There are instances when a kid doesn t show the usual signs of development compared to their peers. Most parents take it casually thinking that their child will catch up in due course only to find a larger problem associated with it. It is therefore extremely important to discuss speech and language related delays with a medical practitioner to find out whether a child is immature or has a genuine problem which requires medical help. A child can show different signs as per age:

Different age group:

Within the first 12 months, a baby should be able to relate to his environment and make babbling and cooing sound. It is often observed that by month 9, a baby is capable of stringing sounds after seeing things. If a baby is intently watching objects, but is unable to make any sound, this may be an early symptom of speech or language related problem.
Between the 12th and the 15th month, a baby should be capable of making a wide array of sounds including few commonly used words. Babies should also be able to take few basic instructions and oblige those.
Between the age of 18th and 24th months, a baby becomes smart enough to pronounce anywhere in the range of 20 to 50 words. They also start combining words and make simple sentences. They should be capable of identifying common objects and remember their names.
By the age of 3, a toddler should be smart enough to combine 4-5 words and form sentences. Kids of this age also become smart enough to take straightforward instructions and perform them comfortably. Any deviation on this should be immediately reported to the Doctor.
What are the warning signs?
If a child between the age of 1-2 is not able to do the following things:

Fails to use gesture
Use more gesture than vocalising by the age of 18 months
Produce no voice by 18th-month
Fails to perform simple instructions
A child between the age of 2-3 needs evaluation if:

Capable of imitating words but isn t spontaneous in vocalising
Repeats certain words multiple times
The tone of voice is unusual compared to his peers
Possible causes of speech and language delay:

Problems with palate leading to oral impairments
Short frenulum restricting sufficient tongue movement to produce speech
Oral-motor problems leading to speech limitation
Problems related to hearing
Chronic infection of the ear leading to speech delay
What does the pathologist assess?

What can the child speak?
What can the child understand?
Oral-motor status
Clarity of speech
Post the above evaluation a pathologist directs a plan of action. Sometimes speech therapy sessions are recommended in order to improve kids  skill. For a motor related problem, a doctor can state a plan of action and limit the expectation of parents.

Speech & Language Delay - Spot The Signs!

When the vocal cords suffer from the accumulation of non-cancerous and abnormal growth, these are known as vocal cord lesions. These lesions usually cause a variety of voice and speech related problems. These are also known as singer s nodules and nodes, which may be caused by pressure, stress and stretching of the vocal cords. Women between the age of 20 to 50 are more prone to this condition. Here is everything you need to know about the types, causes and treatment of these lesions.

Types: There are three kinds of vocal cord lesions, that is nodules, polyps and cysts. A vocal cord polyps may be caused on one side of the vocal cords and may also lead to many disturbances in one s voice. Another type of vocal cord lesions includes a mass of tissue that may manifest in the sac or membranes around the vocal cord. This cyst can be on the surface of the vocal cord or in the ligaments of the vocal cord. This may require surgical removal as well as voice therapy thereafter. Nodules are the third type of lesion that may form in the vocal folds. These are basically calluses that may disappear once the pressure and overuse of the vocal cords diminish.

Causes: These lesions are usually benign or non-cancerous growths that may be caused due to a variety of reasons. Screaming and overuse of vocal cords are few of the most common reasons for the eruption of such lesions. The heavy use of one s voice can cause quite a bit of trauma to the vocal cords and may lead to problems including lesions and disturbances in one s voice. Conditions like reflux and allergic reactions may also cause vocal cord lesions as a side effect.

Symptoms: From hoarseness to pain, there are a number of symptoms caused by this condition. A low pitch and difficulty while speaking are also some of the common symptoms of this condition. Patients suffering from the growth of such lesions will also find themselves making an effort in order to speak normally and to be heard. Constant throat clearing may be required as well.

Treatment: Besides giving your voice a rest and gargling warm saline water with salt, one can also have the condition checked by the doctor so as to ascertain whether or not it is a serious lesion that may require surgical removal and voice therapy. The doctor will usually prescribe medicines in order to deal with any underlying conditions that may have caused the lesions, including allergic reactions, reflux, sinusitis and other such ailments. One will also have to stop smoking so that there is less chemical pressure on the vocal cord. Finally, one will have to go through voice therapy for more serious lesions.

