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Speech problemsSSpeech problemsSpeech problemsEnglishDevelopmentalBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)MouthMouthConditions and diseasesCaregivers Adult (19+)NA2013-07-02T04:00:00Z9.3000000000000054.70000000000001034.00000000000Health (A-Z) - ConditionsHealth A-Z<p>An easy-to-understand overview of the causes, signs, and treatment of difficulties in your child's ability to talk.<br></p><h2>What are speech and language difficulties?</h2> <p>Speech and language difficulties are made up of two sets of delays or difficulties. Speech difficulties include challenges in pronunciation or articulation like stuttering or lisping. Language difficulties include challenges in speaking using words and/or gestures (expressive language). It can also include challenges in understanding language commands and questions (receptive language).</p><h2>Key points </h2> <ul> <li>Development of speech and language milestones varies tremendously from child to child.</li> <li>Children who are not meeting milestones or are at risk for speech and language delay should have a hearing test, be seen by their doctor and then assessed by a speech language pathologist.</li> <li>Children with speech and language difficulties should be evaluated as early as possible. Watching and waiting is not recommended.</li> <li>Articulation difficulties and stuttering may be normal until about 5 years of age.</li> <li>Speech and language therapy is very helpful for children and the earlier the intervention is started the better the outcome.</li> </ul><h2>Causes </h2><h3>Genetics </h3><p>A family history of speech and language difficulties is common. A family will often report that someone was a 'late talker'. Learning difficulties or developmental delays may also be more prevalent and increase the risk of a child having speech and language difficulties.</p><h3>Hearing loss </h3><p>The presence of any amount of hearing loss can affect your child's communication. If your child has had some <a href="/Article?contentid=8&language=English">ear infections</a>, this may put your child at risk for hearing loss. <a href="/Article?contentid=761&language=English">Meningitis</a>, severe <a href="/Article?contentid=775&language=English">jaundice</a> as a newborn or prematurity can also cause hearing loss. If you think your child is not hearing well for any reason, ask your doctor about performing a hearing test.</p><h3>Another condition </h3><p>Speech and language difficulties can be a sign of another condition like <a href="/article?contentid=1493&language=English">autism spectrum disorder</a>. Physical disorders like cerebral palsy can also affect your child's ability to speak. Many other medical conditions such as snoring or allergies, and more complex conditions which cause developmental delays, may also cause speech and/or language problems.</p><h2>When to see a doctor </h2> <p>Monitor your child's speech and language development. If you have questions, speak to your child's doctor on the next visit. If you are concerned, see your doctor as soon as possible.</p> <h2>What your child's doctor can do</h2> <p>Your doctor will take a medical and developmental history and do a physical examination to assess the cause of the speech and language difficulties. Treatment and intervention will depend on the cause of the speech and language difficulties, and on how severe the problem is. Your doctor will order a hearing test to rule out hearing loss and may recommend that your child see a speech-language pathologist (SLP) or another type of specialist (developmental paediatrician; ear, nose and throat specialist).</p> <h2>Treatment</h2> <p>If possible, the underlying cause should be treated (hearing loss) with a referral to an ear, nose and throat specialist. If the speech and language difficulty is part of another condition (autism spectrum disorder), then this should be evaluated and a referral to a developmental paediatrician may be needed. All children with significant speech and language problems should be seen by an SLP.</p> <p>Parents can self-refer their child to their provinces Preschool Speech and Language Services program. This is a free service funded by the government and offered to children from birth until school age.</p> <p>An SLP will help your child develop their speech and language skills. An SLP may work one-on-one with your child or work in a small group setting with other children needing support. The SLP will teach parents techniques to use at home to encourage your child to speak.</p><h2>​Virtual care services for children<br></h2><p>Boomerang Health was opened by SickKids to provide communities in Ontario with greater access to community-based services for children and adolescents. For more information on virtual care services in Ontario to support speech problems, visit <a href="http://www.boomeranghealth.com/services/hearing-screenings/">Boomerang Health</a> powered by SickKids.<br></p><p><br></p>
