$Unique_ID{PAR00153} $Pretitle{} $Title{Medical Advice: Speech Problems and Stuttering} $Subtitle{} $Author{ Editors of Consumer Guide Chasnoff, Ira J} $Subject{Speech Problems stutter stutters Stuttering problem stammer stammers stammering speak speaks speaking spoke spoken sing sings singing read reads reading monotone nasal quality vocabulary vocabularies pronunciation pronunciations brain centers larynx voice box throat nose palate tongue lips hear hears hearing babble babbles word words sentence sentences sound sounds alphabet deaf deafness mental retardation language languages exposure brain damage physical abnormality abnormalities listen listens listening listened} $Log{} Your Child: A Medical Guide Speech Problems and Stuttering Quick Reference SYMPTOMS - Marked delay in achieving speech - Continued stuttering or stammering HOME CARE - Speak to and listen to your baby in order to encourage speech. - Correct a child's speech gently. Never punish or ignore the child for incorrect speech or try to make the child practice speaking. - Do not get angry or anxious if the child stutters, and don't let other children tease or ridicule the child. PRECAUTIONS - Consult your doctor if your child's speech patterns do not appear to be developing according to the normally accepted timetable. - Children learn to speak by imitation. Speak, sing, and read to your child. - A child who is not speaking clearly should not be forced to practice speaking, be deliberately misunderstood or teased, or have attention drawn to his or her speech. - Consult a doctor if your child speaks only in a monotone, has a marked nasal quality to his or her speech, or seems to be regressing rather than improving in vocabulary or pronunciation. - Stuttering between the ages of two and five years old is not a problem unless it persists for several months. - Severe, constant, or prolonged stuttering requires professional attention. Children learn to speak by imitation, but they learn at different rates depending on their intelligence, their hearing, and their control of the muscles involved in speaking. Speech may be delayed or impaired if the speech centers in the brain are not normal, or if there is any abnormality of the larynx (voice box), throat, nose, tongue, or lips. Speech development also depends on how often a child hears speech and how much he is encouraged to speak. Because of the wide range of individual differences in learning to speak, parents should not be unduly alarmed if their child does not reach a certain stage exactly "on schedule." A general timetable for speech development includes the following milestones: By the age of four to six months, most babies have begun to babble and to make letter-like sounds. By eight months, most children have achieved a typical baby vocabulary, using such "words" as "goo," "ba-ba," and "da-da." By 12 months, most babies will be using two-syllable "words" meaningfully ("ma-ma" for mother, "ba-ba" for bottle), and by two years old will be connecting words purposefully ("go bye-bye," "want cookie"). A child of five years can generally speak five-word sentences, and by the age of six can make all the sounds of the alphabet, except perhaps the sounds for s and z. Children between two and five years of age often lack fluency and may stutter or stammer at times. If the lack of fluency or the stuttering or stammering continues, the child may have a speech problem. Speech that does not develop normally may also be due to partial or complete deafness, mental retardation, inadequate exposure to language, brain damage, physical abnormalities, or malfunction of the speech centers. SIGNS AND SYMPTOMS Any impairment of speech or marked delay in a child's achieving speech should raise the suspicion of a speech or hearing problem. HOME CARE If your baby is to learn to speak adequately, he or she must be spoken to and listened to. Incorrect speech should be corrected, but a child should not be scolded, deliberately ignored, or forced to practice speaking. Stuttering in children aged two to five years can be disregarded unless it is still a problem several months after its onset. It should not provoke anger or anxiety, suggestions that the child speak more slowly or more clearly, or laughter and taunts from brothers and sisters. Stuttering warrants professional attention if it is severe, constant, or prolonged. PRECAUTIONS - If your child's speech does not develop more or less in accordance with the general timetable, consult your doctor. - Do not refuse to understand your child or try to force him or her to speak more clearly. - Do not call the child's attention to stuttering. - Read, sing, and speak to your child whenever possible. - If your child speaks only in a monotone or with a marked nasal quality or if the vocabulary and ability to pronounce words are diminishing instead of improving, consult your physician. MEDICAL TREATMENT Your doctor will perform a complete physical examination, checking the child's throat, palate, and tongue, and testing the child's hearing. If your child is under the age of five you may be referred to a speech pathologist for evaluation and treatment if stuttering is severe, constant, or unduly prolonged; if the child seems to be severely frustrated in his or her efforts to speak clearly; or if you need assistance in handling your child's development of speech. If your child substitutes sounds or stutters after the age of five or six, your doctor may suggest that he or she be seen by a speech specialist. RELATED TOPIC: Deafness