Parents tend to put as much emphasis on their baby's first word as they do on the first time he takes a step. Remember that the speech milestones are guidelines. Not every baby begins to use single words (or sentences) at the same age.

Normal Speech Problems

Sometimes parents are concerned about speech problems that are actually temporary, normal, and unavoidable. A common concern is when a child in early elementary school is not able to pronounce the s or th sounds. Because children of this age lose their front teeth, and front teeth are needed to make these sounds, the problem is unavoidable — at least until the permanent teeth grow in.


Speech represents a child's understanding of language and his ability to use it. Speech and language are necessary to function in life, and begin to develop very early. Contact your doctor with concerns about your baby's speech development. A true speech delay can be caused by many things (medical or developmental) and should be addressed as soon as possible.

Physical Disabilities and Speech

Some speech problems have a physical cause requiring intervention. Before surgery, a child with a cleft palate does not have the closure of mouth and lips needed to make all speech sounds. Other children have difficulty because of the structure of the tongue and lips or the ability to use them correctly. Some children cannot speak properly because of problems with tonsils, adenoids, or severe allergies.

Impact of Other Disabilities on Speech and Language

Very often, disabilities don't show up alone. Speech and language difficulties are not uncommon tag-alongs with other kinds of special needs. Many children with developmental delay or learning disabilities have difficulty with language. They may show delays in understanding vocabulary or in putting words into sentences.

In many instances, these children do not understand what is being asked when questioned. When asked what they ate for lunch, for example, they may respond by explaining where they ate. In some cases, they do not understand that the speaker is even asking a question that requires a response.


Work with your child's speech and language therapist and his teacher to monitor the time he misses class to attend speech therapy. Speech and language are critical skills, and yet there is a time when the effects of missing lessons in reading, math, and science outweigh the benefits of continued speech instruction.

Selective Mutism

Some children are physically able to speak, but do not do so. This may take place in all areas of the child's life or only in a few places (at school or in large groups). There are several possible social or emotional factors that can cause selective mutism.

Hearing Loss and Speech

Hearing loss impacts a child's speech and language. He cannot say what he has not heard, or he says something in a way that he has heard it — possibly missing or substituting some sounds according to the loss.

A hearing loss that affects speech may or may not be permanent. While some children have a permanent hearing loss, others have fluctuating hearing loss that can be caused by fluid in the middle ear. This fluid can be the result of ear infections or allergies. If a child has frequent ear infections, he may be missing valuable words and language.

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