مشاكل النطقممشاكل النطقSpeech problemsArabicDevelopmentalBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)MouthMouthConditions and diseasesCaregivers Adult (19+)NA2010-05-07T04:00:00Z8.0000000000000058.0000000000000580.000000000000Flat ContentHealth A-Z<p>نظرة سهلة الفهم عن الاسباب والعلامات ومعالجة الصعوبات في قدرة الطفل على الكلام.</p>
语言障碍语言障碍Speech problemsChineseSimplifiedDevelopmentalBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)MouthMouthConditions and diseasesCaregivers Adult (19+)NA2010-05-07T04:00:00Z58.00000000000008.00000000000000580.000000000000Flat ContentHealth A-Z儿童话语能力困难:原因、迹象以及治疗的普及性概述。
語言障礙語言障礙Speech ProblemsChineseTraditionalDevelopmentalBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)MouthMouthConditions and diseasesCaregivers Adult (19+)NA2010-05-07T04:00:00Z58.00000000000008.00000000000000580.000000000000Flat ContentHealth A-Z兒童話語能力困難:原因、迹象以及治療的普及性概述。
Élocution : développement et troublesÉÉlocution : développement et troublesSpeech problemsFrenchDevelopmentalBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)MouthMouthConditions and diseasesCaregivers Adult (19+)NA2013-07-02T04:00:00Z000Health (A-Z) - ConditionsHealth A-Z<p>Voici un aperçu facile à comprendre des causes, des signes et du traitement de difficultés dans la capacité de parler de votre enfant.<br></p><h2>En quoi consistent les problèmes d’élocution?</h2> <p>Les problèmes d’élocution sont des retards ou des difficultés dans la capacité de parler de votre enfant. Il pourrait avoir de la difficulté à comprendre le langage et à communiquer. Votre enfant pourrait avoir de la difficulté à prononcer les mots ou à parler couramment. Le bégaiement et le zézaiement sont des formes de problèmes d’élocution.</p><h2>À retenir</h2> <ul> <li>Le développement du langage varie considérablement d'un enfant à l'autre.</li> <li>Les enfants à risque d’un retard d’élocution devraient être évalués et suivis par un orthophoniste.</li> <li>Les enfants atteints d’un retard d’élocution qui ont de la difficulté à communiquer devraient être évalués le plus tôt possible.</li> <li>Les difficultés d'articulation et le bégaiement peuvent être normaux jusqu'à l'âge de 5 ans environ.</li> <li>Les traitements d’orthophonie peuvent être très utiles à de nombreux enfants qui ont des problèmes de langage.</li> </ul><h2>Signes et symptômes des problèmes d’élocution</h2><p>Il y a plusieurs étapes clés à un développement « normal » de la parole. Ces étapes peuvent varier d'un enfant à l'autre. En général, voici les étapes:</p><h3>De 8 à 13 mois</h3><ul><li>pointe des objets;</li><li>secoue la tête pour dire non;</li><li>fait des signes de la main pour dire au revoir;</li><li>utilise des sons comme s’ils étaient des mot;</li><li>imite les sons des adultes.</li></ul><h3>De 12 à 18 mois</h3><ul><li>commence à développer un vocabulaire réceptif de mots qu’il comprend. Par exemple, il est capable de pointer des objets nommés par un adulte;</li><li>comprend quelques mots et courtes phrases;</li><li>utilise environ 10 à 20 mots pour désigner des objets.</li></ul><h3>De 18 à 24 mois</h3><ul><li>comprend des questions et des ordres simples;</li><li>commence à combiner deux mots pour former une phrase;</li><li>le vocabulaire expressif de l’enfant, ou les mots qu’il utilise quand il parle, augmente à jusqu'à 200 mots;</li><li>commence à utiliser des négatifs : « pas de jus ».</li></ul><h3>De 24 à 36 mois</h3><p>Pendant cette période, votre enfant devrait commencer à faire des phrases de trois mots. Ses phrases deviendront plus longues pendant cette période. Sa grammaire deviendra plus précise. Voici quelques autres étapes clés.</p><ul><li>utilise des prépositions comme « dans » et « sur »;</li><li>ajoute les terminaisons aux verbes;</li><li>ajoute des auxiliaires aux verbes : « il peut jouer »;</li><li>commence à distinguer le pluriel du singulier;</li><li>apprend à utiliser les pronoms, les conjonctions de négation et des conjonctions au milieu des phrases « il », « ne peut pas », « et ».</li></ul><p>Votre enfant commence aussi à utiliser le langage à des fins plus complexes:</p><ul><li>comprend de nombreux concepts : dedans et dehors, petit et gros, aller et arrêter, animaux, jouets, haut et bas;</li><li>peut suivre une directive en deux parties : « mets ton manteau et tes mitaines »;</li><li>suit des histoires simples tirées d’un livre;</li><li>commence à poser la question « pourquoi? »;</li><li>commence à raconter des histoires;</li><li>peut dire les sons suivants : h, p, m, d et k;</li><li>les paroles de l'enfant sont compréhensibles 75 % à 100% du temps.