Speech and Language Impairment

What are speech and language impairments?

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The term speech impairment covers a range of problems. One common speech problem is when your child has difficulty pronouncing certain sounds or words. Stuttering is another example of a problem with talking.Stutteringis when your child’s words don’t flow together or when your child can’t get the word out.

Language problems are different. They have to do with meanings, rather than sounds. Language impairments are usually more serious than speech problems (unless your child’s speech is beyond understanding).

Speech and language disorders are the most common developmental problem among preschool children. They affect 5-10 percent of preschool children.

More boys are affected than girls. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), between 6 and 8 million people in the United States have some form of language impairment.

Children with these problems also can have behavior problems. This may be due to the frustration they feel in trying to communicate. That is why it’s best to start speech and language therapy as early as possible.

What’s the difference between speech and language?

Speech and language are often confused, but there is a difference between the two:

  • Speech is the ability to make sounds and to talk.
  • Language is made up of how we put words together (expressive language) and is how well we understand what is spoken by others (receptive language). It means understanding and being understood through communication. Writing, sign language, sounds, and any system for giving and receiving information. It involves knowing how to carry on a conversation.

Although problems in speech and language differ, they often overlap. Your child might have only a speech problem or only a language problem, or both. Although we know many of the causes of these problems, sometimes the reason is unknown.

How can I tell if my child has a speech or language impairment?

You need to know what normal development is before you can know if your child is delayed. Click on KidsHealth for Parents for information on speech and language delays. This website will show what is considered to be average early language development by age.

What can I do to help my child?

You have made an important first step by reading more information on speech impairments. Another step you can take is to talk to other parents of children with speech impairments. They have gone through what you are going through now and may be able to help. You also can get great help from parent support and advocacy groups. Research tells us that the earlier we begin to help children, the better the results for the child and the family.


Getting Started


  • Get my child evaluated (tested):

    If your child is between ages birth to 3 years old, your child can be evaluated by a team of experts through the Early Steps program for free. Your child may be eligible for free services. You can contact one of the centers closest to your home.

    Early Steps


    For more information or to make a referral to Early Steps, please call (800) 218-0001

    or visit the contact list :http://www.floridahealth.gov/AlternateSites/CMS-Kids/home/contact/earlysteps.pdf

    If your child is 3-5 years old and has problems with learning, speaking, playing, seeing, walking or hearing, he or she can still receive free screening through the Child Find/Florida Diagnostic and Learning Resources System (FDLRS) program. They also provide testing for special education programs.

    Florida’s FDLRS Child Find


    Statewide Contact:

    Janie Register

    Bureau Liaison

    Florida Department of Education

    (850) 245-0476

    E-mail: Janie.Register@fldoe.org

    Contact list:http://www.fdlrs.org/images/pdf/contactlists/ChildFindContactList5.5.15.pdf

  • Contact Children’s Medical Services (CMS):

    CMS, with local offices, sometimes will refer children to medical centers that work with CMS. Services are provided to help care for children with disabilities, special needs or major medical conditions. These services range from early intervention programs such as Early Steps to ones for a specific medical condition.

    Children’s Medical Services


    Main Phone: (850) 245-4200

    Contact Form :http://www.floridahealth.gov/AlternateSites/CMS-Kids/home/contact/central_office.html

  • Work with my child’s service providers:

    A service provider is anyone who works with you and your child, such as your pediatrician, a physical therapist, a teacher, a principal, a social worker, or any professional. Remember that you know more about your child than anyone else and are the main influence in your child’s life. Service providers are there to help you and your child. Here are some tips for speaking with service providers:

    • Feel free to ask questions and make comments. Be specific about what you know about your child and what you want and need for your child. Be honest about what you expect, any worries you may have, or about anything you don’t understand.
    • If you think your child needs something (like a speech evaluation or assistive technology), keep asking until you get it or until you understand why it is not needed.
    • Work with professionals in early intervention or in your school to write your child’s IFSP or IEP. Be sure it includes related services such as speech-language pathology, physical therapy and occupational therapy. Don’t forget about assistive technology, too.

    Get more information: Visit more websites. Read a book. Watch a video on speech impairments. Include your child and family. Talk with another parent that has a child with Rett’s syndrome, who can help you meet other parents and get services

What Can I Do Every Day To Help My Child?

