“What led to my son’s speech delay? Was it the pandemic where the social interaction was less or did genetics lead to my child’s condition?” were the questions that a young couple from Bengaluru kept asking themselves. Their only child, a boy baby born in June 2019, could not speak like kids of his age even as he turned three. He is currently taking speech therapy for his condition.
Causes of speech delay in children
While speech delay can occur due to lack of stimulation in a child’s surroundings, some of the other causes can include social, physical, developmental, genetic and neurological issues.
In addition to this, Dr Swetha RD, consultant neonatologist and developmental paediatrician, Rainbow Children’s Hospital, Bengaluru, explains that a child’s communication can be divided into the following categories:
- Non-verbal communication (communicating with gestures)
- Receptive language (understanding instructions)
- Expressive language (response to spoken words)
A setback in one of these parameters for a child can result in speech delay at an early stage.
Dr Swetha stresses that by the time children turn three-years-old, they must be able to partially communicate. “If a child is not able to respond verbally at the age of three, they may be facing selective mutism (an anxiety disorder where a child is unable to speak in social situations).”
“Parents seek help when their child is not speaking at around two to four years old, as some parents are not aware of the speech milestones. They bring their child for an intervention only when their kin and teachers notice,” Dr Swetha said.
On the other hand, Dr Lakshmi Ananth, an ENT consultant at Sagar Hospitals, Bengaluru, points out that hearing loss is a common cause of speech delay in children and it can happen as early as during infancy. “Parents must be alert and take note when their child remains calm and does not respond to being called or react to any loud noises. The child should be examined by an ENT before turning six years old to treat this early warning sign,” she says.
Universal screening test for speech delay
Dr Ananth emphasises that early detection of hearing loss in children is possible with universal screening. “This is a test that can be done right after delivery. A probe is inserted in the baby’s ear and data is recorded which will roughly tell us whether the child can hear or not. If they do not pass the test, the child must be taken for further follow-up,” she says. Some children fail this test if they have wax in their ears or if high amount of amniotic fluid (fluid from the womb) remains in their ears after birth. However, the child recovers within one or two months and can pass the test.
In addition to these tests, Dr Swetha highlights the importance of taking a child for yearly follow-ups after being born. “The follow-ups give the doctors a chance to see the child’s overall development and detect any issues at an early stage,” she says.
Early interventions and communication
Talking about early interventions, Dr Swetha emphasises the importance of a child’s environmental modifications. “Some parents would tell us how the child interacted (babbling) and played with them up until six to nine months, then due to excessive screentime or busy work schedules of the parents, their child stopped communicating. We recommend speech therapy only after the environmental modifications are implemented,” she says.
Dr Ananth explains that if a child is recommended to wear a hearing aid, they must test his/her hearing ability before sending him/her for speech therapy. “Speech therapy will be recommended if a child can hear properly at one year of age. If the child cannot hear with a hearing aid, he/she will be treated surgically,” she adds.
The Bengaluru couple felt guilty for a long time as their son could not speak. “We then understood the development milestones. We only wish that our son speaks like all other kids,” the couple said, voicing the concerns of many such parents who have observed speech delay in their kids.
According to Dr Swetha, parents must be aware of the speech milestones that a child must achieve during his/her developmental stages.
Riddhi Mapari, a speech and language pathologist and audiologist at Dr Dhvani Gala Occupational and Speech Therapy Clinic, Mumbai, explains how the strategies are tailor-made for each child. “Modelling is a general activity we include in our strategies. In case of modelling, a child is taught what to say to a person or thing in a particular situation,” she explains.
Dr Swetha elaborates that parents must be aware of the early warning signs in their child that can lead to speech delay.
Takeaways
Effective ways to improve your child’s speech
- Avoiding excessive screen time.
- Encouraging human interactions, especially in playgroups.
- Talking slowly and stressing each word.
- Giving your child opportunities to talk.
- Checking with doctors during regular vaccination sessions to confirm if the child is meeting the speech milestones.