</li></ul><h3>De 3 à 5 ans</h3><p>Maintenant, votre enfant comprendra la majorité de ce qu'on lui dit. Ses phrases et ses histoires deviendront plus complexes. Ses habiletés en conversation s'amélioreront. Il comprendra comment attirer l'attention de quelqu'un pour commencer une conversation et comment attendre son tour de parler pendant une conversation. Son vocabulaire passera d’environ 1 000 mots à l’âge de 3 ans à 5 000 mots ou plus à l’âge de 5 ans.</p><p>Un étranger devrait pouvoir comprendre 75 % de ce qu’un enfant de 3 ans dit.</p><p>Sa grammaire deviendra plus complexe, par exemple :</p><ul><li>fera des liens entre les idées en utilisant «et», «parce que», «quoi», «quand», «mais», «cet», «si», «alors»;</li><li>utilisera les pronoms correctement : je, elle, il, lui, moi, mon, ils;</li><li>élaborare mieux ses questions, en inversant l'ordre des mots et en utilisant des auxiliares : « Qu’est-ce qu’il fait » au lieu de « il fait quoi »</li><li>utilisera le passé simple pour raconter des histoires</li><li>utilisera des formes de négation plus avancées : « je/il n’a pas »</li><li>généralisera à outrance certaines règles : « il est mouru », « des festivaux ».</li></ul><p>Entre 3 et 5 ans, la capacité de votre enfant de prononcer les lettres et les sons augmentera. Les enfants seront en mesure de prononcer les sons suivants : </p><ul><li>À l’âge de 4 ans: w, b, t, f, g, ng, n<br></li><li>À l’âge de 5 ans : l, ch, s, j</li><li>À l’âge de 6 ans : z, r</li></ul><h2>Causes de problèmes d'élocution</h2> <h3>Génétique</h3> <p>Des antécédents familiaux de problèmes d’élocution ou de difficulté d’apprentissage, ou encore de retards de développement pourraient mener à des problèmes de langage.</p> <h3>Perte d’audition</h3> <p>Une perte d’audition légère ou importante peut modifier la capacité de votre enfant à communiquer. Si vous soupçonnez que votre enfant n’entend pas bien ou s’il a eu de nombreuses <a href="/Article?contentid=8&language=French">infections d’oreille</a>, demandez à votre médecin de vérifier ses oreilles.</p> <h3>Autres problèmes</h3> <p>Les problèmes de langage peuvent être un signe d'un autre problème comme l'<a href="/Article?contentid=21&language=French">autisme</a>. Les troubles physiques comme l'<a href="/Article?contentid=847&language=French">infirmité motrice cérébrale​</a> peuvent aussi modifier la capacité de votre enfant à parler. Toute pathologie qui peut causer un retard de développement peut causer des problèmes d'élocution. La méningite, une grave jaunisse chez le nouveau-né ou une naissance prématurée peuvent causer une perte d'audition.</p><h2>Quand consulter un médecin</h2><p>Suivez de près le développement du langage et de l’élocution de votre enfant. Si vous avez des questions, parlez-en à son médecin durant votre prochaine visite. Si vous êtes inquiet, consultez votre médecin le plus tôt possible.</p><h2>Ce que le médecin de votre enfant peut faire</h2><p>Le médecin évaluera la cause du problème d’élocution. Le traitement dépendra de la cause du problème d'élocution et de sa gravité. Le médecin pourrait référer votre enfant à un spécialiste des problèmes du langage ou à un autre spécialiste.</p><h2>Traitement</h2><p>Dans la mesure du possible, la cause sous-jacente doit être traitée (par exemple, la perte d’audition) en dirigeant l’enfant vers un otorhinolaryngologiste. Si le problème d’élocution fait partie d'une autre pathologie (par exemple, trouble du spectre de l’autisme), celle-ci devrait être examinée en premier. Il peut être nécessaire de diriger l’enfant vers un pédiatre du développement. Tous les enfants qui ont d’importants problèmes d’élocution doivent être suivis par un orthophoniste. </p><p>Les parents peuvent amener eux-mêmes leur enfant aux services d’orthophonie pour enfants d’âge préscolaire de leur province. Ces services sont offerts gratuitement par le gouvernement aux enfants d’âge préscolaire. </p><p>L’orthophoniste aidera votre enfant à développer ses aptitudes au langage. Il travaillera individuellement avec votre enfant ou en petit groupe avec d’autres enfants qui ont besoin de soutien. L’orthophoniste enseignera aux parents des techniques à utiliser à la maison pour encourager leur enfant à parler.</p>
Trastornos del hablaTTrastornos del hablaSpeech ProblemsSpanishNAChild (0-12 years);Teen (13-18 years)NANANAAdult (19+)NA2010-05-07T04:00:00Z58.00000000000008.00000000000000580.000000000000Flat ContentHealth A-Z<p>Una descripción sencilla de las causas, los signos y el tratamiento de las dificultades de su niño para hablar.</p>
