Images of speech bubbles, mother and child and a speech therapist and child.

How do we assess and manage a child with speech delay?

It can be hard to know when to seek support for your child’s speech, and when seeking support what to look for and how to ask for it. This article will help give you an about how to assess and manage a child with speech delays and discuss the difference between speech disorders and delays.

Understanding Speech Delays in Children

Speech difficulties are a common part of childhood development and most people will have had some quirks to their speech within their lifetime. Problems like a child saying ‘pasghetti’ instead of ‘spaghetti’

or ‘wabbit’ instead of ‘rabbit’ are common and usually not a sign for intervention. While occasional speech mistakes are expected it’s important for parents and caregivers to understand the difference between what is developmentally typical and what may indicate a speech delay or disorder.

Speech delay vs disorder

A speech delay means that the types of speech error being made are common in children younger than yours. Think of saying a ‘w’ instead of an ‘r’, this is a common error for children under 6 years but if a child is 9 and says ‘wobot’ and ‘wabbit’ instead of ‘robot’ and ‘rabbbit’ then they have what’s called a ‘speech delay’. Speech delays can be broken into mild, moderate, and severe depending on the amount of delay and number of issues.

A speech disorder means that the types of speech errors being made are not common for any age. This may involve your child saying ‘cat’ and ‘car’ as ‘nat’ and ‘nar’ or ‘bat’ and ‘book’ as ‘at’ and ‘ook’. These errors are often more noticeable because they don’t always follow predictable patterns and can make it more difficult to understand what your child has said.

Speech pathologists are trained to look at the specific speech patterns and errors being made and consider what is and is not common for your child’s age. Speech pathologist will also consider a range of other conditions like articulation disorders or apraxia of speech.

When Should Parents Be Concerned?

Parents and caregivers are often best at understanding their child and may find it surprising when educators, family or friends recommend seeking a speech pathologist.

While it is normal for kids to not be able to say every word and to struggle with some sounds, it can be difficult for parents to know when professional help is needed. Some general questions you can ask yourself are:

Is my child struggling to express themselves because of their speech
Does my child become upset or frustrated when others don’t understand them
Is my child self-conscious of their speech
Is my child struggling to learn to write because of their speech

If you find that your answers are yes, it may be worth seeking out a speech pathologist for assessment and treatment.

Another important consideration is how much you can understand of your child’s speech versus how much unfamiliar people can understand, if you find there’s a large gap between them it may indicate that your child has problems with their speech.

In Australia kinder teachers and preschool field officers may also provide you with guidance around when you need to seek support and may be able to pick up specific sounds that need some work.

Practical Strategies Parents Can Use at Home

While you look or wait for a speech pathologist there’s some things you can be doing at home to support and develop your child’s speech at home.

Highlight specific sounds using gestures or stressing the sound in words. Don’t ask your child to say the word back it’s enough to have them listen the sound.
Show how the sound is made and what your mouth is doing. You can do this by slowing down and getting face to face with your child, try holding what you’re talking about next to you lips while slowing down on specific words.
Break down longer words into syllables, you can do this with clapping or pointing at real world objects to show how many syllables are in the world.
When you hear your child saying words with a mistake say it back to them correctly.

When using these strategies it’s important to model without expectation. That means that we’re showing them how to make the sound without directly asking them to copy what we’re saying. We do this to make sure that speech practice is fun making it more likely that they’ll join in, we also want to reduce feelings of self-consciousness about their speech.

How Speech Delay Is Assessed

In your first speech session a speech pathologist will complete some speech screening tools, the main one involves showing your child pictures and asking them to name what is on them. Each picture is carefully selected to make sure we hear each sound at the start, middle and end of the word.

Once this screener is completed a speech pathologist will want to hear your child speak in conversation, this is important as often speech mistakes can happen in conversation but not with single words.

Depending on the results of the screeners a speech pathologist may also complete what’s called an oro-motor exam, this is a test which considers your child’s mouth movements to make sure that they are physically able to produce all sounds.

Find out more about speech assessments at Moi!

Speech Therapy: What It Involves

If your clinician completes a screener or assessment and feels your child would benefit from speech pathology sessions they will typically discuss a treatment approaches and how often sessions and home practice need to be completed. Typically sessions will happen weekly or fortnightly with home practice provided between each session.

Some common speech therapy treatments are:

Minimal pairs
Maximal oppositions approach
Articulation therapy
Core vocabulary
Nuffield

Tracking Progress and Celebrating Small Wins

Speech therapy can take time and it’s important to constantly monitor the progress being made both at home and in clinic. If you feel like your child has plateaued or regressed it’s important to talk to your speech therapist as external factors may be impacting out comes or a new treatment approach may be needed.

It’s also important to celebrate speech wins when they happen, working on a specific sound doesn’t necessarily mean they will be able to make that sound in conversation immediately, your child will likely need a stepped approach working first on sounds, then words, phrases and finally in conversations.