Your baby communicates with you through non-verbal means with gestures, facial expressions and body language. Learning to verbalize her thoughts, feelings and desires is an important part of her development. Many babies speak their first word around a year, but of course, each baby is unique and it could be quite a bit longer until that first "Mama" or "Dada." (For information on speech milestones, please see Language Development.) Because speech is so closely linked to hearing, difficulties speaking may indicate some hearing loss or deafness. Below, you will read about the different types of speech and hearing problems, their causes, and the appropriate action to take if you suspect your child of having either.
Speech Problems and Stuttering
There are many reasons why your child may talk a little later, or even much later, than other children his age. Few of them are serious, and most kids eventually catch up. For example, most girls talk earlier than most boys. A child's environment can affect the development of speech, too. If your family is not one that talks a great deal, your child will probably be a late talker and will probably talk less than some other children. If he spends days in a child care center or nursery school where one caregiver is responsible for several children, development of speech may be slowed. Competition for individual attention at home may be responsible for late talking, also. For example, if you have two children very close in age, or twins, you may not be able to devote a great deal of individual time to each. The private language twins sometimes develop is more often the result of lack of one-on-one time with a parent than a desire to talk only to each other.
Other factors that affect speech development are a child's intelligence, hearing, and control of the muscles involved in speaking. Speech may be delayed or impaired if the speech centers in the brain are not normal, or any abnormality of the larynx, throat, nose, tongue, or lips exists. Speech that does not develop normally may also be due to partial or complete deafness, mental retardation, brain damage, or malfunction of the speech centers in the brain.
Stuttering and stammering. Children between two and five years of age often lack fluency in speech and may stutter and stammer sometimes when they can't find words to express themselves. Involuntary pauses or blocks in speaking and rapid repetition of syllables or initial sound of a word may occur. These problems can be temporary, occurring only occasionally when a child is excited, impatient, or embarrassed, or they may be chronic, due to muscle spasms or underlying mental or emotional conflicts that may need to be resolved before speech improves.
When it occurs in children two to five years of age, stuttering can be disregarded unless it is still a problem several months after its onset. The child may not even be aware of it unless it is pointed out to him. To help a child who stutters, do not show anger or impatience by refusing to understand, finishing the child's thought, or trying to force him to speak slowly and more clearly. Ignore the stuttering yourself, and don't allow siblings or other children to tease or laugh at the child. Read, sing, and speak to your child as much as you can.
When to be concerned. Consult your doctor if your child speaks only in a monotone or with a marked nasal quality, if his vocabulary and ability to pronounce words seem to be diminishing instead of improving, or if stuttering is severe, constant, or prolonged. In addition to testing the child's hearing, the doctor will perform a physical examination, checking the child's throat, palate, and tongue. If your child is younger than five years old, your physician may refer you to a speech pathologist for evaluation and treatment if he or she considers the stuttering a severe problem, if the child seems to be extremely frustrated in his efforts to speak clearly, or if you yourself need assistance in handling your child's speech development. If your child continues to substitute sounds (th for s, for example) or stutters after the age of five or six, the doctor may suggest a consultation and, possibly, treatment by a speech pathologist.
Ear Infections and Deafness
Deafness, or impaired hearing, is a partial or complete loss of the sense of hearing in one or both ears. A child may be born with a hearing loss, or it may develop at any age. Since children learn to speak by imitation, a child who can't hear speech can't produce it.
Normal hearing occurs when sound waves pass down the ear canal and cause the eardrum to vibrate. Vibrations of the eardrum in turn move the three tiny bones in the middle ear. This motion of the bones transmits the vibrations across the middle ear to the inner ear, where they are changed to electrical impulses carried to the brain through the eighth cranial nerve. The brain interprets these electrical impulses as sound. Damage, disease, or malfunction of any of these structures can result in deafness. Any of the following problems may lead to hearing difficulties, which are likely to lead to learning difficulties.
- Ear canal problems that may cause hearing loss include a buildup of earwax, a foreign object in the canal, and an infection known as swimmer's ear.
- Eardrum and middle ear problems may be caused by an inflammation of the middle ear or a blockage in the eustachian tube, which connects the throat and the middle ear. Middle ear infection (otitis media) occurs most commonly in the first two years of life, especially among children who receive frequent exposure to it in child care centers. The infection often involves a fluid buildup that causes mild to moderate, intermittent hearing loss for as long as nine months, threatening proper development of language skills.
- Inner ear problems may be caused by injuries or infections.
- Eighth cranial nerve problems have several possible causes. (This nerve is responsible for carrying all signals from the ears and balance structures to the brain.) A child may be born with a nerve that has not developed properly or that was damaged before birth. For example, if a pregnant woman has rubella (German measles), the virus may infect the eighth cranial nerve in the fetus. After birth, an injury or an infection with a virus (mumps or measles) or bacterium (meningitis) can damage this nerve. Certain medications can also affect this nerve.
Detecting hearing loss. Often, the parents first detect signs of a child's hearing loss. You may suspect a hearing loss if any of the following behavior occurs: An infant older than three months ignores sounds or does not turn her head toward sound; a baby older than one year of age does not seem to understand at least a few words; a child older than age two does not speak in at least two- or three-word sentences; or a child simply does not seem to hear well. These symptoms may also have other causes, so if you think your child may have a hearing problem, see your doctor. He or she may refer you to a center that specializes in speech and hearing. A child with impaired hearing should start special education as soon as the condition is discovered, even if she is as young as one year old.
Take precautions. You may be able to prevent hearing problems for your child by taking proper precautions. Never put any object, including cotton swabs, into your child's ear canal for any reason; you may force earwax to become packed into the canal, or you may damage the eardrum. See that your child has the recommended immunizations against measles and mumps, the side effects of which can cause deafness. If you are a woman of childbearing age, consult your doctor about rubella immunization for yourself.
Regardless of the disability your child might have, you will have to make a special effort to aid their development. On the following page, we provide an outline of steps you can take to stimulate a disabled child's development.
This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.