பேசுவதில் பிரச்சினைபேசுவதில் பிரச்சினைSpeech ProblemsTamilNAChild (0-12 years);Teen (13-18 years)NANANAAdult (19+)NA2010-05-07T04:00:00Z58.00000000000008.00000000000000580.000000000000Flat ContentHealth A-Z<p>உங்கள் பிள்ளையின் பேச்சுத் திறமையில் பிரச்சினைகளுக்கான காரணங்கள், அறிகுறிகள், மற்றும் சிகிச்சைகள் பற்றி இலகுவாக விளங்கிக் கொள்ளக்கூடிய ஒரு கண்ணோட்டம்.<br></p>
بولنے‮ ‬کے‮ ‬مسائلببولنے‮ ‬کے‮ ‬مسائلSpeech ProblemsUrduNAChild (0-12 years);Teen (13-18 years)NANANAAdult (19+)NA2010-05-07T04:00:00Z58.00000000000008.00000000000000580.000000000000Flat ContentHealth A-Zآپکے‮ ‬بچے‮ ‬کی‮ ‬بات‮ ‬کرنے‮ ‬کی‮ ‬صلاحیت‮ ‬کے‮ ‬بارے‮ ‬میں‮ ‬ایک‮ ‬حائزہ‮ ‬جس‮ ‬میں‮ ‬بیماری‮ ‬کی‮ ‬وجوھات‮ ‬،‮ ‬علامات‮ ‬،‮ ‬علاج‮ ‬کے‮ ‬بارے‮ ‬میں‮ ‬بیان‮ ‬کیا‮ ‬جائے‮ ‬گا۔

 

 

School Age ChildSchool Age ChildSchool Age ChildSEnglishNASchool age child (5-8 years)NANANACaregivers Adult (19+)NALanding PageLearning Hub<p>Starting school is a landmark in a young child's life. Learn about the typical physical, emotional and communication milestones for school-age children and how to handle issues such as bullying, bladder control and sleep problems.</p><p>Starting school is a landmark in a young child's life. Learn about the typical physical, emotional and communication milestones for school-age children and how to handle issues such as bullying, bladder control and sleep problems.<br></p><div class="asset-video"> <iframe src="https://www.youtube.com/embed/2MVtfq0xFTQ?list=PLjJtOP3StIuXbgK4LObxQVt1sgxcE-L5r" frameborder="0"></iframe><br></div><p>For more videos from SickKids experts in collaboration with Youngster, visit <a href="https://www.youtube.com/channel/UCoKMd2cYwegtZX19uHdNLQA">Youngster on YouTube</a>.</p><div class="panel panel-primary"><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span><h2 class="panel-title">Overview</h2></div><div class="panel-body list-group" style="display:none;"><p>Find out how you can support your school-age child's independence, communication and motor skills.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"><a class="overview-links" href="/Article?contentid=502&language=English">Attachment</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=732&language=English">Speech and language development in children aged 0–3 years</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span><h2 class="panel-title">Milestones</h2></div><div class="panel-body list-group" style="display:none;"><p>Learn about the standard physical, social and cognitive (information processing) skills for a typical school-age child.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"><a class="overview-links" href="/Article?contentid=711&language=English">Cognitive development in school-age children</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=712&language=English">Physical development in school-age children</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=713&language=English">Social and emotional development in school-age children</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span><h2 class="panel-title">Caring for your school-age child</h2></div><div class="panel-body list-group" style="display:none;"><p>Discover how to manage issues such as bullying, discipline, sleep and speech problems and immunizations.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"><a class="overview-links" href="/Article?contentid=303&language=English">Bullying</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=714&language=English">Disciplining your child</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=493&language=English">Immunizations</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=306&language=English">Sleeping problems</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=298&language=English">Speech problems</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span><h2 class="panel-title">Common health issues</h2></div><div class="panel-body list-group" style="display:none;"><p>Read how to identify and respond to issues such as skin infections, poor bladder control and suspected ADHD or autism spectrum disorder.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"><a class="overview-links" href="/Article?contentid=21&language=English">Autism spectrum disorder</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=16&language=English">Bed-wetting (nocturnal enuresis)</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=47&language=English">Biofeedback to help your child's bladder control problems</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=49&language=English">Bladder retraining</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=28&language=English">Molluscum contagiosum</a></li></ol></div><div class="panel panel-primary"><div class="panel-heading clickable"> <span class="pull-right panel-heading-collapsable-icon"> <i class="mdi mdi-chevron-down"></i></span><h2 class="panel-title">Learning and education</h2></div><div class="panel-body list-group" style="display:none;"><p>Find out how you can support your child's learning and set fair rules for behaviour and homework.