What You Must Know About Speech Problems

"Many children between the ages of 18 months and five years find it hard to express their thoughts verbally."

When Marianne (not her real name) heard her four-yearold daughter pronounce her playschool friend Rory’s name as “Wowy”, she got worried.

“Over time, I noticed that it wasn’t just his name that she couldn’t say properly; she was substituting ‘w’s for ‘r’s almost all the time.

“Her friends her age didn’t seem to have trouble pronouncing their ‘r’s and I seriously began to wonder if she had a speech impediment. The fact that she couldn’t say her friend’s name correctly was, I thought, abnormal, and frankly, a little scary.”

It’s not uncommon for young children like Marianne’s daughter to have difficulty pronouncing or articulating certain words. Many children between the ages of 18 months and five years also find it hard to express their thoughts verbally, sing along to nursery rhymes or understand the difference between good and broken English.

Indeed, learning how to talk is a journey – one that’s filled with as much frustration as it is joy. 

Fortunately, most speech and language development problems can be remedied, according to experts Young Parents talked to. Here are the best ways to address 10 of the most common ones.

How do I know if my toddler’s language development is on track?

There are certain language milestones toddlers ought to have reached by the time they get to specific ages, explains Lisa Lim, clinical director and speech language pathologist at The Speech Practice.

By the age of 18 months, for example, they should be able to say 10 to 15 meaningful words, imitate words that they hear, identify body parts, and play by pretending to feed their dolls or toy animals.

By 24 months, they should be able to use at least 50 words, use two-word phrases frequently, use simple sentences such as ‘I want milk’, name simple body parts such as their nose or eyes, sing simple songs like The Wheels on the Bus, and listen to stories and say the names of pictures.

By age three, children should have a vocabulary of many hundreds of words, and be able to compose sentences made up of three or four words, use plurals and pronouns (he/she), understand the concept of mine and his/hers and be able to identify almost all common objects and pictures.

By age four, they should have a vocabulary of more than 1,000 words and be able to compose sentences of four or five words.

Children this age also tend to talk constantly and argue with their peers, and ask questions like ‘Why?’ even when answers have already been given.

"Comparing kids isn’t the best idea, as each one is different. What’s more important is that she’s reached those speech and language milestones that are expected of kids her age."

What can I do to encourage my toddler’s language development?

“This is basic advice, but I suggest you interact with your child,” says Agnieszka Debowska, senior speech-language therapist and founder of Bubblebee Speech Therapy Centre.

“Go down to her level – this may mean laying flat on the floor. When she sees your face, she will be better able to read all the nonverbal cues of speech.

“It will also allow you to see what your child is interested in. Once you know what’s on her mind, you can say the right words. Don’t overwhelm your child with talking but try to describe what the both of you are doing, highlighting the key words. Stay engaged with your child and keep the interaction fun.”

Lisa suggests activities like reading to your little one, telling her stories and playing with cause-and-effect toys, which not only encourage hand-eye coordination but also offer sensory exploration and present the opportunity for simple repetitive actions and play.

Always follow her lead, but don’t use mobile devices or computers – basically, anything with a screen – when trying to teach her how to talk, because these have been shown to negatively affect speech development, Agnieszka says.

My caregiver talks to my kid in Singlish and broken English. Will that harm my little one’s language development?

It’s inevitable that your toddler or preschooler will pick up these words if they are used around her all the time, says Magan Chen, a speech and language therapist and founder of Leo Magan, a speech therapy and language therapy centre.

Fortunately, you can help her speak better.

“If you hear your little one using broken English or saying Singlish words like ‘lah’ or ‘meh’, you should point out that that is not good or correct English, and instead, model the right way the sentences should be said.

“Be sure to also speak proper English when you are around her. She will soon understand the differences between good and poor English.”

Why doesn’t my three-year-old like to talk? I know he understands what I’m telling him.

“It’s impossible that a child doesn’t ‘like’ to talk,” Agnieszka says.

“Of course, personality does determine how much the child could be talking or with whom he will interact, but three-year-olds are not non- verbal by choice.

“If your little one isn’t talking when expected, it’s important to get the problem investigated by a speech and language therapist.”

There are many reasons as to why a young child may not be talking, Agnieszka adds.

It could be due to global developmental delays – when a child takes longer to reach certain development milestones compared to other kids their age – underlying disorders, oral-motor difficulties such as problems with using their mouth, jaw or tongue, or even issues with muscle tone or motor planning, just to name a few.

If you are worried that your three-yearold isn’t talking when he should be, get him assessed immediately, Agnieszka advises.

