Speech FAQs

How do you know if you have a speech, language or hearing problem?

• A speech or language problem refers to any deviation from the assumed normal or standard speech or language pattern in your specific natural and regional environment.
• A speech or language deviation:
  • attracts attention to itself (conspicuous)
  • Interferes with communication (unintelligible)
  • Causes the speaker or listener to feel uncomfortable (unpleasant)

How do you know if your child needs a speech and language evaluation?

A speech-language pathologist should be contacted when any one of the following conditions exists. If your child:

• Is a "late talker," "quiet baby," and not talking much by 2 years of age.
• Has poor speech intelligibility at 3 years old (most children have nearly 100% speech intelligibility at 3 years of age).
• Leaves off beginning or ending consonants after age 3 years.
• Isn't using 3-4 word sentences at age 3 years.
• Word endings are consistently missed after age 5 years.
• Has sentence structure that is noticeably faulty at 4 years.
• Is disturbed about his/her speech during any of the preschool years (common behaviors of children who have difficulty talking are shyness, playing alone, covering mouth, refusing to try to talk, tantrums, shutting down, crying, etc.).
• Has non-fluent speech more than 50% of the time (stuttering).
• Has a voice that sounds too loud or too soft, monotone, or nasal and whiny.
• Has a voice that is too high or low for his/her age or sex.

How do you know if your child has normal nonfluency or stuttering?

Many children between the ages of two and six years may engage in periods of dysfluent speech when they are tired, excited or apprehensive about their lack of talking clearly. This is called Normal nonfluency.

Normal nonfluency is the repetition of sounds, syllables, words or phrases, the prolonging of sounds and pauses, or the use of sounds like “um” or “ah”. A three year old child will often repeat a sound like “s-s-s” or a syllable like “cra-cra-cra-cracker”, or a word “like-like like” this. Repeating, pausing, backing up, holding on to sounds, and general confusion of “thinking and talking” are very typical as children are learning to talk. Children between two and four years have many experiences they want to talk about but don’t have the fast muscular coordination it takes to express themselves smoothly. It is therefore easy to understand why their speech may be dysfluent during these years.

Too often, however, parents call this normal nonfluency “stuttering”. The mismanagement of nonfluency can develop into stuttering. The “do’s” and the “don’ts” that follow are the kind of things that are very important in helping you avoid the problem of stuttering. As one who has seen so much unhappiness because of this problem, I can say that the proverb “An ounce of prevention is worth a pound of cure” fits perfectly.

There are definite ways for you to react to your child’s nonfluency. The following suggestions reduce his chances of becoming a stutterer.

• Pay attention when your child talks to you. Let him know you are listening. Give him your time and attention when he has something urgent to say. Remember that he wants to share his feelings, experiences and ideas with you. Let him know you are interested. Don’t rush him!
• If you are in the middle of a task, like doing dishes, stop for a minute. Bend down so that you and your child are on an eye-to-eye level, and listen. A little touch on the arm or scooping him close to you will let him know you are really listening. When a busy parent comes home to sit down and read the paper or catch a few minutes of television, this may be the very moment your child takes to come running to tell you about his day. Put down the paper, turn away from the television and pay attention to him, this won’t take very long.
• Don't put him on exhibition for relatives and friends by having him recite stories and little rhymes. Don’t coax him to say “hello” or talk when he doesn’t want to. When he feels like talking, he will. If you are concerned about his developing manners, just use them yourself! Be his role model and he will copy you.
• Don't insist that he talk if he's crying, has hurt himself, or is obviously upset. These situations will almost always disrupt his fluency. Calm him down first. Comfort him and stop the heavy sobbing before you ask him what happened.
• Do keep your own speech slow and easy to understand when you are talking or reading to him. Let him hear talking that is easy for him to copy.
• Don't interrupt him when he's talking, or complete his sentences out loud. He will not like your interruptions. All he wants is a good, attentive listener. He shouldn't have to worry whether you'll let him finish.
• Don't make suggestions to him about talking in a better way. Never make comments like "Slow down", "Count to ten", or "Start over". This advice only gives a strong idea that something is wrong with the way he talks. It makes him think that his speech is not good enough to please you.
• Do avoid situations where he will feel that he's failing. Encourage him to play games and to do things he does well. Don't tell him "Grow up", "Stop acting like a baby", or "You can say that better if you want to or try harder." The amount of nonfluency in his speech development will often depend on how he thinks about himself. Build his self-ego with kind, praising comments on all the actions he does well.
• Do empathize with your child's feelings. If he is frustrated and complains "I can't say that word", or "I can't talk right", then let him know, by explaining, that some words give you trouble too. Convince him that you have trouble talking sometimes also and must talk easier.
• If he seems to become startled or upset by saying words nonfluently, you should calmly reuse the words in a natural and typical way. If he says "Billy broke my t-t-t-toy", you might say, "Did he break your toy? Where is it? Let's go see if we can fix that toy".
• There will be days when things are going well and he is much more fluent. Take advantage of these times to let him talk. Suppose he comes in from playing, really wanting to talk and tell you what's been going on, and he starts out without any hesitations or repetitions. Join in by asking him easily to tell you all about it. Don't ask too many questions, though. Just let him go. Suppose however, he starts out with a lot of repetitions and hesitations. Then choose your questions carefully. Ask questions that take short answers. "Were you having fun?" (He can answer "Yes", "No", or "Uh uh"). "Who were you playing with, Mary or Billy?" In this instance, ask a question that will take a short specific answer. Take the pressure off him so he won't have to struggle to tell you what's been going on.
• Do tell other people not to imitate or joke about his nonfluent speech. This includes his brothers, sisters, other relatives, friends, babysitters, and especially grandparents. Be very definite and outspoken about how you want others to react to him when he is nonfluent. They should ignore it.
• Do not discuss his nonfluency when he can overhear you. He should not be made to feel that the way he talks is special or wrong.
• Refer your child to a speech/language pathologist for a complete fluency evaluation:
  • When your child is dysfluent more than 50% of the time;
  • When you or your child are bothered by his dysfluency;
  • When the dysfluency is accompanied by any secondary characteristics (such as eye blinks, facial grimaces, abnormal head or jaw movements, jerked body movements);
  • When there are frequent "failed communication episodes" with outbursts of crying or covering the mouth.