</p></div><ol class="list-group" style="display:none;"><li class="list-group-item"><a class="overview-links" href="/Article?contentid=653&language=English">Learning disabilities: Overview</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=722&language=English">Mathematics milestones</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=720&language=English">Phonological processing: Sound awareness, memory, and retrieval</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=651&language=English">Reading milestones</a></li><li class="list-group-item"><a class="overview-links" href="/Article?contentid=3871&language=English">Writing milestones</a></li></ol></div>https://assets.aboutkidshealth.ca/AKHAssets/Ages_stages_school-age.jpgyourschoolagechildhttps://assets.aboutkidshealth.ca/AKHAssets/Logo_chelsea.png<span class="recognition-text">Production and maintenance of these articles were made possible in part by an educational grant provided by the <a href="/Sponsors#chelsea">Chelsea Hotel</a>. SickKids is grateful for the generous support of our corporate partners but does not endorse specific products or services, nor receive any editorial direction from its sponsors.</span><br>

 

 

Speech problems298.000000000000Speech problemsSpeech problemsSEnglishDevelopmentalBaby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)MouthMouthConditions and diseasesCaregivers Adult (19+)NA2013-07-02T04:00:00Z9.3000000000000054.70000000000001034.00000000000Health (A-Z) - ConditionsHealth A-Z<p>An easy-to-understand overview of the causes, signs, and treatment of difficulties in your child's ability to talk.<br></p><h2>What are speech and language difficulties?</h2> <p>Speech and language difficulties are made up of two sets of delays or difficulties. Speech difficulties include challenges in pronunciation or articulation like stuttering or lisping. Language difficulties include challenges in speaking using words and/or gestures (expressive language). It can also include challenges in understanding language commands and questions (receptive language).</p><h2>Speech and language milestones</h2><p>There is a wide range of speech and language milestones which can vary from child to child, but there is an expected age range of onset. In general, speech and language milestones include: </p><h3>8 to 13 months </h3><ul><li>starts using gestures like pointing, shaking head to indicate "no", waving good-bye</li><li>uses sounds as if they were words (babbling and repetitive babble like "mamama")</li><li>imitates adults' sounds</li></ul><h3>12 to 18 months </h3><ul><li>uses approximately 10 to 20 words or word approximations<br></li><li>expands use of gestures (nodding, eye contact, hand gestures)</li><li>begins to develop a receptive vocabulary of understood words (points to objects when named by an adult)</li><li>responds to name</li><li>understands a number of single words and short phrases</li></ul><h3>18 to 24 months </h3><ul><li>using too many single words to count (200+)</li><li>begins to combine two words ("mommy up", "daddy go")</li><li>understands simple questions</li><li>follows one-step commands</li><li>begins to use negatives: "no juice"</li><li>speech is 50% intelligible to strangers at 2 years</li></ul><h3>2 to 3 years </h3><ul><li>uses three-word sentences ("I want juice")</li><li>grammar will become more precise (adds 'ing', 's' for plurals, using 'a' and 'the' to fill and lengthen sentences, uses prepositions such as "in" and "on")</li><li>learns to use pronouns, negatives, and conjunctions in the middle of sentences: "he," "can't," "and"</li><li>understands many concepts: in/out; big/little; go/stop; top/bottom; animals; toys</li><li>follows two-step directions: "get your coat and close the door"</li><li>follows simple stories in books</li><li>begins to ask "why?"</li><li>can produce the following sounds: h, p, m, d and k</li><li>speech is 75% intelligible to strangers at 3 years</li></ul><h3>3 to 5 years </h3><ul><li>vocabulary increases to 1,000 words at 3 years and 5,000 words by 5 years</li><li>uses full sentences</li><li>retells stories</li><li>turn taking and conversational skills develop</li><li>speech is 100% intelligible at 4 years</li><li>complexity develops (links ideas in sentences using "and," "because," "what," "when," "but," "that," "if," "so")</li><li>adjusts order of words in sentences ("What is he doing?" as opposed to "What he is doing?")