There are many ways you can combine what you do in an ordinary day to help your child’s development. Bath time, mealtime, shopping, traveling in the car and family outings are great times to help your child’s language and learning. Look below for some suggestions:

  • Carry your baby in a front pack while doing chores around the house: Talk with him or her about what you are doing. For example, “Mommy is putting the laundry in the washing machine. Do you hear the water going in and smell the soap, sweetie?”
  • Speak to your child regularly, using short sentences with simple words so he or she child can imitate you.
  • Model good speech for your child by being a good example: Repeat what your child says to you, using correct grammar or pronunciation. For example, if your child says, “Ball baybo,” you can respond, “Yes, the ball is under the table.” This allows you to demonstrate more accurate speech and language without actually “correcting” your child.
  • Take a walk around the neighborhood with your child and talk about the everyday noises you hear, e.g., dogs barking or cars and trucks driving by. Encourage your child to bark like the dogs, make motor noises like the trucks and other sounds.
  • Use a tape recorder or other device to record the family talking, sounds around the house and your child’s own voice: If your child is mature enough, let him or her use the recorder himself. It can be a fun way to have your child pay attention to what he/she says and to have more control over speech and language.
  • Sing with your child: Nursery rhymes are fun for everyone. Wee Sing has a collection of children’s songs and comes with an illustrated song book. The audio packages teach new and classic children’s songs. Great for the car or home. Little Language Songs for Little Ones by Laura Dyer is a CD collection of songs written with a specific speech and language goal in mind. You can try music therapy or music classes for older children.

How can I deal with all this?

First of all you need to take care of yourself!

Having a child with a disability is hard work. Yes, there are times of joy and celebration, but also times of heartbreak. It is easy to get overwhelmed.

Yes, you can make a difference in your child’s life by working with your child and therapists, doctors and teachers. But before you can take care of anyone else you need to be kind to yourself. Taking care of yourself is not selfish, but instead necessary. You can’t help your child if you are overworked and overstressed.

Figure out how to take care of your own needs. The next time friends or family say, “What can I do to help?” let them baby-sit or lend a hand so you can have some time to yourself. Below are some things you can do to “recharge your batteries”:

  • Do something that makes you feel happy, e.g., going out with a loved one or friends, taking a long bath, or a creative project.
  • Exercise is vital for your mind, body, and spirit: Remember to exercise — long walks, lifting weights, bike riding or an aerobic class. Whatever you do, make sure it is fun.
  • Talk with other parents of children with speech impairments.
  • Stay hopeful: Many parents find the following poem, “Welcome to Holland,” to be a comfort.

What are some causes of language impairments?

Here are some common causes of language problems. Click on underlined words for more information on each cause.

  • Hearing loss
  • Intellectual disability (mental retardation).
  • Premature birth.
  • “Extreme environmental deprivation” can cause delay: This means if a child does not hear others speaking, he or she will not learn to speak normally.
  • “Selective mutism”: Diagnosed when a child can talk, but does not. This happens mostly in situations when the child feels anxious, such as school.
  • Autism or Autism Spectrum Disorders:: Autism is a developmental disability with many symptoms, ranging from mild to severe. Nearly all children with autism have problems communicating.
  • Genetics: It “runs in the family.” Up to 70 percent of children with language impairment have at least one other family member with language impairments, too. Several researchers are studying twins in hopes of learning more about a possible family connection.
  • Developmental speech or language delays: When your child develops speech or language more slowly than other children.

What are some causes of speech impairments?

Below are some common causes of speech problems. Click on the words underlined for links for more information on that term.

  • Cleft lip and cleft palate:: This means the tissues of the mouth or lip did not form properly while the baby was growing inside the mother.
  • Conditions such as cerebral palsy, muscular dystrophy and traumatic brain injury can affect the muscles needed for speaking.
  • “Apraxia of speech”: Children with this condition have great difficulty planning and producing the movements of the tongue, lips, jaw and palate necessary for intelligible speech. Other names for this condition are verbal apraxia, developmental apraxia of speech, or verbal dyspraxia.

What effect do speech and language impairments have on my child?

That depends on how severe the problem is, the cause of the problem is, and if the child has other disabilities.

Your child – indeed everyone – learns by receiving and understanding information. A language impairment can get in the way with that process. Children who have difficulty communicating often do poorly in school because they struggle with reading and they find tests hard.

Speech or language disorders can make it harder for children to make friends. If your child has a speech impairment that makes him or her hard to understand other children might tease or pick on your child because he/she is “different.” Other problems can be frustration and low self-esteem.

Language impairments also get in the way of socializing, but in a different way. Children with language difficulties often don’t understand the same social cues that others understand without effort; it can make them feel lonely.

