February, 2013:

When My Child Seems To Understand Almost Everything But Isn’t Speaking

There are young children out there who have great difficulty speaking and expressing themselves. They may seem to understand language spoken to them, but really struggle to form the sounds into intelligible words, and may even be considered nonverbal.  Consulting  with a trained and highly experienced Speech-Language Pathologist is the best thing to do if you are concerned about your child’s speech and language development. Don’t listen to others who might tell you that your little one is “Just slow in talking,” or a pediatrician who might suggest you wait another 6 months.  Apraxia is a neurologically based motor planning disorder that interferes with the timing and coordination strategies necessary to produce a series of speech sounds.  As parents often report, these children are typically quiet babies who do not go through the normal development of cooing & babbling in their vocal exploration. If they do speak at all, they may use sounds that are considered more complex in the profile of sound development in young children.  For example, rather than using earlier developing sounds such as p, b, m, they may be heard saying word approximations with f, v, th, ch.  Parents also share that their child may have said a particular word or phrase that was fairly complex and also intelligible, and then they were never able to say it again, even when a model was given to try to get the child to repeat what they said earlier.  Since there isn’t a blood test or brain scan or even any current standardized speech & language tests that can clinically diagnose apraxia, specialists rely on characteristics and lists to help identify the signs & symptoms of this disorder. Below are some signs & symptoms  that can be looked at to help a parent decide if their child who is a late talker might benefit from being evaluated by a Speech and Language Pathologist.

  • produces one syllable for many or all words (“da” means ‘daddy,’ ‘dog,’ ‘book’)
  • often omits a sound or syllable (“wah” for ‘water’)
  • finds speech easy one day and more difficult another day
  • reverses sounds or syllables (says “shif” for ‘fish’)
  • adds extra sounds or syllable in words….lots of times a mid-central “ah” vowel
  • produces more errors as they try to say longer utterances
  • correctly says a difficult word then cannot repeat it
  • comprehends language much better than being able to express themselves
  • speaks too slowly or too quickly and also places inappropriate stress on certain syllables or words
  • exhibits “groping” behaviors while trying to find the correct mouth positioning
  • displays expressive language delays that could include limited vocabulary, grammatical errors, or incorrect syntax
  • may have signs of hypotonia (low muscle tone) especially in the trunk and oral hypotonia, little facial expression (low muscle tone in oral cavity)
  • displays gross and fine motor incoordination (clumsy child)
  • may have sensory integration dysfunction and self-regulatory issues (difficulty calming self)
  • uses both hands (child usually show a hand dominance by age 2)
  • comes from a family with speech, language, and learning problems