My four-year-old isn’t as articulate as his cousin of the same age, who is very chatty and knows many words. Should I be worried?

Comparing kids isn’t the best idea, as each one is different. What’s more important is that she’s reached those speech and language milestones that are expected of kids her age.

“Speak to your child’s kindergarten teachers and share your concerns with her paediatrician,” Agnieszka advises.

“They should be able to determine if there is indeed a problem. If you are concerned that your kid’s speech and language aren’t as developed as they should be, or your child clearly stands out from the rest of her peers, who all have extensive vocabularies and are chatty, then you should consult a speech therapist.”

At what age should I be worried that my child can’t pronounce specific letters like “r”? For example, my threeyear-old pronounces her friend Rory’s name as “Wowy”.

“Sounds develop at different ages as part of normal development,” says Evelyn Tay, senior speech therapist at Magic Beans, a speech and language centre.

“It is therefore common for children to present with certain speech sound errors when they are still learning to pronounce sounds correctly.”

The “r” sound, for example, is usually acquired at about five years of age, but of course, this varies from child to child.

The substitution of “w” for “r”, in the case of “Wowy”, is known as gliding and kids will typically stop doing it by about five years of age.

Evelyn says that if errors with the “r” sound persist beyond the age of five, you should monitor your child’s speech closely and get advice from a speech therapist.

Could my child have hearing loss? When should I take my kid to get his hearing checked?

Children get their hearing checked at birth, so if your little one has a hearing impairment, her doctor would likely have already pinpointed it.

Hearing impairments are rare, says Magan, but if you suspect that your little one is hearing impaired – for example, she doesn’t pronounce words properly and isn’t responsive when you talk to her – take her to a specialist to rule out hearing loss first.

The more likely reason for her hearing problem is an ear infection or a build-up of fluid or wax in the ear – these are common problems in kids that age that can affect their hearing.

If you’re worried that your child can’t hear properly and that this is affecting her speech, Magan suggests taking her to the doctor to get her ears checked or cleaned.

Is drooling past the age of three a sign of speech delay?

There are many reasons why a child continues to drool past the baby years, Evelyn says. Some common ones include weak and unstable oral structures (jaw, tongue and lips).

Mouth breathing, poor awareness or a developmental issue may also cause drooling, but it doesn’t necessarily indicate a speech delay on its own, she explains.

“However, this posture, as well as a reduced ability to move their lips, tongue and jaw, may impact your child’s speech development and the clarity of their speech sounds, all of which may increase his risk of speech delay.

If you’re concerned, consult a speech therapist to determine the cause of the drooling and find out if there’s a problem, Evelyn suggests.

Why does my kid say “fok” instead of “frog”, or “kwee” instead of “three”?

Such articulation problems may signal that your child isn’t moving his tongue properly or cannot hear the difference between the two sounds, which may indicate auditory processing disorder.

If you are concerned about the way he pronounces certain words, it might be a good idea to get advice from a speech and language therapist.

However, you can also help your child by pointing out that he is pronouncing “frog” and “three” incorrectly.

“Tell him it’s not ‘fok’ and ‘kwee’, and then demonstrate the right way to say those words,” says Magan. “He needs to be able to hear the differences between the right and wrong pronunciations.”

What should I do if my child stutters?

Kids who stutter know what they want to say, but can’t say it. “We don’t know the exact cause of stuttering, but many experts believe it is due to genetics,” says Magan.

“The first and most important thing you can do is to acknowledge the stuttering and let your child know that there are many different ways of talking.

“You can even demonstrate this by talking slow and then talking fast, or talking in a high voice and then in a low voice. The point is not to pretend that the stuttering doesn’t exist and to let your child know that stuttering is nothing to be ashamed of.”

It’s also important to reassure your child that he can take his time saying whatever he needs to say.

You can say something like, “Mummy and Daddy will listen to you, so don’t rush whatever you want to tell us”. Being patient with your kid will help build his confidence.

Some children stutter because they just don’t have an extensive vocabulary.

In this case, Magan suggests saying the whole sentence for your child before breaking the sentence down and then teaching him the individual words.

CAN SPEECH AND DRAMA CLASSES HELP KIDS WHO DON’T SPEAK MUCH?

“Speech and drama classes can be a good platform for children who have already acquired appropriate speech and language skills for their age.

“However, they may not be appropriate for those who may have a pre-existing speech or language delay; they are not the appropriate intervention for children who have yet to develop their speech and/or language.

“A more appropriate route could be speech-language therapy to develop their communication skills first.” – Jona Esquivel from Headstart for Life