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

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!

Cerebral Palsy (CG) is a neurological disorder caused by an injury to the brain or a brain malformation that occurs while the child s brain is still developing   in the mother s womb before birth, during birth, or immediately after birth.

This disorder affects the child s movement and muscle coordination and control. It also affects his:

Reflexes
Balance
Posture
Motor skills and
Oral motor functions
In easy to understand language, CG can impact the child s ability to walk, talk, sit, do simple tasks like eating, combing hair, talking, and other activities we take for granted. The physical impairment caused by cerebral palsy can affect all limbs, the face and head, or it may just affect one limb. Since CG affects muscles and a child s ability to control them, common symptoms include muscles that contract too much, too little, or all at the same time, leading to limbs that are stiff and forced into awkward positions. Other complications also arise such as intellectual impairment, seizures, or vision/ hearing and speech impairment.

How does Speech Therapy help?
Speech problems affect more than half of all children with cerebral palsy as they have difficulty controlling the muscles in their face, throat, neck and head. Apart from speaking, this also affects chewing and swallowing. It can also cause drooling and the ability to learn, difficulty hearing and understanding spoken language.

This is where speech and language therapy comes in. Speech therapy improves a child s speech and communication by strengthening the muscles used for speech. It also improves understanding of speech and language as well as help with swallowing disorders, like dysphagia.

Speech therapy helps exponentially as when children improve their speech and communication, they are able to express their needs, share their thoughts and interact with others, leading to an overall improvement in their overall quality of life.

Speech therapy can help with the following:

Listening
Articulation of words
Pronunciation
Fluency
Sound and word formation
Language and vocabulary development
Breath control
Chewing
Swallowing
Speech muscle coordination
Apart from this, the other primary benefits are boosting self esteem, socialization, independence and reducing shyness. 

Exercises used in Speech Therapy
Speech therapy treatment usually consists of exercises tailored to a child s specific needs. Different exercises are used in speech therapy like:

Articulation therapy: The therapist uses language cards to help focus attention on specific sounds to encourage the child to make sounds while looking in the mirror to help him understand how his mouth moves.
Blowing exercises: The therapist encourages the child to blow bubbles or a whistle to train the mouth muscles to produce sounds.
Breathing exercises: Work is exclusively on inhalation and exhalation to strengthen the diaphragm.
Jaw exercises: The child is encouraged to eat foods that require extra chewing to strengthen jaw muscles.
Language and word association: The therapist uses flashcards with different words and sounds written on them.

Cerebral Palsy (CP) - How Speech Therapy Can Help You?

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?

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?	

Voice results from the air that comes out of the lungs and passes through the vocal cords. The latter is also known as the voice box. Speech results from the vibration of the chords. Voice disorder might occur for various reasons such as tone, pitch, and volume of the if the voice. The roots of all problems boil down to the malfunctioning of the cords.

Voice disorder examples:

Laryngitis: Laryngitis results from the swelling of the vocal cords. It can lead to a temporary halt of voice or a voice with hoarseness. It often occurs due to a viral attack in the respiratory tract. It can last from a few days to a few weeks. The treatment suggested for cases like these include resting the voice and intake of a lot of fluids. Some common causes that are responsible for laryngitis are GERD, chronic cough, and asthma.
Vocal cord paralysis: Paralysis of the vocal cord can be temporary or permanent. The possible cause of this scenario can be from viral infection, cancer, surgical injury to the nerve etc. In the case of a paralysis of the vocal cord, a person might find difficulty in breathing, can result in weak voice etc. While this condition improves for many people with voice therapy and surgery, for some they permanently lose their ability to speak.
Spasmodic dysphonia: The vocal cord spasm due to a problem with the nerve. This condition can lead to a quivery, hoarse, groaning or jerky voice. In this condition, a person might find it easy to speak at times and have difficulty in speaking later. Botulinum toxin and speech therapy help to improve this condition.
Possible causes of voice disorders:

Growth: Extra tissue formation on the vocal cords might stop the vocal cords to work properly leading to voice disorders. The growth can be treated with injection, medicine or surgery.
Swelling and inflammation: Exposure to chemicals, vocal and alcohol abuse, surgery-related complications can lead to inflammation or swelling of the vocal cords resulting in voice-related problems.
Hormone: Disorder of the male, female and thyroid hormone can lead to voice related disorders affecting speech.
Symptoms of voice disorders:

The harshness of the voice
Voice is breathy, weak and whispery
The voice sounds like choppy or strained
A quivering sound while speaking
The voice sounds harsh or rough while speaking
Diagnosis of Voice related disorders:
Voice related disorders can be detected through a process known as Laryngoscopy. This helps a doctor to view the throat region and find out the possible culprit that may be causing the problem. Some other popular methods are stroboscopy, EMG and imaging tests such as MRI and X-Ray of the throat.

Voice Disorders - Signs You Are Suffering From It!

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