Early intervention can help a great deal. Click on the Early Steps for more information on Florida’s Early Intervention Program.

What treatment and tools are there for my child with speech or language impairment?

Many treatments and devices can help your child. The Individuals with Disabilities Education Act (IDEA) ensures that children with disabilities receive free, appropriate early intervention programs from birth to age 3 and throughout the school years (ages 4 – 21).

Technology has improved and increased much in recent years. Many more devices are available to help with speech or language impairments. Don’t worry if your child can’t type or push buttons; other ways can make the technology work. Enabling Devices has a children’s catalog of communication devices.

What does speech and language impairments mean about intelligence and learning?

Having a speech or language disorder does not mean that your child cannot learn. But how much and how fast they learn may be different. Your child will need support and extra time to learn.

Many children with language impairments also have other problems. A child with other disabilities should be evaluated (tested) by a qualified psychologist who can tell you if your child’s ability to learn has been affected. Sometimes children with speech or language problems have difficulties with behavior and attention. An evaluation by a psychologist can be helpful. You can have your child tested at one of several places. Click on the link below to find a psychologist for an evaluation.

You may be entitled to ongoing evaluations through the Early Steps program (birth to 3 years) and/or in a preschool program in the public school system that will check your child’s ability to learn and reason. Some parents also seek private evaluations.

Who are some professionals my child may need to see?

Your child may need to see many different health care specialists. For example:

  • Pediatrician: A doctor who specializes in treating children. The word “pediatric” in front of a professional’s title means he or she works with children.
  • Pediatric neurologist: A doctor trained in diagnosing and treating nervous system disorders, including diseases of the brain, spinal cord, nerves and muscles. Speech and language can be affected by problems in these areas.
  • Speech-language pathologist: A professional trained to evaluate and treat children and adults with voice, speech, fluency, language or swallowing disorders.
  • Audiologist: A specialist who tests for hearing loss.
  • Social worker and counselor: A professional who provides counseling and emotional support for the child and family, and may help coordinate services, too.
  • Care coordinator: An individual responsible for organizing the details across agency lines and serving as your contact to help you get services and assistance.
  • Early childhood special educator/special-education teacher: A teacher trained to work with your child, focusing attention on your child’s development and working with you to learn techniques to benefit your child.
  • Assistive technology specialist: A person who works with individuals with disabilities to provide assistive technology solutions. Those help a person with a disability to eat, speak, get around, work, play. An assistive technology specialist is familiar with many options to help your child live life to the fullest. Some services and assistive devices may be covered under Medicaid.

What are some websites where I can learn to help my child?

  • NICHCY http://www.kidsource.com/NICHCY/speech.html The National Dissemination Center for Children with Disabilities has information on disabilities in infants, toddlers, children and teens. For a fact sheet on speech and language disabilities, click on the following link:
  • Speechville Express http://www.speechville.com/index.html A resource for families, educators and medical professionals, offering information about speech and language development.
  • Family Guide To Assistive Technology (online publication) http://www.pluk.org/AT1.html by Katharin A. Kelker, Roger Holt, and John Sullivan (2000). This guide will help parents learn more about assistive technology and how it can help their child. Parents can better meet their child’s needs if involved in selecting and planning assistive technology.
  • For links to many sites on a variety of topics, click Speech Language Pathology http://www.herring.org/speech.html

Need books for either you or your family? The following are some suggestions:

Books for parents:

The Late Talker: What to Do If Your Child Isn’t Talking Yet by Marilyn C. Agin, Lisa F. Geng and Malcolm Nicholl. Written by the mother of a boy with a speech disorder, a pediatrician and former speech-language pathologist, and a writer, this guides parents to understand speech delays and problems.

The New Language of Toys: Teaching Communication Skills to Children With Special Needs, a Guide for Parents and Teachers by Sue Schwartz, Ph.D.

Sound & Articulation Activities for Children With Speech-Language Problems by Elizabeth Krepelin and Bonnie Smith. Written by an elementary schoolteacher, this book Includes more than 100 flannel-board figures in full color to motivate young children with speech-language difficulties.

Does My Child Have a Speech Problem? By Katherine L. Martin. Answers to the 50 most common questions about children’s speech and includes strategies for parents. Written by a speech-language pathologist.

Communicating Partners: 30 Years of Building Responsive Relationships with Late-Talking Children including Autism, Asperger’s Syndrome, Down Syndrome, and Typical Development by James McDonald. Family-friendly ideas from a professor of speech and language pathology and developmental disabilities at Ohio State University. The book offers many techniques for working with your child in everyday life.