When is hoping that “the child will simply start talking later” no longer enough?

One of the key prerequisites for children to integrate successfully with their peers and learn in kindergarten or school is sufficiently developed speech and language. How are speech development affected by hearing, mouth breathing, and habits? And why is it important to notice speech and language difficulties before a child starts school? Our clinic’s certified audio-speech therapist and myofunctional therapy specialist, Kima Kāne, explains.

What speech and language skills are considered normal for a child?

Children start kindergarten at different ages: some at one and a half, others at three or four; they start school at six or seven. Expected skills should be assessed according to the child’s age.

At one and a half years old, a child should be able to say individual words or form short phrases so that they can communicate their basic needs to adults and peers: say that they want to eat or drink, that they are sleepy, and what they want or do not want. By the time school begins, a child’s speech should already be fully developed, clear, and understandable – like an adult’s. Even if their vocabulary is not yet as broad, the child should be able to communicate and learn freely.

What signs may indicate that a child’s speech development needs greater attention?

Although children can develop at different rates, there are generally accepted milestones for what they should be able to say at each age:

• around one year – first words;
• around one and a half years – simple word combinations, such as “mummy, no” or “daddy, up”;
• around two years – short sentences, such as “I want that” or “come here, mummy”;
• around three to four years – the child should be able to converse, ask questions, and, on returning home from kindergarten, say what they ate for lunch. If language has developed, pronunciation inaccuracies can begin to be corrected at this age.

Of course, children develop differently. One child may start stringing sentences together at one and a half, another at two and a half. However, if an eighteen-month-old child still does not use a single meaningful word, parents should not simply wait – it is worth finding ways to help.

Speech clarity is another important indicator. It depends on the child’s speaking experience: a child who starts speaking later is likely to pronounce sounds accurately later than their peers. However, if only the mother can understand a three-year-old child, this should not be considered normal.

How can impaired hearing, mouth breathing, and other ENT problems affect speech?

A child’s ability to hear and understand speech is essential to speech and language development, so hearing often needs to be assessed when language development is delayed. If a child cannot hear language, they cannot learn it fully. A specialist will often refer the child for a hearing test before starting therapy.

Prolonged mouth breathing can also affect speech clarity: the tongue rests in a low position, the lips remain open, and the tongue may not move in the correct direction. This affects sound production – speech becomes less clear and the child may pronounce sounds incorrectly. Mouth breathing also becomes shallower and faster.

A persistently blocked nose and enlarged adenoids can force a child to breathe through the mouth. Enlarged adenoids can also affect movement of the soft palate, making speech sound nasal – as though the person is speaking through their nose.

What are myofunctional disorders?

Myofunctional disorders are a group of abnormalities in the function and development of the muscles of the mouth, face, and jaws – incorrect tongue position, breathing, and swallowing that negatively affect bite and speech development. Such disorders may be related to altered muscle function or anatomical changes, such as a shortened lingual frenulum, as well as habits. Prolonged pacifier use, for example, can interfere with the development of precise tongue movements and alter lip closure. Likewise, a child who was frequently ill at an early age may develop a habit of breathing through the mouth even though the nose functions normally. This weakens the oral muscles and creates a vicious circle that can be broken with the help of an audio-speech therapist or myofunctional therapy specialist.

Audio-speech therapists observe a broad range of symptoms, with an emphasis on speech, language, reading, writing, and food intake; myofunctional therapy specialists focus in greater depth on muscle function in the mouth area. If parents are unsure, they can consult an audio-speech therapist, who will determine whether help is needed from another specialist – an otolaryngologist, myofunctional therapist, orthodontist, psychologist, or someone else.

During an appointment, the myofunctional therapy specialist pays attention to:

• the type, frequency, volume, and other aspects of breathing;
• the resting position of the lips and tongue;
• chewing;
• the bite;
• tongue movements while speaking and swallowing.

Why is it important to notice speech and language difficulties before school?

Speech and language development form the foundation for later reading, writing, and learning skills. If a child pronounces sounds inaccurately, this can affect text perception, comprehension of tasks, and writing. Language development determines whether the child understands instructions, has a sufficient vocabulary, and can write words and sentences correctly.

Normal speech and language development is the foundation on which a house can be built – reading and writing – and a roof added – learning. Difficulties should therefore be corrected as early as possible. Of course, specialists can also help at school age and even during adolescence if necessary.

What can parents do every day to encourage speech and language development?

The environment in which a child grows plays a major role in speech and language development. Children who talk with adults, read books together, and hear varied language have a much broader vocabulary and more developed language. If adults simplify language, the child’s vocabulary does not grow because children learn what they hear. In everyday conversations, therefore, instead of simply calling a bird a “bird”, specify that it is a tit or a sparrow; call a dog a dog rather than “woof-woof”.

Adults should not say everything on the child’s behalf either, although it must always be assessed whether the child has a language development disorder that must not be ignored. If there is no language disorder, it is advisable to:

• read books aloud to the child;
• talk a lot and spend little time in front of screens;
• use a varied vocabulary and explain things accurately and specifically;
• give the child opportunities to tell stories, ask questions, and answer independently.

The better developed a child’s speech and language are before starting school, the easier school will be and the better their academic results.