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Speech Problems in Children

A number of factors influence a child's progress in speech and language, including physical maturity, heredity, and environment. Hearing problems are common causes of speech imperfections, but even children with normal hearing may go through stages of "dysfluencies," or articulation problems. Ten to 15 percent of preschoolers have some kind of speech disorder, according to American Speech-Language-Hearing Association (ASLH).

Here are the three most common speech imperfections.

1. Stuttering: At 2 to 3 years of age, it's very common for children to stutter at the beginning of a sentence, notes Greg Prazar, MD, FAAP, a pediatrician practicing in Exeter, New Hampshire. This normal stuttering can take the form of repeating the first sound or syllable in a word or the first word in a sentence. It is more likely to happen when a child is tired, excited, or in a competitive situation, such as trying to express herself better or faster than her peers.

2. Lisping: Lisping is another common articulation problem when young children are learning to talk. Preschoolers typically make substitutions of an easy sound for one that is more challenging for them to make, such as "th" for "s," causing them to say "thand" for "sand." They also may substitute "w" for "r," saying "wabbit" for "rabbit."

3. Lengthy pauses: Another speech imperfection is the appearance of long pauses between words or thoughts. This is a sign that a child is groping for the correct word or thinking about how to structure her next sentence.

In the early stages of stuttering, parent education and guidance may be all that's needed to create a more relaxed environment for your child to express himself. We still don't have a clear-cut answer as to why children stutter, but there are things parents can do to help alleviate the problem. Here are three ways:

1. Reduce your child's stress. While it's not clear why children stutter, it is known that emotional stress is significantly associated with stuttering, as is a family history of the condition, says Jane Fraser, president of the Stuttering Foundation of America. Avoid pressuring your child to speed up her language skills or correcting her speech imperfections.

2. Read to your child. The best way to help your child develop language skills is to read to her, notes Dr. Prazar. Research shows that kids who are read to on a regular basis are likely to develop meaningful language -- saying their first real words -- earlier and more effectively. Make sure to point out the car, the ball, or the puppy in the book and say the words clearly.

3. Eat dinner as a family. Studies show that families who eat together have kids with better verbal skills. It's possible that when children regularly participate in conversation with adults, they learn a wealth of new vocabulary words and the proper ways of using language, says Dr. Prazar.

Preschoolers: Speech imperfections are usually not serious in preschoolers. Most kids with speech imperfections master the correct sounds by the early school years, when they have gained better control over the muscles involved in speech. If you're worried in the meantime, your child's pediatrician and pediatric dentist can rule out physical problems, including dental deformities, that can cause these dysfluencies to occur. Sometimes the solution is as simple as waiting for your child's permanent front teeth to come in.

School-age children: Six percent of children in grades one through 12 have some kind of speech disorder, according to ASLH. Dysfluencies like stuttering and lisping call for professional attention when they continue for prolonged periods or get worse, or if they cause your child anxiety, says Dr. Prazar. If your child's stuttering lasts for longer than eight months, or if he is upset by his difficulty to communicate clearly, consult his pediatrician. Depending on the problem, she may refer you to a speech-language therapist, who will work with you as well as your child.

Bilingual children: Many children nowadays grow up learning two languages. Mixing vocabulary from the two languages, making more grammatical errors, and speaking relatively little are all common behaviors among children in the early stages of mastering a second language. The imperfections usually cease, however, as the child becomes more proficient in both languages. These normal characteristics are sometimes mistaken for language delays, so make sure your child's pediatrician is aware that your child is learning two languages if you report any of these behaviors to him.

Additional reporting by Nancy Arnott

The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.