KUALA LUMPUR: When babies become toddlers, they will crawl vigorously, starting to walk, even talking a little. They will be able to communicate with people around them long before they speak a single word.
For normal toddlers between 15 to 18 months, the speech and language milestones are as follows: they can point to an object or picture when it is named for them, recognise names of familiar people, objects, and body parts, and also say several single words.
But it is not the case for Muhammad Adwa Rizqi, the son of a government servant Mohd Khirul Mudarikah, when his child was not able to speak more than 10 words by the time he reached 18 months old.
According to Mohd Khirul, “I first noticed he was having trouble speaking, the best he could do was two or three simple words like Papa and Mama. I was worried about his speech and language development as we had to check with the Hospital Selayang paediatrics to confirm whether he had a speech delay problem or not.
“But luckily with swift intervention including regular speech therapy sessions with the hospital, his speech and language condition is far better compared to the situation before. Now at the age of seven, he has grown up well and can now speak normally like other children of his age,” he shared.
Worrying condition
When contacted recently, consultant paediatrician at Columbia Asia Hospital Cheras Dr Kenneth Looi Chia Chuin told Bernama that child speech delay is a worrying condition when a child has trouble using verbal expression as part of communication and that includes articulation, which is the proper way sounds and words are formed.
If a child has reached the age of 18 months but he or she can only speak around one or two words, then a proactive action should be taken immediately because according to the national guidelines of normal child language development, the child should at least be able to acquire around 10 meaningful words, and can show some basic body parts when asked.
Dr Kenneth said, 24-month old toddlers should at least acquire around 30-50 meaningful words and can combine two words to make simple sentences such as ‘love Daddy’, and kids from 2 to 3 years old can acquire about more than 50 words and should start combining two or more words into phrases.
“The main problem that arises is that some parents are not aware that their children are experiencing speech delay, many would think that it is normal to speak slower and they will catch up soon. This causes them to hesitate to seek advice from medical professionals.
“Many parents will reassure themselves that their toddler will eventually catch up, but little do they know this can delay the toddler’s speech development even further and miss the golden period of treatment,“ he said.
He further explains, speech delay is slightly different from language delay; the latter means they have trouble expressing themselves or understanding others not only by using speech as a medium but also other types of language such as sign and body language. But essentially both of these terms are interrelated.
No screen time
There are many factors that can cause speech delay. It can be due to health problems such as hearing loss, disruption towards brain development for example cerebral palsy, or simply because of problems with the articulator’s movement such as tongue-tie (ankyloglossia), said Dr Kenneth.
“The causes can also derive from inheritance, where an affected child may have a close family member with a history of a language delay or communication disorder, or those who have a developmental syndrome like autism spectrum disorder (ASD) or Down syndrome as well,” he said.
From his observation, he noted that there has been a significant increase in child speech delay cases, which is very worrying, especially during the previous Movement Control Order (MCO), because most parents who were working from home, had to give gadgets to their toddlers due to task constraints.
According to the 2015 statistics by the National Institute on Deafness and Other Communication Disorders (NIDCD), the prevalence of speech delay in young children is 8 to 9 per cent.
“One of the common mistakes made by the parents is that they are giving too much gadget screen time to their toddlers especially those under 18 months. According to the World Health Organisation (WHO) screen time guidelines, parents cannot even give any gadget screen time at all. As for those aged 2 to 3 years old, the recommended screen time is just about one hour every day.
“In addition, there is no active gadget screen time applied whenever their toddlers use the gadget. What I mean is that parents should take an active part in managing device usage and promoting healthy habits. Choose the best types of activities to fit your family, as well as spending family time by playing learning games and using interactive fun activities together,” Dr Kenneth said.
Speech delay therapy
Meanwhile, managing director and consultant occupational therapist at Well Rehab Centre Lee Wei Qing said, there are practical ways to treat child speech delay problems, in which every child should start his or her therapy journey with an assessment first.
This assessment will eventually allow the speech therapists to identify the child’s strengths and weaknesses and establish a baseline to compare his or her progress during therapy.
“During the assessment, verbal communication, number and types of words, and sounds your child may be using will be reviewed. Next, therapists should also provide you with a therapy management plan to identify key goals to focus on the therapy programme,” he said.
After the assessment, the therapy sessions will begin with the therapists supporting the children to enrich their day-to-day language environment and maximise ways to model and stimulate speech and language.
“For children with only single words, therapists may look to increase the number of action words (verbs) so they can be joined with naming words to create the beginning of short phrases.
“We will be also looking to expand their range of vocabulary – to increase the variety of words through child-directed play. Increasing their understanding (comprehension) of language through book reading and playing strategy games is also vital during the therapy. We will also help resolve any potential hearing problems,” he said.
Practise at home
But the therapy sessions with the speech therapists are not always going to be enough if parents do not practise speeches with their children at home regularly, Lee said.
“If they have trouble saying a certain sound “f” for example, encourage them to just make that sound all by itself. Once that comes more easily from their mouth, you can incorporate it into syllables like “fi-fi-fi” before moving onto actual words that use it.
“Parents should also focus on what their children can do, because it is as important as to pay attention to their improvements in speech. Always remember to praise them when they achieve even small victories like picking up toys, being polite, or using the bathroom properly,” he noted.
Lee also said that parents should also keep background noise and distractions such as TV and smartphone to a minimum during learning sessions, as too much of it can delay their language and speech development progressively.
“The biggest concern right now is that most of the parents nowadays tend not to talk as much to their children as they otherwise would, while in fact, children will learn to speak best when they are spoken to.
“Other than keeping the ‘digital noises’ at bay, reading a favourite book to your child and then having them read it back to you can also provide excellent reinforcement. Even if the child is too young to be able to read words, having them explain what they see in the book and remembering the context from hearing it can strengthen speech and confidence,” he added. - Bernama
