Childhood speech and language issues are not uncommon. In fact, delayed speech or language development among the most common childhood speech and language issues, according to the University of Michigan Health System.
The types of speech and language issues children can experience vary greatly. While some disorders affect how children physically form words, other issues involve a child’s social skills or how language is processed and understood.
The cause of some speech and language problems can be identified but many have no known cause. Experts encourage parents to seek out a professional evaluation if they feel their child may have a delay.
“If a child isn’t talking by age 2, they need to have an evaluation by a speech and language pathologist,” says Nancy Kaufman, owner and director of Kaufman Children’s Center in West Bloomfield. “That doesn’t necessarily mean they have a problem, but they need to be evaluated.”
Parents should also understand the importance of early intervention for kids who have speech and language disorders, Kaufman says.
“They should be seen as early as possible,” she says.
Here’s a look at the most common types of speech and language issues affecting children.
1. Speech or articulation delays
Speech refers to the motor or mechanical aspects of talking, Kaufman says. Speech issues include stuttering, difficulty combining vowels and consonants or problems with the pronunciation of words. Physical problems, such as cleft lip or palate, can also affect a child’s speech.
Childhood apraxia of speech, a less common speech disorder, means a child has difficulty making accurate movements with their face, tongue, lips or jaw to form speech.
Certain speech errors that parents notice may not require speech therapy.
“There are speech errors that are common and don’t require intervention,” Kaufman says, pointing out that most articulation errors should be corrected by about age 5.
2. Expressive language disorders
An expressive language disorder causes problems with verbal expression.
“This is where kids have difficulty combining words to formulate their thoughts,” Kaufman says.
A child might leave out auxiliary verbs or start sentences with a possessive pronoun, such as “her go” instead of “she is going.”
“They really should have expressive language completely in place by age 5,” Kaufman says. “It is still important to work on expressive language as early as possible, because the next layer that is tied to speech and language is literacy.”
Speech and language pathologists work with children on early phonics, sound-letter associations and pre-literacy skills that help them to be effective with later academics, she says.
3. Receptive language or language processing disorders
Some children with language processing disorders hear words but have trouble decoding them in their brain.
“Sometimes what people think is a delay in speech is really a delay in receptive language,” Kaufman says.
As children mature, it can be difficult to know whether they are truly comprehending language or simply memorizing routine and repetitious language, she says.
“It can be very difficult for parents to realize whether or not their children are understanding language well and that’s because so much language can be memorized,” Kaufman says. “Parents are pretty much using very routine and repetitious language to their children – ‘Go get your shoes’ or ‘It’s time for a bath.'”
4. Social and pragmatic speech issues
Pragmatic language is another important aspect of a child’s development and relates to understanding semantics and the appropriate use of language in social situations. Children with a pragmatic speech delay or disorder may talk excessively without noticing the listener isn’t interested, for example, Kaufman says.
“Are you engaging the listener, are you looking for nonverbal communication to let you know whether your verbal interaction is successful, are you allowing turn taking in the conversation,” she describes.
This also includes making eye contact and understanding the social rules at school or in other situations, says Alyssa Capeling, a senior speech-language pathologist at Children’s Hospital of Michigan.
5. Voice disorders
Though they are less common in children, voice disorders can also affect a child’s speech and language.
“The most common is vocal cord nodules or polyps. That causes a hoarse voice,” Capeling says.
This can be caused by too much air pressure or speaking too loudly, which can damage the vocal cords, she says.
This post was originally published in 2015 and is updated regularly.