Definition

A typical developmental speech disorder (SSD) refers to a condition where a child is unable to pronounce certain consonants at the age when they are expected to. These speech-sound disorders can be broken down into articulation disorders and phonological disorders. Articulation disorders involve difficulty pronouncing specific consonants, such as the "sh" sound, while phonological disorders are marked by repeated errors in consonant pronunciation. Children with phonological disorders may be able to produce sounds correctly but place them incorrectly in words.

This type of speech disorder can lead to difficulties in understanding what a child is trying to communicate. It can also influence the way a person pronounces certain words.

Causes

Several factors may contribute to speech disorders in children. Some children have difficulty with speech due to problems in transmitting signals from the brain to the muscles responsible for pronunciation. This can make it challenging for these muscles to understand when and how to move to articulate a word correctly, a condition known as apraxia. Another potential cause is weakness in the muscles of the tongue, a condition referred to as dysarthria.

Other factors that may lead to this disorder include:

• Brain injury.

• Cognitive and developmental disorders.

• Hearing issues.

• Physical issues affecting speech muscles.

• Nerve damage related to speech can also result in difficulty pronouncing words.

While this disorder is most commonly seen in children, it can persist into adulthood, often as a continuation of childhood disorders. Additionally, conditions such as brain injuries or strokes can lead to the development of speech disorders in adults.

Risk Factor

Certain conditions increase the likelihood of children developing speech disorders, including:

• Autism spectrum disorder and genetic disorders such as Down syndrome

• Hearing loss, particularly from recurring ear infections

• Central nervous system disorders like cerebral palsy, which causes paralysis in various muscles

• Physical issues affecting the speech muscles, such as a cleft lip or palate

Beyond medical conditions, environmental factors can also contribute to the development of speech disorders. These include excessive use of pacifiers or severe thumb-sucking, low levels of parental education, and insufficient support for learning and education at home.

Symptoms

Speech sound disorders are classified into articulation disorders and phonological disorders. Though these conditions share similarities, they are distinct in nature. Articulation disorders are characterized by difficulties pronouncing specific sounds after a certain age, while phonological disorders involve specific patterns of errors in speech at later stages of development.

Articulation disorders can present with:

• Omitting certain sounds from words (e.g., pronouncing “or” instead of “skor”)

• Adding extra sounds to words (e.g., saying “korim” instead of “krim”)

• Changing sounds within words (e.g., saying “tia” instead of “dia”)

• Substituting sounds (e.g., saying “wadio” instead of “radio”)

Phonological disorders often manifest as:

• Pronouncing only one syllable of a word (e.g., saying “lah” instead of “sekolah”)

• Simplifying words by repeating two syllables (e.g., “bobo” instead of “botol”)

• Omitting consonant sounds (e.g., saying “ca” or “at” instead of “cat”)

• Changing consonant sounds (e.g., pronouncing “ucing” instead of “kucing”)

Diagnosis

A typical developmental speech disorder (SSD) is usually diagnosed after a child has reached a certain age, as some symptoms can naturally appear as a child is learning to speak. This condition should be suspected if there are significant delays in meeting certain speech milestones:

• At 3 months: Produces sounds like "oooo..." or "aaa..."

• At 5 months: Laughs and makes happy sounds

• At 6 months: Babbling with sounds like "pa," "ma," and "ba"

• At 1 year: Longer babbling sounds, such as "papa," "mama," and "bababa"

• At 3 years: Able to produce consonants such as "m," "n," "h," "w," "p," "b," "t," "d," "k," "g," and "f" in words, and speech is generally understandable to familiar people

• At 4 years: Can pronounce "y" and "v" sounds in words, but may still have trouble with consonants like "s," "sh," "ch," "j," "ng," "th," "z," "l," and "r." Generally, speech is understandable to most people

If you notice any delays, a speech therapist can help assess the situation. The therapist will listen to your child's speech and observe how they move their lips, tongue, and jaw while speaking. To ensure the diagnosis is correct and not due to other issues, the therapist will also administer a language test, as many children with speech disorders also experience language difficulties.

Additionally, visiting a doctor, such as a general practitioner or an ear, nose, and throat (ENT) specialist, is a good step. A thorough checkup of the child’s hearing is necessary since speech disorders can sometimes stem from hearing loss. If a child cannot hear sounds and words properly, it can significantly affect their ability to develop speech.

Management

Treatment for typical speech developmental disorders is typically carried out by a trained speech therapist. The therapist will work with you to develop a speech therapy plan for your child. This plan generally involves teaching your child how to pronounce words correctly, recognizing when they pronounce something correctly or incorrectly, practicing words, and gradually working up to longer sentences.

Therapists often work closely with parents, providing strategies that help reinforce correct speech practices at home. If there are other underlying medical issues such as a cleft palate, hearing loss, or other conditions, the therapist will collaborate with relevant specialists to address those concerns.

Regular speech therapy has been shown to significantly improve a child's speech abilities, especially when there is active participation from parents at home.

As a parent, here are some key actions you can take to support your child's treatment:

• Keep scheduled appointments with your speech therapist or pediatrician.

• Discuss with the therapist or doctor which other healthcare professionals might be involved in your child's treatment. The treatment team will be tailored to your child's specific needs and the severity of the disorder.

• Communicate with your child’s teachers to make sure they are aware of the disorder and can assist in providing necessary accommodations. Often, managing speech disorders involves collaboration between healthcare providers and educators.

• Join support groups where you can connect with other parents who have children with similar conditions, sharing insights and experiences.

Complications

Children with speech developmental disorders can face various complications. The most common issue is difficulty with communication, which can lead to heightened anxiety levels. For some individuals, this anxiety can worsen into more severe conditions such as an anxiety disorder or even a phobia related to speaking.

Prevention

Preventing typical speech developmental disorders is challenging, especially since the causes are often unknown. However, as a parent, you can help by regularly talking to your child from birth and monitoring their speech development. Ensuring routine child development checks, along with scheduled vaccinations, is also essential to track your child's overall developmental progress and address any concerns early on.

When to See a Doctor?

If you or someone around you suspects that your child may have a typical speech developmental disorder, it is important to take them to a doctor. The doctor can evaluate your child and, if necessary, refer them to a specialist or speech therapist for further testing and treatment. While you can visit a speech therapist directly, a referral from a doctor may be more cost-effective.

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