</li><li>uses pronouns correctly (I, she, he, her, him, me, mine, they)</li><li>uses more advanced forms of negatives ("didn't")</li><li>uses plurals, but may make some errors ("two gooses") and overgeneralizes some rules ("I runned")</li></ul><p>Between 3 to 5 years, pronunciation improves and blended letter use grows. Children are able to produce the following specific sounds: </p><ul><li>at 4 years: w, b, t, f, g, ng, n</li><li>at 5 years: l, sh, ch, s, j</li><li>at 6 years: z, r</li><li>some pronunciation of specific sounds and articulation difficulties (like stuttering) may be normal until about 5 years old</li></ul><h2>Key points </h2> <ul> <li>Development of speech and language milestones varies tremendously from child to child.</li> <li>Children who are not meeting milestones or are at risk for speech and language delay should have a hearing test, be seen by their doctor and then assessed by a speech language pathologist.</li> <li>Children with speech and language difficulties should be evaluated as early as possible. Watching and waiting is not recommended.</li> <li>Articulation difficulties and stuttering may be normal until about 5 years of age.</li> <li>Speech and language therapy is very helpful for children and the earlier the intervention is started the better the outcome.</li> </ul><h2>Causes </h2><h3>Genetics </h3><p>A family history of speech and language difficulties is common. A family will often report that someone was a 'late talker'. Learning difficulties or developmental delays may also be more prevalent and increase the risk of a child having speech and language difficulties.</p><h3>Hearing loss </h3><p>The presence of any amount of hearing loss can affect your child's communication. If your child has had some <a href="/Article?contentid=8&language=English">ear infections</a>, this may put your child at risk for hearing loss. <a href="/Article?contentid=761&language=English">Meningitis</a>, severe <a href="/Article?contentid=775&language=English">jaundice</a> as a newborn or prematurity can also cause hearing loss. If you think your child is not hearing well for any reason, ask your doctor about performing a hearing test.</p><h3>Another condition </h3><p>Speech and language difficulties can be a sign of another condition like <a href="/article?contentid=1493&language=English">autism spectrum disorder</a>. Physical disorders like cerebral palsy can also affect your child's ability to speak. Many other medical conditions such as snoring or allergies, and more complex conditions which cause developmental delays, may also cause speech and/or language problems.</p><h2>When to see a doctor </h2> <p>Monitor your child's speech and language development. If you have questions, speak to your child's doctor on the next visit. If you are concerned, see your doctor as soon as possible.</p> <h2>What your child's doctor can do</h2> <p>Your doctor will take a medical and developmental history and do a physical examination to assess the cause of the speech and language difficulties. Treatment and intervention will depend on the cause of the speech and language difficulties, and on how severe the problem is. Your doctor will order a hearing test to rule out hearing loss and may recommend that your child see a speech-language pathologist (SLP) or another type of specialist (developmental paediatrician; ear, nose and throat specialist).</p> <h2>Treatment</h2> <p>If possible, the underlying cause should be treated (hearing loss) with a referral to an ear, nose and throat specialist. If the speech and language difficulty is part of another condition (autism spectrum disorder), then this should be evaluated and a referral to a developmental paediatrician may be needed. All children with significant speech and language problems should be seen by an SLP.</p> <p>Parents can self-refer their child to their provinces Preschool Speech and Language Services program. This is a free service funded by the government and offered to children from birth until school age.</p> <p>An SLP will help your child develop their speech and language skills. An SLP may work one-on-one with your child or work in a small group setting with other children needing support. The SLP will teach parents techniques to use at home to encourage your child to speak.</p><h2>​Virtual care services for children<br></h2><p>Boomerang Health was opened by SickKids to provide communities in Ontario with greater access to community-based services for children and adolescents. For more information on virtual care services in Ontario to support speech problems, visit <a href="http://www.boomeranghealth.com/services/hearing-screenings/">Boomerang Health</a> powered by SickKids.<br></p><p><br></p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/speech_problems.jpg" style="BORDER:0px solid;" />https://assets.aboutkidshealth.ca/AKHAssets/speech_problems.jpgSpeech problemsFalse

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