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Speech and Self-Esteem for Children
By: Cathy Hammargren, Director of Speech Pathology and Audiology at University MedicalCenter

In our society, how we speak and express ourselves is important to the way in which we are perceived by others. If an individual suffers from a speech deficit, it will influence how people perceive them and in turn effect their self-esteem. This is especially true for children. That's why it's important for parents to pay particular attention to their child's speech and language development. Children who suffer from speech deficits may also experience difficulties in the development of reading and writing skills, and the development of peer relationships could be affected. They may be perceived as less intelligent because they have difficulty properly expressing themselves in the classroom.

Some sounds and words are more difficult to produce and develop later on in a child's life, however, there are speech deficits parents need to be aware of since these deficits may cause future problems for their child.

In some cases, concern about a child's speech is unfounded. The child's speech may fall within the range of normalcy for speech and language development. What patterns will children outgrow and what patterns should parents be concerned about? The following are questions commonly asked by parents when they bring their children into our outpatient clinic at University Medical Center.

1. When should children start saying their first words?
   There isn't an exact timetable as to when children will say their first words. Every child develops at his or her own pace. Usually, parents can observe the following guidelines when deciding if their child is developing at an appropriate rate. At six months, children should participate in vocal play through making varying sounds at varying pitches and at different levels of volume and intensity. They should react to loud voices and turn and look towards new sounds. At 8 months, children should respond to their name, produce four or more different sounds and try to imitate sounds. At age twelve months, babies recognize their name, understand simple commands and begin to produce simple words.
   
   
2. Do speech problems run in families?
   There is no research, as of yet, that has proven that speech deficits are inherited. However, some speech patterns may be learned from family members and certain speech disorders appear to run in families.
   
   
3. What causes speech problems?
   There are a variety of factors to consider when discussing the cause of a child's speech or language deficit. Some factors to consider are chronic ear infections, accidents or injuries, neurological deficits, hearing loss, developmental delays, many types of syndromes, etc. Each child is different with individual needs and causes.
   
   
4. I've noticed my child can't say certain words, is this normal?
   Yes, some sounds and words are more difficult to produce and are not expected to develop until later in the child's life. The first sounds to emerge are usually vowel sounds and then consonant sounds such as p,b,n,m and d. Later developing sounds include s, r, and th.
   
   
5. I think my child stutters, how can I tell for sure that he/she has this speech deficit?
   In general, children begin to develop increasingly complex language skills around the age of three years. Many three year old children will make revisions throughout their conversations that sound like stuttering. If these defluencies are in conjunction with facial grimaces, eye blinking, body tension or any other unusual behaviors, your child may be stuttering.
   
   
6. How early can speech therapy begin?
   Speech therapy could begin as early as before a child leaves the hospital at the time of their birth. Speech services can begin at anytime. Parents are encouraged to seek out services as concerns arise.
   
   
7. How long will my child be in speech therapy?
   The amount of time is highly individualized and is based on the child's diagnosis, the severity of deficit, related disorders, family involvement and many other factors.

Cathy Hammargren, Director of Speech Pathology and Audiology at University MedicalCenter

BIOGRAPHY
Cathy Hammargren is a Masters level graduate from the University of North Carolina at Greensboro with eleven years of experience in Speech Pathology in a variety of settings, from school systems, Head Start programs, Home Health, Acute Care, Rehabilitation to Long Term Care. Currently, she is the Director of Speech Pathology and Audiology at University Medical Center.