Vocal Cord Lesions - Causes + Treatment

It might happen that you may not find your child, at twelve months to two years of age, at the same level as their peers in verbal communication. You think it's just a developmental problem they are facing and put off seeking professional advice; an intrinsically wrong step to take, because your child might be suffering from Speech Delay.
Delayed speech, or alalia, can be roughly defined as a delay in the development and use of the biological mechanisms that produce speech.
The symptoms of speech delay are roughly categorized into age related groups, generally beginning at the age of 12 months and continuing through the early adolescence, and they are:
1. Age-12 months
a. It is indeed a symptom if your child cannot point at objects or cannot manage gestures, such as waving good-bye.
b. Another symptom is that if your child does not prefer to communicate verbally as much as his/her peers.
2. Age-15-18 months
a. If your child is unable to pronounce familiar syllables or simply cannot call you even by this time, it's a worrying symptom.
b. You find your child unable to, or simply not reciprocating to 'no', 'hello', 'hi', 'bye'.
c. If your child is unable to extend his/her vocabulary up to 15 words by fifteen months, then it's a symptom.
3. Age-2-4 years
a. You find your child unable to spontaneously produce speech and words.
b. Another worrying symptom is if your child is lacking consonant sounds at the beginning and end of words while speaking.
c. If you still find your child unable to form simple sentences and words, then it is indeed a troubling symptom, confirming the disorder.
The causes for the speech delay disorder are:
1. A primary cause can be physical disruption in parts of the mouth such lips or palate, which may be deformed.
2. Another serious cause can be an oral-motor dysfunction which is the disruption in the creation of the specific area of the brain which deals with speech and communication.
3. The disorder can also be attributed to impairment in the development of the child's intellectual, receptive and expressive abilities.
4. There can also be psychological causes involving school environment and peer relationships which might lead to disruption of speech patterns and reluctance in speech expression and development.

Causes and symptoms of Delayed Speech

Language disorder is commonly known as language impairment, it is a common childhood disorder, which makes it difficult for kids to understand what the people around them are saying to them and to face difficulty in following simple directions, it also includes difficulty in expressing the thoughts and feeling through speech.

Language disorder can be classified as:

Receptive language disorder: This disorder makes it difficult to understand what the other person is saying to the one suffering from it.
Expressive language disorder: Kids suffering from it are not able to express themselves and their thoughts.
Mixed receptive expressive disorder: These kids have combined symptoms of receptive language disorder and expressive language disorder, making it difficult to understand and to make someone else understand.
Symptoms of language disorder:

Difficulty in understanding: The ones suffering from language disorder, finds it difficult to understand what the people around them are saying.
Limited vocabulary: It is one of the prominent symptoms, in which the vocabulary of the kids is very limited as compared to other kids of that age.
Trouble learning new things: Learning new things is a difficult task for the kid suffering from language disorder
Repeat usage of certain phrases: Kids tend to use the same phrase again and again, which is one of the basic symptoms.
Frustration: As the kid is either not able to understand or to make other understand or both, kids with this disorder tend to remain more frustrated in comparison to other kids, as they are unable to do things. 
Sentences which do not make sense: Making incomplete or senseless sentences is a key indicator of language disorder.
What you should do?

Speech therapist: The treatment may include speech therapy, in which the speech therapist will work towards building the vocabulary and improving the grammar of the kids suffering, making the kids more confident and feel good about themselves.
Psychotherapy: If the kid is also suffering from emotional issues because of the language disorder, then one should also undergo Psychotherapy, as it not only improves the morale of the patient, but also provides the guidance on how to keep improving further from the language disorder.
Positive Atmosphere: The kids suffering from such a disorder should be made comfortable enough to enjoy their being, giving plenty of time to your young ones is the best way to cure such disorder, so one should always communicate well with his kids and make them learn new things, sing to them, listen to various sounds, show different pictures, colours, shapes to make them learn.
Parental Support: The parents should also understand the issue well, be patient, and should support the kid to work out on the disorder. Parents should also interact with other parents, who have been there, to learn more about the language disorders and how their kids overcome the disorder.
As language disorder is one of common issue in kids, this can be managed and cured well to improve after all the required knowledge and best practices to follow.

Language Disorder - How to Diagnose it?	

Change in voice or voice mutilation happens when the voice breaks that commonly occur when a person reaches puberty. Before puberty, almost all the girls and boys have the same voice pitch. But after puberty, a boy s voice deepens an octave and the girl s voice deepens only several tones. Therefore, it becomes easy to identify the gender through voice. 

