Speech: Evaluating your toddler's speech

My youngest child has an overbite on the bottom jaw. He can only say "mama" and "dada" and "go" well enough for us to understand. How can we know if he is on target with his speech?

Question:

There are several areas that should be considered in assessing a child's ability to communicate:

  1. oral motor and feeding problems
  2. articulation
  3. language
  4. voice
  5. fluency.

Perhaps your son's difficulty may be an articulation and/or language problem.

Articulation involves making speech sounds by varying the breath and by using the lips, tongue, teeth, and palate. Certain conditions can cause mild to severe distortion of sounds. There is a sequence of sound development that has been devised based on age. For example, about the age of two, "m", "n", and "h" sounds are correctly produced. At about two and a half, "p", "b", "ing", "w", "d", and "g" are clearly enunciated. At these age levels, speech may only be easily understood by people familiar with the child. By three, 80 to 90 percent of the child's speech should be easily understood by most people. Again, this sound development is based on average ages.

Language development is more complex. A child may have the inability to understand language or express language or both. While language learning may proceed in a somewhat predictable order, there is some variation in the expression of language skills. If there is excessive delay in production of words and phrases or inability to participate in conversation, this may not indicate a long-term problem, but it should be investigated. This investigation can be done by a speech pathologist with the participation of a dentist.

A speech pathologist is involved in assessing the structure and function of the mouth, jaw, pharynx, and larynx. Possible tools for this assessment may include video-fluoroscopic x-rays or naso-endoscopy during speech and swallowing. These diagnostic procedures can be extremely helpful in determining if structural and/or functional problems exist which may adversely effect speech. In the case of your son, some of these diagnostic procedures may be unnecessary if it is determined the jaw development is contributing to his speech pattern.

A speech pathologist may be available through a local community health center or hospital. Private practioners are also available, and some speech pathologists are more specialized than others. A pediatric dentist or a general dentist should also be able to make a referral to a speech pathologist. A referral should be made if a child is not babbling a wide variety of sounds by eight to ten months and is not easily understood by caregivers by two years old. There are other conditions for referral, but these sound most pertinent to your situation. Assessment and treatment by a speech pathologist should be coordinated with a dentist. In this manner, proper speech and dental treatments can be coordinated for the best results.

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