Perhaps you’re child has been recently evaluated and diagnosed, and now you’re looking for information on what his diagnosis means. Or maybe you’re concerned about your child’s speech and language development and you’d like to know more about various speech and language problems. Below is a list of the most common speech and language diagnoses in children, what each diagnosis means, and what you can expect concerning your child’s speech and language development. This is by no means an exhaustive list. More information can be found at ASHA’s website. If you have questions concerning your child’s speech and language development, please contact me for a FREE phone consultation, or refer to my Speech & Language Developmental Guidelines.
Childhood Apraxia of Speech
Childhood Apraxia of Speech (CAS) is a motor speech disorder. Children with CAS have a difficult time programming and planning the motor movements needed for speech. When a child has Apraxia, it means there is a problem with the connection between the brain and the child’s mouth. The child’s brain and the muscles in their mouth are typically developmentally normal, but for some unknown reason, CAS causes a problem with the signals being sent from the brain to the child’s mouth, making it difficult for the child to plan and produce the very precise motor movements needed for speech. Think of it as like trying to write with the hand that you don’t typically write with. Your brain knows the letters and how to form them. The muscles in your hand are strong and able to produce the movements. However, when you try to form the letters, they come out sloppy and distorted because your hand isn’t quite capable of making those refined movements.
What does this diagnosis mean for my child?
This, of course, depends on the child and the severity of the disorder. Apraxia is a relatively rare speech disorder. Children with CAS usually require several years of intensive speech therapy. This is because the goal of therapy for a child with CAS is to train the child’s brain to program common motor movements for speech. Teaching a child to program and produce these movements automatically can take significant time.
An Articulation Disorder is the most common and the least severe of the speech and language disorders. A child is diagnosed with an Articulation Disorder when they cannot correctly produce one or more developmentally appropriate sounds. For example, if your 3rd grader is having trouble saying the /r/ sound, he will most likely be diagnosed with an Articulation Disorder, and will need to receive speech therapy. The same is true for your Kindergartener who cannot produce her /k/ and /g/ sounds. Articulation Disorders range in severity, but a good speech therapist can correct most Articulation Disorders in a relatively short amount of time.
Phonological Processes Disorder
A Phonological Process Disorder is very similar to an Articulation Disorder in that a Phonological Process Disorder affects the sounds a child produces. The difference is that, rather than affecting one sound, a Phonological Process Disorder affects a class of sounds. For example, your preschooler may drop most or all of the sounds at the end of his words (ie: “cat” becomes “ca”). This Phonological Process is called Final Consonant Deletion. Like an Articulation Disorder, a Phonological Process Disorder can range in severity, but a good speech therapist can correct most phonological processes in a relatively short amount of time.
Fluency Disorder (Stuttering)
A Fluency Disorder refers to the smoothness and fluidity of a child’s speech. Stuttering is by far the most common Fluency Disorder. It is typically characterized by syllable repetitions (ie: m,m,m, mom…), abnormal breathing patterns during speech, and blocks (ie: a child becomes “stuck” on a word or sound). Stuttering is a serious and often life-long diagnosis that can affect a child socially and psychologically. As with nearly every speech and language disorder, early intervention is critical. This is especially true for stuttering. Younger children have a much higher likelihood of outgrowing stuttering than do older children. If you believe your child is exhibiting signs of stuttering, it is important to consult with a Speech-Language Pathologist as soon as possible.
Language Disorder: Receptive and Expressive
While Articulation and Phonological Process Disorders refer to the sounds a child produces, a Language Disorder refers to the actual words a child says and hears. There are two types of Language Disorders: Expressive and Receptive. Most children diagnosed with a Language Disorder have difficulty in both areas, though the severity of each may differ.
Expressive Language Disorder
An Expressive Language Disorder refers to difficulties producing language. Typical problems include difficulties with grammar, sentence creation, vocabulary, word finding (it’s on the tip of my tongue…), and difficulty with expressing wants, needs, and ideas.
Receptive Language Disorder
A Receptive Language Disorder refers to difficulties processing and understanding spoken language. Difficulties may include lack of auditory comprehension, inability to answer questions, difficulty following directions, difficulty understanding social cues, difficulty maintaining conversations, and inability to understand humor or sarcasm.
What does a Language Disorder mean for my child?
Unfortunately, a Language Disorder is a life-long disorder. Children cannot be cured from or simply “grow-out” of a Language Disorder. However, with long-term (usually at least from grades PK-12), intensive speech therapy, the affect of a Language Disorder on a child’s life can be dramatically reduced. Think of it this way: Have you ever tried to learn a second language? If you have, then you know it is a very time consuming and difficult process. Most second language learners never become as fluent as a native speaker even after years of intensive study. For children with Language Disorders, it is as if they are learning a second language their whole life. Learning a language (even their first!) does not come naturally for them, and it takes years of specialized instruction to become fluent and comfortable with language.
A Voice Disorder is one of the more rare speech disorders among children, and involves problems with a child’s vocal folds. Usually, these problems occur in exceptionally loud, outgoing, and noisy children. Yes, all children are prone to noise and yelling from time to time, but some children do not stop yelling, talking, etc. Vocal over-use behaviors coupled with allergies and dehydration can lead to nodules or polyps on the vocal folds. This causes a child’s voice to sound hoarse. If you suspect your child has a Voice Disorder, the first thing to do is to take your child to an Ear, Nose, and Throat (ENT) specialist. If you visit a speech therapist first, she will refer you to an ENT before she can begin treatment. A Voice Disorder is often associated with a medical diagnosis, and the type of speech treatment needed depends on the medical diagnosis given. If your child does present with a Voice Disorder, it is usually resolved with a few months of speech therapy.
Surprising, but yes, Speech-Language Pathologists can and do diagnose and treat Pediatric Feeding Disorders. A Feeding Disorder occurs when a child is unable or unwilling to consume enough calories needed for proper growth and development. These children are often labeled as picky eaters, but in reality, they are problem eaters. Feeding Disorders often occur due to other medical or developmental difficulties. For example, children who were born premature, or children diagnosed with a disorder such as Autism or Sensory Processing Disorder often have a co-occurring Feeding Disorder. Children with digestive issues such as reflex or food allergies can also develop Feeding Disorders. Some children develop Feeding Disorders after a traumatic event, such as choking. Characteristics of a Feeding Disorder include:
- History of medical or developmental problems
- Very limited food repertoire. Often child with a Feeding Disorder cut out whole categories of food from their diet.
- Rigid eating behaviors: Children with Feeding Disorders often will not eat if changes are made to their feeding routine. They are very rigid about the location, preparation, and presentation of food.
- Misbehavior during meal times
- Presence of gagging or vomiting while eating
What does this diagnosis mean for my child?
If your child exhibits symptoms of or is is diagnosed with a Feeding Disorder, it is critical to get treatment for your child right away. Children do not grow out of a Feeding Disorder, and it will often become worse with age. Children with Feeding Disorders often require treatment from a Speech-Language Pathologist for several months in order to increase their caloric intake and food repertoire.
Until next time,