There are many signs that might indicate speech impairment in children. They include failing to make appropriate sounds by the expected age range and failure of a child to recognize or show interest in sounds in his environment. Making fewer sounds and speaking fewer words than one's peers may also signal a problem. Parents and caregivers also can stay alert for abnormal sound qualities or distortion in children's voices. Additionally, if a child's words are difficult to decipher after he has reached about four years of age, this can be a sign of impairment.
One of the most common signs of speech impairment in children is a delay in beginning to speak. If a child has not begun speaking long after his peers have begun chattering away, this can be a sign of a problem. Likewise, if a child says some words but does not seem capable of speaking as many words as his peers, this may indicate an issue as well. It is important to note, however, that some children just begin to speak later than others or take longer to develop a wide vocabulary, so this is not always a sign of a problem. As such, parents are often advised to discuss their worries with a pediatrician rather than jumping to the conclusion that something is wrong.
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In many cases, one of the earliest signs of speech impairment in children is the lack of producing sounds in response to the people or things around them. For instance, most children make cooing or squawking sounds before they reach a year old, and many begin to babble sounds that seem to resemble words, like mama and dada, even if they do not associate these words with their mothers or fathers. By about a year and three months old, many children are able to imitate at least some of the sounds they hear in their environments and say at least a couple of words. At two years of age, many children are able to make rather simple sentence constructions, and between the ages of two and three years old, vocabulary typically increases dramatically. The lack of such progression may indicate a speech impairment.
As a child grows older, the signs of speech impairment may include a voice that sounds strange or distorted. For example, it might have an odd quality or sound raspy. Parents and caregivers can also be alert for pitch abnormality when trying to detect speech difficulties. Likewise, if a child seems to speak much slower than normal, he may need evaluation. Leaving out certain letter sounds after three or four years of age can indicate an issue as well.
Some people worry about speech impairment in children when the words a child says are difficult to understand. To some extent, however, this is normal and not a cause for concern. Most children say things that are difficult to decipher until they are about four years old. If a child is older than four and most of his words are difficult for people outside his household to understand, this may indicate a need for a speech evaluation.