Communication Skills and Disorders Health Article

they will begin experimenting with expressing themselves through speaking and gesturing. Speaking will begin as repetitive syllables, followed by words, phrases, and sentences. Later, children will acquire the skills of reading and writing, the written forms of communication. Although milestones are discussed for the development of these skills of communication, many children begin speaking significantly earlier or later than the milestone date. Parents should refrain from attaching too much significance to either deviation from the average. When a child's deviation from the average milestones of development cause the parents concern, a pediatrician or other professional may be contacted for advice.

Spoken language problems are referred to by a number of labels, including language delay, language disability, or a specific type of language disability. In general, experts distinguish between those children who seem to be slow in developing spoken language (language delay)

and those who seem to have difficulty achieving a milestone of spoken language (language disorders).

Language disorders include stuttering; articulation disorders, such as substituting one sound for another (tandy for candy), omitting a sound (canny for candy), or distorting a sound (shlip for sip); and voice disorders, such as inappropriate pitch, volume, or quality. Causes can be related to hearing, nerve/muscle disorders, head injury, viral diseases, mental retardation,

drug abuse, cleft lip

or palate.

In the past, most parents, pediatricians, and educators recommended giving the child time to outgrow a difficulty with spoken language. As of the late 1990s, research had shown that early speech and language disorders could lead to later difficulties in learning to read, write, and spell. Thus, many professionals recommended evaluation by a speech-language pathologist for toddlers who demonstrated language delay. However, not all speech-language specialists agree on early evaluation and therapy. Those who feel early intervention is unnecessary cite the results of research by Rhea Paul at Portland (Oregon) State University. She found that about two-thirds of children who were not talking at age two showed continued delays until age three, and one-half were still behind the typical language development schedule at age four. But by kindergarten, only one-fourth of those children had not caught up with their peers.

Parents and their pediatrician should communicate frequently about a child's spoken language development, and should consider all factors related to spoken language delay when considering whether to have a specialist evaluate and treat the delay. Such factors as the possible stigma attached to labeling a child with language difficulties versus whether intervention will prevent social and educational difficulties should be considered in making the decision.