in turn, poses limitations to academic achievement.
A person with a hearing impairment has a full or partial loss of the ability to hear and discriminate sounds. This is due to an abnormality in the structure and/or functioning of the ear. A Hearing Impairment can be congenital (present by birth) or may be acquired later in life. Congenital hearing impairment can lead to speech and language delay if the hearing loss is not identified and treated in early years of a child’s life.
Childhood Apraxia of Speech (CAS)
Childhood apraxia of speech (CAS) is a neurological childhood speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits (e.g. abnormal reflexes, abnormal tone). CAS may occur as a result of known neurological impairment, in association with complex neurobehavioral disorders of known and unknown origin, or as an idiopathic neurogenic speech sound disorder. The core impairment in planning and/or programming spatiotemporal parameters of movement sequences results in errors in speech sound production and prosody. (ASHA, 2007b, Definitions of CAS section, para.1)
Alternative Augmentative Communication (AAC)
As per American Speech and Hearing Association (ASHA), Augmentative and alternative communication (AAC) is an area of clinical practice that addresses the needs of individuals with significant and complex communication disorders characterized by impairments in speech-language production and/or comprehension, including spoken and written modes of communication. AAC uses a variety of techniques and tools, including picture communication boards, line drawings, speech-generating devices (SGDs), tangible objects, manual signs, gestures, and finger spelling, to help the individual express thoughts, wants and needs, feelings, and ideas. AAC is augmentative when used to supplement existing speech, and alternative when used in place of speech that is absent or not functional. AAC may be temporary, as when used by patients postoperatively in intensive care, or permanent, as when used by an individual who will require the use of some form of AAC throughout his or her lifetime.
Speech Sound Disorders/Delay
When children are developing speech they may make mistakes with the sounds they use. There is a typical order in which each speech sound develops and a range of ages when a child should be able to say each sound correctly. A speech sound delay is when speech is developing in a normal sequential pattern but occurring later than is typical. A speech disorder is when mistakes are not “typical” sound errors or are unusual sound errors or error patterns. Speech sound delays and disorders include problems with articulation (i.e. making sounds) and/or phonological processes (i.e. sound error patterns). A child may have sound errors in their speech which are not considered a speech problem because they are part of the dialect or accent to which the child is exposed. If a child’s speech sound errors affect speech intelligibility in such a way that he/she may struggle during daily communication, seek professional advice.
Autism Spectrum Disorder/ASD
Autism spectrum disorder (ASD) is typically a developmental disorder that affects communication and behaviour. Although autism can be diagnosed at any age, it is said to be a “developmental disorder” because symptoms generally appear in the first two years of life. Speech & Language Therapy proves to be an integral part of managing and improving the disorder to make the child self-confident and improve communications and other life skills.
Selective mutism is a disorder in which a person chooses not to speak within at least one social setting but is able to speak in other situations. The child usually fails to speak in specific social situations before the age of 5 years. The time in which the child does not speak in a certain situation often lasts more than one month. The reason for not speaking is usually not due to a lack of knowledge or an inability to produce the language required within the social situation. A child’s lack of speaking may interfere with preschool/kindergarten, school and/or with social communication.
Language-Based Learning Disabilities
Learning difficulties are a cluster of disorders involving significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning or mathematical abilities. These disorders are specific to the individual (and vary significantly between individuals) and are presumed to be due to central nervous system dysfunction.
Even though a learning disability may occur in conjunction with other handicapping conditions (e.g. sensory impairment, intellectual impairment, social and emotional disturbance) or environmental influences (e.g. cultural differences, insufficient/inappropriate instruction), it is not the direct result of those conditions or influences.
Cleft Lip & Palate
A cleft lip and/or palate occur when the tissues of the mouth and/or lip do not form properly during early fetal development. A cleft palate is a hole in the roof of the child’s mouth so that there is a connection between the nasal cavity and the mouth. A cleft lip is when the top lips do not join together and a gap is left in the lip. Cleft lip and palate can occur together or separately within a new-born baby. If a child has a cleft lip only, they generally do not have any feeding or speech difficulties. However, a baby with a cleft palate will have difficulties with early feeding if the cleft is not surgically repaired. Often a child with a cleft palate (even if it has been repaired) will have some difficulties with speech production for which professional’s advice is recommended.
A voice disorder occurs when a child has difficulty with the pitch, volume or quality of their voice which distracts a listener from what is being said. Their voice quality is noticeably different from those of their peers. A child with a voice disorder may have difficulties projecting their voice and may also experience pain or discomfort in the throat region. This inappropriate voice parameter may pose barriers to academic and social-communication domains of development.