Speech therapy supports children experiencing difficulties in speech, language, or social communication. Early intervention is important; the sooner these issues are detected and corrected, the better the long-term outcomes tend to be. Research has shown that early speech therapy enhances a child's communication skills. Communication is essential as it is an integral mechanism through which most learning processes occur, including social interactions for emotional development and academic learning at school. Speech therapists play a significant role in this process as they provide support that encourages an appropriate and effective ability to talk, which facilitates a child's general development.

Understanding speech and language development

Speech and language skills are usually achieved through the development of a child's brain during the first three years of life. 

Speech and language milestones for toddlers

At 0-3 months, the child

• Earns that crying will provide food, comfort, and companionship
• Starts identifying the important sounds of their surroundings, such as their mother's or primary caregiver's voice
• Starts to coo, making sounds like ooooo, aahh
• Is quiet or smiles when someone is talking to them

 At 4-6 months, the child

• Babbles and makes many sounds at playtime¹
• Uses different sounds to show likes and dislikes
• Will look toward the sources of noise
• Respects changes in the pitch of your voice
• Recognises that certain toys make noise
• Recognises music

 At 7-13 months, the child

• Responds to "no-no" and "yes-yes"
• Uses expressive gestures
• Tries to copy your words, especially the first word of a sentence

At 14-18 months, the child

• Responds to simple questions using gestures
• Speaks 2 to 3 words to refer to a person or object (the word may not be clearly understood)
• Tries to copy simple words
• Knows and has a vocabulary of 4 to 6 words

At 19-24 months, the child

• Gazes around when asked "where" questions, for example: "Where is your toy?"
• Follows commands—such as "Give me the ball," "Hug your pillow," "Come here," or "Show me your hands”
• Uses pointing to ask for, comment about, or point something out ⁶
• Understands and uses words to identify familiar objects, actions, and people they see in their lives
• Acknowledges one or more parts of the body
• Sometimes gestures with excitement, clapping, high-fiving or sticking their tongue out or making funny faces
• Speaks words comprising long sequences of sounds or syllables

At 2-3 years, the child

• Has some sense of spatial concepts like "in" or "on"
• Understands and uses more pronouns, such as "we"
• Knows expressive words and adjectives like "small" or "happy"
• Responds to simple questions appropriately
• Follows two-step requests, for example, "Get your ball and come here."
• Uses sentences with three to four words, such as “give me food”,”I am happy”
• Uses plurals, for example, "shoes" or "socks", and a regular past tense verb such as "jumped"¹
• Has improving speech pronunciation. However, they may still miss ending sounds, and strangers may not understand much of what they say

Signs of speech and language delays

A speech and language delay is when a child fails to achieve speech or language milestones at the expected age. This includes:

Limited vocabulary

If a child has fewer than 50- 60 words by the age of 2 years old, or shows limited interest in new words, then this may be a sign of delay. If speech becomes inconsistent, and children start finding it difficult to put words together, it may also signify a delay.

Poor language understanding

This might involve an inability to understand simple directions such as "come here" or "give me the bag" at 19-24 months, or being unclear on oral cues. Parents often describe the child giving inappropriate answers to questions posed and showing indifference to verbal communication.

Articulation challenges

If a child's speech is frequently confusing or if they fail to pronounce certain sounds by the ages outlined above, they may require testing. For example, ongoing failure to articulate sounds correctly, for example, using the "w" sound instead of the "r" sound, would warrant further testing.

Causes of speech and language delay

• Intellectual disability
• Hearing loss²
• Lack of stimulation
• Bilingualism²
• Autism
• Neurological problems like cerebral palsy or brain injury

Benefits of speech therapy

Attending speech therapy can have numerous benefits for young children with speech or communication challenges:.

Improved communication skills

Speech therapy helps to improve a child's ability to freely and clearly communicate thoughts and ideas through speech, which is essential for the child’s development. To do this, the speech therapist will aim to expand the child's vocabulary, correct poor pronunciation, and assist the child in using language to communicate their needs and feelings.

Improved social relationships

The ability to communicate enhances a child's social relationships. Through the development of strong communication skills, a toddler becomes more assured of themself in social situations, during which they can share those skills with their peers. They learn how to take their turn talking, what questions to ask, and what to clarify, which are necessary tools for making friends.

Boosted confidence and self-esteem

As toddlers develop in speech therapy, they tend to become more confident. Better communication can reduce frustration and anxiety, hence enhancing self-esteem. The child may develop the confidence to take part in class activities and express their needs, since they are able to do so fluently.

Better potential for future academic achievement

Strong foundational communication skills go a long way in channelling academic success. Children who receive speech therapy are provided with skills to perform well in reading, writing, and classwork participation. Early intervention helps them prepare for the linguistic challenges that school life brings, thus reducing their risk of future learning difficulties.

Types of speech therapy approaches

Different approaches to speech therapy cater to varied needs and preferences. Understanding these options can help parents choose the right fit for their child.

Articulation therapy 

 This includes exercises that help the child correct sounds and syllables in words and sentences, usually during play activities. The play level would appropriately match the child's age and particular needs.³

Oral motor language intervention therapy

This involves oral motor exercises (mouth exercises) and is used when the source of a child’s speech difficulties is identified to be a problem with movement and sensation.

Neuromuscular Electrical Stimulation

This is a therapy where electrical stimulation is administered along the patient’s neck to treat speech problems. 

LSVT - Lee Silverman speech therapy

Lee Silverman Voice Treatment is a speech disorder treatment for patients with conditions like cerebral palsy or Down syndrome.⁴ It seeks to amplify vocal strength by targeting the vocal cords and involves four weeks of intense therapy, consisting of four one-hour sessions a week, to enhance the patient's voice and speech capabilities. The sessions centre around "thinking loud to speak loud and making exaggerated movements and behaviours".

Modeling techniques

This is another effective technique in treating speech problems, during which the adult gives the child the correct models for speech and/or language by modelling regular everyday chat and conversation.

It includes self-talk, recasting, praise, and expansion.⁵

1. Recasting- Repeating what the child says in the correct manner or with the correct language
2. Self-talk- Talking about what you feel, see, and hear
3. Expansion- Adding more words to the sentences to correct the sentence structure, grammar, and speech sound
4. Praise- Verbal or non-verbal responses to an attempt by the child to communicate correctly

This speech and language therapy is very effective when administered by a speech therapist. However, if the parent is providing treatment to the child, they should make sure to:

• Speak clearly and at a slow rate
• Use simple sentences
• Use correct language
• Practice without disturbance in a silent environment
• Not repeat or dwell on a child's blunder

Summary

Speech therapy is offered to children with difficulties with speech, language, or social communication. The sooner a difficulty is identified and addressed, the better the long-term outcomes. Early intervention is conducive to improved communication, which is an important aspect of learning, emotional growth, and social interaction.