How can children maintain a healthy voice?

It is generally agreed that misuse of the voice is the most common cause of voice problems in children. This misuse can take many forms, such as:

• Yelling and excessively loud talking. This does not affect all children in the same way, but if a child has hoarseness, then such abuse should be discouraged.
• Using the voice to imitate cars, motor boats, machine guns, and the like may contribute to voice problems due to the unusual strain on the voice. Cheerleading, singing, and acting may add to the problem and should be carefully supervised.
• When a child has a sore throat and hoarseness, reduce all vocal activities, including talking, to a bare minimum. In the cast of severe laryngitis, vocal activity should be discontinued until the voice is healthy.
• Good physical health is important to a sound, healthy voice. Voice problems may be caused by such conditions as:
  • Upper respiratory infections that may result in swollen, inflamed membranes.
  • Repeated colds should receive medical attention.
  • Coughing is especially abusing to the vocal folds. Repeated or prolonged coughs should receive attention.
  • Infected tonsils may spread infection to the laryngeal area.
  • General poor health tends to be reflected in one's voice. We are all familiar with the observation of, "You don't sound as if you feel well."
  • Emotional problems also show up in one's voice. A normally speaking child may develop hoarseness under conditions of unusual strain. Sometimes these factors involve:
    • Sibling rivalry in which one could may be trying to keep up with, compete with, or take attention away from another child in the family who for some reason poses a threat to the child. a€¨Disrupted home and family relationships may contribute to emotional problems that may emerge as voice problems.
    • Individual differences make it difficult to understand why one child may engage in a given behavior with no apparent adverse effects on his voice while another child suffers a severe penalty for shouting, coughing, or excessive talking. Being aware of the causes of voice problems, tuned in to them, and aware of remedial procedures should do much to help all children learn to use their voices most efficiently.

Vocal Hygiene Rules

All of us want to maintain a healthy, well-sounding, clear and confident voice. To do this, we must actively participate in a daily vocal hygiene program.

• Avoid shouting, screaming, cheering, and excessive, loud laughing.
• Do not make strange noises with your voice, like speaking while inhaling, abrupt glottal attack, or strange vocalizations like imitating machine guns, motors, airplanes, etc.
• Avoid talking in noisy places - over machinery, lawn mowers, motor cycles, etc., for long periods of time.
• Talk easily without pushing or straining muscles of the throat, neck, or larynx.
• Talk with adequate loudness, at the best pitch for you with a good moderately slow rate.
• If you have a case of laryngitis, rest your voice (avoid talking) as much as possible.
• Stop smoking.
• Keep in good health with moderate regular exercise, three times weekly for approximately 30 minutes.
• Use alcohol in moderation. Add more ice or water to your drinks.
• Wear both seat belt and shoulder strap when riding in auto. An abrupt stop could throw you against the dash board or steering wheel and damage your voice box (larynx).
• Remember, it's not what you say, but how you say it. And you want to be able to say it a long time.

Expressive Language Developmental Guidelines

By 3 Months, A Child Should:

• Use differential cries
• Coos and gurgle
• Produce single syllables

By 6 Months, A Child Should:

• Begin babbling
• Use self-initiated vocal play
• Repeat self produced sounds
• Vocalize to people happiness and unhappiness
• Use 12 different phonemes
• Call for attention
• Laugh, coo, and respond to adults entering room

By 12 Months, A Child Should:

• Use 3 to 20 one-word phrases (Ex: momma, dada, bye-bye)
• Love to vocalize during play using a variety of intonations
• React to your voice (really knows your feelings)
• Use 18 different phonemes
• Stop and look when you call their name
• Play “Peek-A-Boo”

By 18 Months, A Child Should:

• Use at least 20 words and 21 different phonemes
• Jargon and echolalia are present
• Uses a lot gestures
• Uses words such as “no, mine, more, up,” and expressions such as “ut-oh, what’s that, and all gone”

By 2 Years, A Child Should:

• Use up to 270 one-word phrases and 25 different phonemes
• Not using much jargon or echolalia
• Averages 75 words per hour during free play
• Talk in several two to three word phrases with speech intelligibility of at least 65%
• Name common objects and pictures
• Uses phrases such as “I want, go bye-bye, up daddy, and ball all gone”

By 3 Years , A Child Should:

• Use 900 words in 3-4 word sentences
• Average 175 words per hour
• Ask and answer simple questions
• Have speech intelligibility nearing 100%
• Be able to tell a simple story and talk about past events
• Use all vowels correctly
• Begin sentences with “I” instead of “Me”
• Use the following sounds consistently /p/, /b/, /m/, /h/, and /w/

By 4 Years , A Child Should:

• Use up to 1500 words in many 5-6 word sentences
• Average 400 words per hour
• Be asking many questions in conversation
• Be able to sing a song and recite a poem from memory
• Be able to name primary colors, know some coins, and relate fanciful tales

Hyman Hearinga€ & Speech Center
5950 Airport Hwy St.
Suite 17€
Toledo, OH, 43615€
Phone: 419-865-7500 
Fax: 419-865-8532
E-mail: hymanhearspeak@aol.com