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Articulation Fluency Disorder/Stuttering Language Disorder

Speech and Language Disorders in Children: More Than Meets the Mouth


November 09, 2017

Speech and Language Disorders in Children:  More Than Meets the Mouth

Three-year-old Janelle notices her babysitter is pregnant. Janelle looks up at her and says: “Dummy. You dummy.” Her babysitter retorts: “That’s not nice!” and puts Janelle in time-out.  

Eight-year-old Malika writes: “Man set traps and catch tiger and go zoo.” His teacher jabs a finger at the paper on his desk, shakes her head. “What is this? You need to do better than that or you’re never going to pass the proficiency test.” Malika puts his head down on the desk.

Ten-year-old Joey gets another “F” on his social studies test. He rips it up, and tosses it into the trash.
Fourteen-year-old Elena gingerly approaches several classmates who are discussing an upcoming softball game. She taps the tall girl on the shoulder and says: “I went to Boston last summer. It was really cool.” Her classmates stop, stare, then turn their backs and continue talking. Elena feels a lump forming in her throat.

Besides their obvious angst, what do these children have in common?  A speech-language disorder. As a speech-language pathologist (SLP) for over forty years, I have witnessed the devastation caused by speech and language disorders, especially when they go undiagnosed. Children have been labeled “weird,” “lazy,” and “stupid” when in reality they are trying their best—  they just have a challenge beyond their conscious control. What can we do?  First, we need to become more aware of speech-language disorders in general.  Second, we need a checklist to help us identify red flags. Third, all those involved in the care of the child need to work together to better support them; to prevent the emotional chaos which can result from their language deficits.  

To start, here’s a basic overview of speech-language disorders. The words speech and language are often used together as they’re intrinsically related; however, speech refers to the actual sounds and words of spoken language, while language refers to the broader category of words and symbols and their meaning.  Many adults fail to refer a child for a speech-language evaluation because he “talks just fine” (usually meaning his articulation and syntax sound normal). But overt speech is only the tip of the language iceberg. Problems can occur in any of the four following areas:  

  1. Articulation: How sounds are produced to form intelligible words and sentences. When Janelle said “dummy,” she meant “tummy.”  As we saw with her sitter’s reaction, one incorrect sound can ruin an entire conversation!
  2. Syntax: Grammar or sentence structure. Malika’s sentence certainly showed problems in this area.  
  3. Semantics: Meanings of words, including vocabulary and concept development. A child who struggles to understand and express complex sentences at age level has problems in the semantics of language, which is often reflected in low grades, like Joey’s “F”.
  4. Pragmatics: How we communicate in daily life. If a student has difficulty taking appropriate turns in conversation, or makes irrelevant comments like Elena’s, that child likely has difficulty with social or executive use of language— also termed a pragmatic language disorder.

With these areas in mind, here’s a quick red-flag checklist:

  1. Speech sound difficulties (e.g. “My tee-tat ih back” for “My kitty cat is black”)
  2. Sentences are less complex, or show grammatical errors (e.g. “Otherwise that boy gotta open his umbrella he stay dry”)
  3. Academic, attention, or emotional/behavioral difficulties
  4. Problems conversing easily with peers and adults

If the child shows one or more of these symptoms, a speech-language evaluation is warranted. The SLP can then take the lead, setting up a team as needed to assess for other possible co-existing disorders. Then, addressing all challenges, including specific language goals, the team can work together to improve quality of life for children like Janelle, Malika, Joey, and Elena.  However, since good speech and language correlates with success in almost every activity of daily living, all children can benefit from language enrichment.  I could offer thousands of language games gathered over my SLP lifetime!  But in this limited space, I’ll share my “Three R’s”:   

  1. Reflect: Say the child’s words back to them, then add a thought or question to show interest.  For example, if the child says: “We saw a movie at school today,” say: “You saw a movie! Wow – what did you think of the main character?”
  2. Read ‘n Rock: Model your enthusiasm for reading! Reading is just speech and language written down, so it’s one of the best ways to enhance all four language areas, especially when you do it together.  What rocks for your child? Pirates? Sharks? Mountain climbing? Spy stories? Pick a favorite lounging spot, turn off all devices, and disappear into other worlds through the magic of books!  
  3. Real time: There’s nothing like hands-on experience to enrich language! Take advantage of family trips: museums, movies, airports, festivals, zoos, water fronts— the list is endless! Then talk, talk, talk about your experiences. To enhance vocabulary, categorize as many objects as you can, e.g. a beach trip - sand, waves, seagulls, beach towels, lifeguards, etc. Play “I Wonder” for inferencing skills: “Hmmm. That tree fell to the ground. I wonder what happened…” Compare and contrast: “What do an elephant and giraffe have in common? What’s different?”  These language games enhance crucial reading skills as well.

I highly recommend the book Verbal Intelligence, by Carmen McGuiness. This language treasure trove offers many more fun language games, and for fascinating information about language and learning in general. Daniel Webster once said: “If all my possessions were taken from me with one exception, I would choose to keep the power of communication. For by it I would regain all the rest.”  Surrounding our children with a language-enriched environment will reap many benefits throughout their lifetime— and yours!


Carol Kauffman, M.A./CCC-SLP. Carol is a speech-language pathologist, in practice for over forty years, and founder of Language Learning Consultants, providing educational materials and services to enhance speech and language development in children.
Contact her at

Articulation Fluency Disorder/Stuttering Language Disorder

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