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Speech and Language Disorders

What is a Speech and Language Disorder?

A child’s communication is considered delayed when the child is noticeably behind his/her peers in the acquisition of speech and/or language skills. Sometimes a child will have greater receptive (understanding) than expressive (speaking) language skills, but this is not always the case.

Speech disorders refer to difficulties producing speech sounds or problems with voice quality. This might be characterized by an interruption in the flow or rhythm of speech, such as stuttering (dysfluency), problems with the way sounds are formed (articulation or phonological disorders), or difficulties with the pitch, volume or quality of the voice. There may be a combination of several problems. People with speech disorders have trouble using some speech sounds, which can also be a symptom of a delay.

A language disorder is an impairment in the ability to understand and/or use words in context, both verbally and nonverbally. Some characteristics of language disorders include improper use of words and their meanings, inability to express ideas, inappropriate grammatical patterns, reduced vocabulary, and inability to follow directions. One, or a combination, of these characteristics may occur in children who are affected by language learning disabilities or developmental language delay. Children may hear or see a word but not be able to understand its meaning. They may have trouble getting others to understand what they are trying to communicate.

How is it manifested?

A child with speech or language delays may present a variety of characteristics, including the inability to follow directions, slow and incomprehensible speech, or pronounced difficulties in syntax and articulation. Syntax refers to the order of words in a sentence, and articulation refers to the manner in which sounds are formed. Articulation disorders are characterized by the substitution of one sound for another, or the omission, or distortion, of certain sounds.

Stuttering, or dysfluency, is a disorder of speech flow that most often appears between the ages of 3 and 4 years and may progress from a sporadic to a chronic problem. Stuttering may spontaneously disappear by early adolescence, but speech and language therapy should be considered.

Typical voice disorders include hoarseness, breathiness, or sudden breaks in loudness or pitch. Voice disorders are frequently combined with other speech problems to form a complex communication disorder.

Who is affected?

The prevalence of speech and language disorders is estimated to be approximately 2-19% of children aged 2-5 years old, with a 2:1 male to female ratio. The overall estimate for speech and language disorders is widely agreed to be 5% of school-aged children. This figure includes voice disorders (3%), specific language impairments (7%) and other speech disorders (i.e. phonology, stuttering (1-14%)). The incidence in elementary school children who exhibit delayed articulation (phonological) development is 2% to 3%, although the percentage decreases steadily with age.

How is it diagnosed or detected?

Speech-language pathologists (speech therapists) diagnose and treat or remediate communication disorders in children.

Developmental paediatricians and paediatric neurologists will also sometimes diagnose a speech or language disorder and refer the child to a speech-language pathologist for treatment.

Additional Resources:

Early Abilities (formerly known as Toronto Preschool Speech and Language Services) This is a community-based program that provides services and information for children and families. It is for children from birth to five years of age who have trouble talking or understanding language.

Ontario Association of Speech-Language Pathologists and
The Ontario Association of Speech-Language Pathologists and Audiologists (OSLA) is the strong, collective, influential voice for the professions in the Province. OSLA represents, promotes, and supports its members in their work on behalf of all Ontarians, especially those with communication disorders, swallowing difficulties, or hearing health care needs.

Speech Foundation of Ontario (Toronto Children’s Centre)
The Toronto Children’s Centre is a specialty service for children with communication disorders. It provides intensive therapy programs for children, ages three to ten, with moderate to severe speech and/ or language disorders. All therapy is conducted in small groups with three to four children and one speech-language pathologist.

Books and Literature:

Communicating Partners, By James D. MacDonald
It is the result of over 30 years of clinical practice and research with pre-verbal and verbal children with language delays, including children with autism, Asperger Syndrome and Down Syndrome. With practical suggestions that are illustrated with personal anecdotes and grounded in research findings, the book offers an innovative approach to working with late-talking children that focuses on building responsive relationships and an understanding of the key stages of communication development.

Enhancing Everyday Communication for Children with Disabilities, By Jeff Sigafoos, Michael Arthur-Kelly and Nancy Butterfield
Practical and concise, this introductory guide is filled with real-world tips and strategies for anyone working to improve the communication of children with moderate, severe, and multiple disabilities. Emphasizing the link between behaviour and communication, three respected researchers transform up-to-date research and proven best practices into instructional procedures and interventions ready for use at home or in school.

Childhood Speech, Language, and Listening Problems: What Every Parent Should Know, 2nd Edition , By Patricia McAleer Hamaguchi
This essential, up-to-date guide explains what parents can do to help. Speech-language pathologist Patricia Hamaguchi employs her 15 years of experience to show parents how to recognize the most common speech, language, and listening problems.

A Parent’s Guide to Children’s Speech: A collection of full length articles and check-lists.
Canadian Association of Speech-Language Pathologists and Audiologists Article available at:
Parentbooks offers the most comprehensive selection of resources available anywhere — from planning a family, to everyday parenting issues, to special needs of all kinds. It also has a selection of resources for caregivers, counselors, therapists, educators, and clinicians.

The content contained in this document is for general information purposes. It is not intended to diagnose or treat a child.

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