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!

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?

Sound travels through different parts of the hearing system to produce the ultimate sense of sound in the brain. People can hear when a sound wave stimulates the neurological component of the inner ear and takes the sound signals to the brain.

When there is a problem with the ear, human beings cannot hear, or hear garbled sounds. Hearing loss may have different reasons. There may be a tumor in the ear, a problem with the eardrum, the inner ear or the neurological structure. Different conditions can plague the hearing system and cause hearing loss. Some of these conditions can be serious and require medical intervention.

Let us discuss 3 such conditions where the intervention of an audiologist is a must.

Tinnitus and Vertigo

 Tinnitus is a medical term for a sense of ringing in the ears. It s annoying, to say the least. But more importantly, it could be a sign of hearing loss. This is why people need to see an audiologist if they have a sense of Tinnitus for a prolonged time. An audiologist can first diagnose the condition, and can then treat this problem with the help of specialized hearing aids.

 Vertigo and dizziness are the other two problems that result from a hearing system problem. It may create balance disorders. It is said that vertigo originates in the inner ear. Vertigo can also be treated with the help of physical therapy and medicine.

 Sudden Hearing Loss

 The human ear cannot hear sounds greater than 85 dB in intensity and 20,000 Hertz in tone. If the sound tone is less than 20 Hertz, then too the human ear is not able to hear anything. Between these two polarities, the human ear is able to catch all types of sounds. If human beings are exposed to sound waves of more than 85 dB in intensity, the ears may get damaged. In that case one may suffer from hearing loss. If a person has recently experienced huge changes in air pressure, exposed to blaring music or noise at close quarters, or had an accident causing loss of hearing, one needs to see an audiologist. The ears need to be assessed for trauma, if any, and treated quickly. However, hearing loss may have other reasons too such as reactions to medicines, head injury or some kind of illness that affects the hearing system. An audiologist would be able to make the right determination.

 Recurrent Ear Infections

This is common in children, but that does not mean that adults are immune to it. If there is chronic ear pain, difficulty in hearing along with drainage and fever or a feeling of pressure, an ear infection is most likely. Any doctor can detect an ear infection, however, if it is a recurrent one needs to see an audiologist. He has the wherewithal to evaluate the middle ear with different tests. A person may need treatment that only an audiologist can do.

There can be many situations in which a visit to an Audiologist is warranted; the above 3 are just a tip of the iceberg.

Audiologist - Why To Visit One?

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?

Speech therapy is a very specific field of medicine where the therapists deal with speech disorders in children and adults, which may be a result of certain mental or personality disorders. These doctors can be essential when it comes to teaching a child how to articulate better and also to be more expressive of his/her feelings. Here is a look at a few of the benefits of a speech therapist in the life of a child suffering from speech impairment.

Improvement of articulation skills: Articulation refers to the movement of the mouth, lips and tongue in such a manner so as to form and pronounce a word properly. Aside from the movement of the mouth, voice modulation also falls within the purview of articulation. A child suffering from speech impairment cannot perform this activity as easily as a healthy child does. This is where a speech therapist comes into play. These specialists can ensure that the child s mouth movement and voice modulation can be in perfect harmony to form words normally.
Language skills: Some form of mental disorders severely limit the number of new words or grammar rules that a child can learn. A speech therapist can aid such children in learning the basic rules of grammar and apply these rules when they speak out. So, it is quite likely that the therapists may also act as teachers for the children and improve their overall vocabulary.
Improvement of listening skills: Difficulty in speaking can sometimes also lead to difficulty in understanding what others are saying. So, if your child has a speech impairment, it may mean that he has problems understanding what you say to him. In such a circumstance, the speech therapist can, for instance, help your child understand the difference between a question and a statement. In the long run, the listening skill will help your child comprehend you better.
Reduction of stammering: Stuttering and stammering are forms of speech impairment that many children suffer from. However, such impairments can be easily rectified by undergoing a few sessions with a speech therapist. The therapist can clear your child s speech and ensure that the stammering disappears by the time he/she grows up.
Treat certain vocal conditions: Your child may be unable to speak clearly due to an issue with his/her vocal chords. If that is the case, speech therapists can sometimes help your child with the same. Abnormal vocal resonance can also be corrected by these specialists. 

How Speech Therapy Can Help Your Child Be More Expressive?

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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