Speech & Language
Due to COVID-19 Livewell Southwest is currently providing urgent care services only. As the Children’s Speech and Language Service is a non-urgent service we will not be arranging any face to face appointments for the immediate future. If you have any urgent concerns regarding your child’s communication you can contact us on 01752 434844.
Learning to communicate with others is one of the most important skills we develop. Unfortunately, it is common for some children to experience difficultly with speech and language as they mature.
Our friendly speech and language team is experienced in helping children who have difficulty speaking clearly, expressing themselves, communicating socially, understanding others, talking fluently, or feeding and swallowing.
We use fun games, images and new words to help your child with their listening, talking and sound-making skills.
Our open help system means if you are concerned about a child’s speech or language development, and they are living in Plymouth, you can request help from us for assessment. Please be aware, we can only consider request for help forms that have parental consent.
Further information and advice is available by clicking here.
As children are learning to talk their speech sounds develop gradually over a period of time, and it’s normal for them to make some errors as they learn to say new words. As a rough guide, children’s speech should be understood about 50% of the time at age two and 75-100% at the age of three.
Sometimes children do not master the sounds we would expect by a particular age and as a result their speech can be unclear and difficult to understand. Often they can make progress with support and practice but sometimes their difficulties can be longer lasting.
There may be a number of reasons why speech sound difficulties occur.
Developmental Language Disorder
Developmental Language Disorder (DLD) is a condition where children have problems understanding and/or using spoken language. There is no obvious reason for these difficulties, for example, there is no hearing problem or physical disability that explains them.
This results in children who have difficulty understanding what people say to them, and struggle to articulate their ideas and feelings. DLD can have a significant impact on progress at school, or on everyday life.
In the past DLD was known as specific language impairment (SLI) but recently the name has changed so that it better reflects the types of difficulties children have.
Autistic Spectrum Condition
Hearing difficulties can affect development of all or just some areas of speech and language, depending on the type and severity of the deafness.
Hearing impairment can vary from mild through to profound. The National Deaf Children’s society explains the difference between the two main types of deafness as:
Sensori-neural deafness, or nerve deafness as it is sometimes called, is a hearing loss in the inner ear.
Conductive deafness means that sound cannot pass through the outer and middle ear into the inner ear. This is often caused by blockages such as wax in the outer ear or fluid in the middle ear (glue ear).
Many children with conductive deafness are unable to hear certain speech sounds clearly, which in turn, affects their ability to say the words clearly. They may also have problems listening and concentrating, so their general language development may be delayed as well.
If you have concerns about your child’s hearing ask your health visitor or GP to refer them for a hearing test.
Learning to talk, like learning to walk, is never completely smooth and does not happen straight away. Young children often stop, pause, start again and stumble over words when they are learning to talk. Between the ages of two and five years, it is normal for a child to repeat words and phrases, and hesitate with “um”s and “er”s, when he is sorting out what to say next.
Many find it easier to talk fluently as they get older. Others continue to find talking difficult and often get stuck.
What is stammering
You may notice your child
- is putting extra effort into saying his / her words
- has tense and jerky speech
- cannot seem to get started, no sound comes out for several seconds (“… I got a teddy”)
- is stretching sounds in a word (“I want a ssstory”)
- is repeating parts of words several times (“mu-mu-mu-mu-mummy”)
- stops what he /she is saying half way through his sentence.
These examples vary from child to child – you may hear some or all of these when your child talks.
It is not known exactly why a child stammers; it is likely that a combination of factors is involved. There is no evidence that parents cause stammering. It is about four times more common in boys than in girls. Stammering often runs in families and occurs worldwide in all cultures and social groups.
- the situation (eg: if it is noisy or quiet, rushed or relaxed, at home or in the nursery)
- whether your child is talking to friends, parents or strangers
- what he /she wants to say (eg: if it is complicated or easy, if the words are new or familiar)
- how he / she is feeling (unwell, tired, anxious, excited or confident).
‘Drooling’ and ‘dribbling’ are different names for the same thing, which is when saliva, drool or dribble escapes from the mouth usually as a result of the child not swallowing often enough.
If your child begins to drool, encourage them to dab around their mouth with a tissue NOT wipe. Dabbing will help to reduce drooling but wiping encourages more drooling.
To download a drooling checklist, click here.
Feeding and Swallowing
Speech and Language Therapists will see infants and children who have eating, drinking and/or swallowing problems (dysphagia). This might be as a result of physical or mechanical feeding difficulties and there is a higher incidence of swallowing difficulties with people with learning difficulties.
Once your child has been seen by a Speech and Language Therapist, they will make make recommendations to support your child’s eating and drinking. These recommendations may include: messy food play; texture development; positioning of your child or the use of different utensils or ways of feeding.
Please note that we do not provide a service to children or young people who:
- Present with feeding difficulties as a result of sensory and/or behavioural issues affecting their eating and drinking.
- Are ‘fussy’ eaters
- Refuse to eat lumpy/chewy foods
- Generally refuse to eat
Children who have English as a second language should not be regarded as having a speech and language difficulty.
Even children who have had limited exposure to English before going to school can become competent communicators in the new language.
However, some of these children may have speech and language difficulties in their home language as well as English and these children may require our support.
Referrals to the Speech and Language Service should be considered if you have concerns about a child’s communication in their home language or there are difficulties in both languages. You should also refer if there are concerns over their speech sounds in both languages; they are stammering or have voice quality and volume difficulties.
As with all referrals to Speech & Language Therapy, a hearing test should be considered.
- Accessing the curriculum – understanding what the teacher is saying.
- Literacy – Reading and writing skills
- Socially – playing and making friends
promote on-going development of understanding of language, speaking in longer sentences and speech skills.
Speech, language and communication development is a gradual process. Children develop skills at different rates, but beyond 8 years, usually children will:
- Use language to predict and draw conclusions.
- Use long and complex sentences.
- Understand other points of view and show that they agree or disagree.
- Understand comparative words e.g. ‘it was earlier than yesterday’.
- Keep a conversation going by giving reasons and explaining choices.
- Start conversations with adults and children they don’t know.
- Understand and use passive sentences e.g. “the thief is chased by the policeman”.
For general enquiries, or to be directed to a specific service or individual, please contact our switchboard on 01752 268011.