Another type of change in voice is known as voice crack. It happens when a person unintentionally enters a higher voice pitch zone for a brief period of time. It may be due to singing, shouting, talking in noise, and several other reasons. Also, there are several medical conditions leading to voice break or hoarseness. 

Medical Causes for Change in Voice

Acute Laryngitis: In this, the hoarseness or voice loss starts suddenly. One of the reasons can be a viral infection that causes swelling of vocal cords. Staying hydrated and less talk can treat it. 

Chronic Laryngitis: It can cause acid reflux disease. Exposure to irritating smoke, infections of vocal cords, or asthma can be some of the reasons. It can be cured only through medication.

Laryngopharyngeal Reflux Disease: This problem causes a change in voice. Due to this disease, people may also suffer from swelling issues, a lump in the throat, hoarseness in voice, and throat pain. 

Voice Misuse: Excessively loud voice, prolonged talking, and inefficient voice use can cause a change in voice and also known as voice misuse. 

Risk Factors That Can Cause Voice Disorder

Aging, alcohol use, and allergies are some of the major reasons for the voice disorder. Apart from these, smoking and throat cancer also results in a change in voice or voice disorders. All these are highly risky causes for the throat and may result in long-time problems. 

Some other risk factors are thyroid, psychological stress, and neurological disorder. 

How to Treat Voice Disorder?

One can use an air humidifier to keep the air of the surrounding moist because breathing moist air is a simple solution to the problem.

Giving rest to voice is also a solution.

One must drink plenty of liquids to keep the throat hydrated.

One must avoid whispering and decongestants to take care of the throat.

One must avoid shouting for a long time.

Avoid staying in a polluted area for a long time.

Gargling the throat every day with lukewarm water is good.

Staying warm during winters is also necessary.

All these remedies are simple and can be tried comfortably. A simple change in voice can turn out to be serious if not taken proactive measures. Therefore, one must not ignore any small unintentional change in the voice.

Conclusion
One must consult ENT doctor immediately for any sudden change in voice and if the problem lasts for a long period of time. 



Change In Voice - What Can Cause It?

Speech therapy helps in improving the speech, understanding the language skills, and also help in communicating in non-verbal ways such as listening and taking turns. Speech therapy treats various kinds of communication and swallowing problems.

Children with Cleft Palate are diagnosed with an opening in the upper tissue palate in the mouth. This condition causes Velopharyngeal dysfunction (VPD) which results in excessive airflow from the nose while speaking. Although it can be corrected with surgery, the patient will still be affected by VPD.

Speech therapists help in this condition by assisting the patient with speech and language skills. The speech therapy for such a patient can be categorized as auditory feedback and articulation practice.

Auditory Feedback

Before involving the patient with any speech therapy, it is essential for the patient to understand the difference between normal voice and nasal voice output.

For this purpose, the child is instructed to use a tube to listen to the voice of the normal person. To understand the difference, one end of the tube is then held near the ear of the child and the other is held near his nasal and then he is instructed to make sounds so that he understands the nasal voice.

After this understanding, the different approaches to speech therapy starts.

Articulation Practice

This is usually where speech therapy begins. In this practice, the different type of condition is understood that relates to different speech organs. The understanding of different vowels, consonants and related sounds is taught to the child for making the speaking sound less nasal.

Some of the methods for achieving these sounds are:

Pharyngeal Plosives: This sound is produced when the tongue is moving backward. The practice of making  ng  sound, and dropping the tongue and producing  k  sound.

Pharyngeal fricatives: When the tongue retracts but is not able to make contact with the pharyngeal wall is when this sound is produced. The speech therapists make the child learn the techniques of making sounds of  t ,  ts ,  ch , or  sh , and provide feedback for learning the proper positioning of the tongue.

Nasal Plosives: This sound usually occurs when the tongue is positioned improperly and it obstructs the vocal tract. A speech therapist may make the child yawn so that the back of the tongue is pushed down, and feel as the mouth stretches.

Palatal-Dorsal Productions: It occurs due to the malocclusion of the teeth. Practicing sounds like  t ,  d ,  n ,  k ,  g , and  ng  often helps in such condition.

Take Away
Cleft Palate is generally developed due to improper growth while the child was in the womb. The difficulty of producing proper sounds when there is excessive airflow in the mouth can be overcome by training and practicing certain sounds, as instructed by a speech therapist.

 Cleft Palate - How Efficient Is Speech Therapy?

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