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How To Identify Speech Problems

Lauren Gillespie didn’t notice a speech problem when her son Shane was a preschooler. “Your kids say weird things, but you know what they’re saying,” recalls the mom of three from Claymont, DE.

But when Shane got to kindergarten, his teacher had trouble understanding him. Soon he was diagnosed with a speech disorder and began work with a therapist. “Shane started to improve by leaps and bounds,” Gillespie says. Now 9, he is much more confident after several years of successful speech therapy.

 “By age 3, kids should be understood by most people outside the home 90% of the time,” says Dorothy P. Dougherty, author of Teach Me How to Say it Right: Helping your Child with Articulation Problems. “Even if they make errors, you should be able to understand what they mean.”

However, some kids don’t speak all sounds correctly until they’re age 8. That’s normal, says Dougherty. She and other speech pathologists recommend becoming familiar with other speech milestones to spot problems.


For speech milestones, visit Asha.org/public/speech/development


Common Toddler Speech Quirks

Pronunciation. “There are many sounds that a 3-year-old may not be saying and that’s perfectly normal,” says Amy Nelson, a speech pathologist at Nemours/A.I. duPont Hospital for Children in Wilmington, DE. Kids are still developing R, S, Z, TH, and L sounds at this age. Into elementary school, kids continue to fine-tune some sounds.

“Typically by the age of 7 or 8, all the consonant sounds should be in,” says Nelson.

Stuttering. Between ages 2 and 6, some children may experience a period of stuttering called developmental dysfluency. (See sidebar, below.) This may sound like: “I was um um um I was…” It occurs as a child’s vocabulary starts to explode, and his mind is working faster than his ability to articulate, says Nelson. “There’s no need for alarm unless it’s worsening,” she says.

How To Help Speech Development

Model words for your children so they can imitate your speech, but don’t ask kids to repeat themselves when they’ve mispronounced something.

“Acknowledge what they’ve said,” says Valeri Le Beau, a speech language pathologist at Children’s Hospital of Philadelphia (CHOP). “Let them know that they were understood, and then model the word correctly.” Use problem words in conversations as many times as you can. Label everything out loud, over-articulate words, and try to expand your child’s utterances. For example, she says  “bus.” You say “big yellow bus.”

Seek Advice for Concerns

“The earlier the intervention, the more successful it is,” says Eileen Rall, a CHOP audiologist. Recent advances in diagnostic technology can identify children with hearing loss at age 2 or 3 months rather than 2 or 3 years, she says. Speech therapy for kids younger than age 3 involves caregivers learning to promote speech development in the home.

Dysfluency Versus True Stuttering

Speech/language pathologist and author Dorothy P. Dougherty offers the following advice to parents of kids ages 2-6 who seem to stutter.

If your child frequently or consistently talks in any of the ways described below, it is wise to seek an evaluation by a speech/language pathologist. This professional will be able to differentiate between normal dysfluencies and true stuttering and make appropriate recommendations.

  • He stretches out a sound, such as "b............aby" longer than one second.
  • He repeats more than two syllables in one word. For example, "Amermericaca."
  • He substitutes "uh" vowel for the vowel that is in the word. For example, instead of saying "bay - bay-baby," he substitutes "buh-buh-buh-baby."
  • The pitch and loudness of his voice increases, when he repeats or prolongs sounds and syllables
  • He exhibits uncontrolled quivering of his lips or tongue when he repeats or prolongs sounds or syllables
  • He appears frightened when he tries to say a word that is giving him trouble
  • He appears to have breathing difficulties or speaks in spurts as if he is struggling to keep his airflow and voice flowing
  • He uses an unusual number of pauses, substitutions of words, interjects extra sounds, words or phrase, or avoids talking all together

Here are seven ways parents can help.

  1. Speak clearly, naturally, and, most of all, correctly. Speaking clearly and naturally includes establishing eye contact, speaking at an easy-to-understand rate, and saying sounds precisely. 
  2. Monitor your child for ear infections. If you suspect your child has an ear infection, call your physician immediately. A temporary mild hearing loss from an ear infection can slow a child’s ability to understand language and their ability to say words clearly and correctly. If he does have an ear infection, remember to take him back to the doctor for a follow-up visit to make sure his hearing has returned to normal.
  3. Model the correct way to say a word. If your child says a word incorrectly, in most cases, it is wise not to ask your child to repeat the word.  (Of course, if your child is participating in speech therapy, follow the speech/language pathologist’s instructions).  Even though many children who say sounds incorrectly have good hearing acuity, they are not able to discriminate between the correct and incorrect production of a troublesome sounds.  Therefore, give your child many opportunities to hear the sound modeled (said) correctly.  Repeat a troublesome word, over-enunciate the sound your child is mispronouncing by saying it louder and longer.  Continue talking and make the troublesome word a natural part of your conversation.
  4. Give your child many opportunities to hear troublesome sounds pronounced correctly. This will make is easier for him to hear the difference between the correct and incorrect productions of sounds, and make it easier to say the sound when he is developmentally ready. Try the activities that follow. As you and your child interact, emphasize the troublesome sound by saying it as often as possible.
    • If your child is having trouble saying /f/ sounds: Talk about things you can do with your feet. Make a favorites list (favorite foods, animals, toys).
    • If your child is having trouble saying /k/ and /g/ sounds:Play with cars in toy garage. Talk about the keys on your key chain Talk about what you might plant in a garden.
    • If your child is having trouble saying /sh/ and /ch/ sounds: Talk about different kinds of shoes. Count the shoes in your child’s closet. Find five things you can shut. Push your child on a swing and talk about other things you can push.
  5. Expect your child to speak clearly. It is important for you to encourage and expect your child to speak the best he can.  Be patient and also tell him how proud you are when he tries his best. If your child has all his wants and needs met without having to say a word, he is, most likely, not getting a lot of opportunities to practice saying speech sounds.  
  6. Prepare your child for new situations. Children who must struggle to communicate often feel self-conscious or apprehensive, especially when facing the unknown.  Talk to your child about a new situation she may be facing.  Rehearse the words she might hear or say in this situation.  Ask your librarian to help you find a book about an upcoming situation, such as a trip to the hospital, the birth of a new sibling, or the first day at school. 
  7. Educate others about your child’s speech difficulties. Of course, you would never allow anyone to tease, laugh, or imitate your child’s speech mistakes.  Privately, talk to his preschool teacher or babysitter and explain his difficulties.  If possible, offer helpful ideas. If he has older sibling, talk to them and enlist their help in modeling good sound productions.  

Suzanne Koup-Larsen is a contributing writer to MetroKids and a Chester County, PA mom of two.

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