FAQs
It is important to undergo regular check-ups with developmental and hearing specialists to ensure that your child meets their developmental milestones. Should there be any issue in your child’s development, your family doctor, professionals who work with your child, e.g. teachers and support staff, or friends and other family members, may raise concerns regarding your child’s ability to understand/follow instructions, communicate their thoughts/feelings/wants/needs or their ability to interact with their peers (social communication).
You may consider seeking Speech-Language Therapy for your child if you are concerned that your child is not reaching their language and communication milestones or are falling behind their peers in these areas. Our clinicians will conduct an initial assessment to ascertain if your child requires Speech-Language Therapy.
The number and frequency of the therapy sessions vary greatly among children. Duration of therapy can range from weeks to years. It would be difficult to provide an exact time frame for intervention due to unique factors, such as the cause of your child’s communication issues, their ability to build new skills and the severity of the delay or disorder.
Following the initial assessment, the therapist will develop, with input from parents/caregivers, both long- and short-term goals for your child. The therapist will then work with the child on achieving these goals, which will be reviewed as and when necessary. This allows both the therapist and parents/caregivers to monitor the child’s development in a meaningful way, ensuring that the specified skills are achieved before progressing to the next stage.
Quite often, when parents and/or teachers raise concerns about a child’s “speech delay”, the child is diagnosed with “language disorder” instead. Are speech and language the same thing? No. Speech and language are different in many ways.
Language is made up of socially shared rules that include the following:
- What words mean (e.g. “star” can refer to the bright object seen in the night sky or a celebrity)
- How to modify words (e.g. friend, friendly, unfriendly)
- How to put words together (e.g. “Peg walked to the new store” rather than “Peg walks store new”)
- What word combinations are best in different situations (e.g. “Would you mind moving your foot?” could quickly change to “Get off my foot, please!” if the first request did not produce results)
Speech refers to how intelligible the child is and may be impacted by the following:
- Articulation or phonology. How the child modifies single sounds to form words (e.g. produce the “r” sound to say “rabbit” instead of “wabbit”)
- Voice. How the child uses their vocal folds and breathing which impacts the way they sound (e.g. voice can be abused from overuse or misuse, which can lead to hoarseness or loss of voice)
- Fluency. The rhythm of speech (e.g. hesitations or stuttering can affect fluency)
There is no one right way to raise a child to be bilingual. Speak to your child in the language that you are most comfortable in. Children benefit from being surrounded by good language models that give them rich and valuable exposure to the language.
Both of the Hanen programmes are delivered by a Hanen-certified Speech-Language Therapist. The programmes can be delivered during individual therapy sessions or group sessions. Both programmes focus on communication in the day-to-day environment and use daily routines and activities to support communication.
The “It Takes Two to Talk” Programme is designed specifically for parents/caregivers of young children, from birth to 5 years of age, who have been identified as having a language delay. Parents/Caregivers are given guidance on interacting in ways that support the development of their child’s language and interaction.
The “More Than Words” Programme is designed specifically for parents of children, ages 5 years and under, on the autism spectrum. This programme provides parents/caregivers with tools, strategies and support to help their children reach their full communication potential. The programme teaches strategies to help improve social communication, back-and-forth interactions, play skills and imitation skills.
Pragmatics or the rules for social language is another area in which Speech-Language Therapists may work on with children. Pragmatics involves using language for specific purposes, such as greeting, informing, demanding, promising or requesting. It allows the speaker to change language according to the needs of the listener or situation, such as talking differently to a peer and an adult or giving context to an unfamiliar listener. Pragmatics also involves following rules for conversations and storytelling, such as taking turns in conversation, introducing and maintaining topics, rephrasing when misunderstood, and using appropriate verbal and non-verbal gestures, facial expressions and eye contact.
A child with pragmatic difficulties/disorders may use complex language but would still have a communication difficulty. They may say inappropriate or unrelated things during conversations, tell stories in a disorganised way or have little variety in the topics they talk about and their use of language.
Speech is the ability to use your lips, tongue and other parts of your mouth to produce sounds. To produce clear speech, children need to be able to produce the different sounds of speech as well as understand the rules for putting those sounds together in words and sentences.
Most children have mastered the following sounds by the following ages:
- around 3 years: b, p, m, n, h, d, k, g, ng (sing), t, w, f, y
- around 4-5 years: f, sh, zh, ch, j, s
- around 6 years: l, r, v
- around 7-8 years: th, z
Most children may have speech errors during the first few years of speech development. By about three years old, most children can be easily understood by their parents/caregivers.
If you are worried that your child might have a speech disorder, think about how often people who do not know your child have trouble understanding what your child said:
- Around 2 years old, about 50% of your child’s speech should be understood by a stranger
- Around 3 years old, about 75% of your child’s speech should be understood by a stranger
- Around 4 years old, about 100% of your child’s speech should be understood by a stranger
We would recommend that you seek professional help if your child:
- Is six months old or more behind the typical age range for the development of specific speech sounds
- Uses speech patterns that should have been resolved by their age or speech sounds that are immature as compared to their peers
- Gets frustrated when speaking. For example, they get upset when they are not understood and have to repeat themselves frequently
If your child has any of the following issues, a feeding assessment might be needed:
- Frequent gagging, choking or vomiting during meals
- Chewing difficulties
- Refusal to try new foods
- Picky of fussy eater – only eating certain types of food
- Food range of fewer than 20 types of food
- Difficult to feed
On the day of the assessment, you will be asked to bring certain types of food from home. Through a thorough interview, the Speech-Language Therapist will observe your child’s feeding and drinking abilities. During the assessment, the therapist may also implement certain strategies that might improve your child’s feeding skills. Depending on the outcome of the assessment, feeding therapy might be prescribed.
Stuttering is a fluency disorder, also known as “stammering” in some parts of the world. Stuttering is characterised by disruptions in the production of speech sound, which may be in the form of repetitions, prolongations or blocks. One or a combination of these behaviours may be observed consistently or variably.
The frequency, duration, type and severity of disfluencies vary greatly from child to child and from situation to situation, with the symptoms typically appearing between the ages of 2.5 to 4 years old. It is also possible for stuttering to start occurring during primary school. About 5% of children have stuttering behaviour, and stuttering is more commonly observed in males than females. Preschoolers may have little or no awareness of their fluency difficulties, especially so when they first start to display stuttering behaviours. However, most people who stutter become increasingly aware of their fluency difficulty and the responses they receive when they do not speak fluently.
The exact cause of stuttering is currently unknown. Recent studies have suggested that genetics plays a role in the development of the disorder and that disruptions in speech motor control, such as timing, sensory and motor coordination, are implicated.