When it comes to speech, every child has a different pace of learning. In the first year, they should be able to recognize and respond to their own names and simple directions like  come , etc. By a child s second birthday, he or she should be able to use a single word or two-word phrases and understand simple questions. If a child s speech development seems atypical for his or her age, you may need to consult a speech therapist. Some of the things you should look out for are:

Mispronouncing vowels: Many children have problems with pronunciation. Pronouncing  bath  as  baf  or  animal  as  amal  is normal. However, if they cannot pronounce vowels correctly, they may be having problems with articulation. For example, your child might say  coo  instead of  cow .
Using only single words: Part of a speech therapist s job is to teach a child to join words together to create phrases and sentences. If even after your child s second birthday, they still prefer using single words instead of phrases, you should consult a speech therapist. For example, they may just say  water  instead of  i want water .
Stuttering: Many children are shy and hesitant of speaking especially in front of strangers. However, stuttering is a more serious problem. This could be in the form of repeating syllables or prolonging words. For example,  s-s-s-s-s-stop  or  mmmmmm me . If this is not nipped in the bud, it could continue into the child s adult life as well.
Answering a question by repeating part of it: By the age of three years, a child should be able to understand and answer simple questions. If the child answers a question by repeating part of it, such as answering  do you want food  with  you want food , it could be a sign of a bigger problem. This is known as echolalia and might be an early symptom of autism.
Limited vocabulary: Each child s vocabulary grows at a different rate but it is important to be able to notice an increase in the child s vocabulary from month to month. If the child uses only a finite set of words and does not catch on to new words, you may need a speech therapist. They can help the child expand their vocabulary and become more receptive to new words.
Other factors you should watch out for include difficulty with pronouns, not being able to follow instructions and understand prepositions and confusion with gender.

When Does My Child Need Speech Therapy?

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

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?

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?

Autism is a kind of developmental disability, which usually crops up before a child attains the age of 3. It is just part of a group of neurological disorders, which involve impaired communication along with impairment in social interaction and cognitive skills. It is better known as Autism spectrum disorder, it might well be linked with a wide variety of traits.

The traits include:

Activities done on a repetitive basis.

Extreme level of resistance to changes brought about in daily routines.

Very unusual reactions to things like touch.

Problem having interactions with the environment.

Children suffering from Autism Spectrum Disorder can have some of the major problems with regard to both speech and carry out communications in a non-verbal manner. Social interactions might also become very difficult propostions for them.

This is where, speech therapy comes to the rescue of these patients. It is the central part of treatment for autistic children. The speech therapy can help take care of a wide variety of communication problems occurring among people with autism.

Common Speech and Communication Problems Associated With Autism

Social communication, development of language and speech can get adversely affected by autism in more than one way.

A person with autism can have the speech problems, wherein they may:

Not communicate at all.

Tend to utter cries, grunts, shrieks, harsh or throaty sounds.

Talk or just hum in a musical manner.

Utter words, might can sound to be alien or robotic.

Often look to repeat whatever another person says.

Around 30% of people, suffering from autism has problem in producing speech sounds to ensure effective communication with others. The language, even if it is present, can be too difficult to be understood by others.

Communication problems can occur in various ways, for people who suffer from autism. The challenges faced by them while communicating are as follows:

Communication requires a person to make eye contact with another person or even make certain gestures. People with autism will have serious trouble in meeting up with the conversational skills.

They would have difficulty in understanding the meaning of words, which are out of context from what they have actually learned.

They would have very little understanding of the meaning of words and symbols.

Treatment through Speech Therapy

Speech therapy can help children get rid of the problems in speaking, as well as those related to communicating and interacting with others. This involves non-verbal skills such as making direct eye contact, taking initiative in conversations and understanding of different kinds of gestures.

This therapy can also teach children the art of expressing themselves by using picture symbols, computers or through sign language.

Five Principles of Speech Therapy

There are basically five principles used as a framework, to work upon in speech therapy with children, suffering from autism. They include:

Establishing Functional Communication In A Spontaneous Manner  

Providing Social Instruction in Different Settings throughout the Day

Target Peer Interactions

Even Provide Training and Support to Other Adults

Look to Fine Tune Communication Skills as Other Areas Improve.

How Speech Therapy Can Help Autistic Children?

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!

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