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Clinic at the Royal Children's Hospital

Speech and language problems

Speech problems occur when children have difficulty producing speech sounds correctly or fluently, and are sometimes diagnosed as speech disorders. Types of speech disorders include: articulation disorder; phonological disorder; dyspraxia; and stuttering.  Difficulties pronouncing sounds, getting the sounds to come out correctly, or having trouble speaking smoothly are all examples of speech disorders.

Language problems occur when someone has trouble understanding others (receptive language), or has trouble sharing thoughts, ideas, and feelings completely using words (expressive language).

Speech and language problems may occur as a result of a medical problem or have no known cause.

Signs of early language and speech disorders include:

  • Says p, b, m, h, and w incorrectly in words most of the time (1–2 years)
  • Says k, g, f, t, d, and n incorrectly in words most of the time (2–3 years)
  • Produces speech that is unclear, even to familiar people (2–3 years)
  • Doesn't smile or interact with others (birth–3 months)
  • Doesn't babble (4–7 months)
  • Makes few sounds (7–12 months)
  • Does not use gestures (e.g., waving, pointing) (7–12 months)
  • Doesn't understand what others say (7 months–2 years)
  • Says only a few words (12–18 months)
  • Doesn't put words together to make sentences (1½–2 years)
  • Says fewer than 50 words (2 years)
  • Has trouble playing and talking with other children (2–3 years)
  • Has problems with early reading and writing skills—for example, may not show an interest in books or drawing (2½–3 years)
  • Struggles to say sounds or words (2½–3 years)
  • Repeats first sounds of words—"b-b-b-ball" for "ball" (2½–3 years)
  • Pauses a lot while talking (2½–3 years)
  • Stretches sounds out—"f-f-f-f-farm" for "farm" (2½–3 years)

If you are concerned the best place to start is a communication assessment with a Speech-Language Pathologist (SLP). SLPs can help identify speech and language problems, and provide therapy to help improve and resolve these difficulties early.

The following practitioners at CPMG can be of service in helping assess and manage speech and language problems in children and adolescents:

Daryl is a paediatrician who has worked at the Royal Children’s Hospital for 30 years and currently holds appointments as a general paediatrician in the department of General Medicine at the Royal Children’s Hospital, associate professor in the University of Melbourne Department of Paediatrics, and senior research fellow in the Murdoch Children’s Research Institute.

Daryl is active in research into better ways to treat children with developmental disorders such as autism, ADHD and Tourette syndrome.

Julian is an experienced paediatrician who currently holds appointments as a general paediatrician in the department of General Medicine at the Royal Children’s Hospital and as a research fellow in the University of Melbourne Department of Paediatrics.

His areas of interest include acute general paediatrics, learning and behavioural disorders and lymphoedema.

Julian also has experience in international child health, working as a WHO consultant in the People’s Republic of China and the Solomon Islands.

Michaela trained as a Paediatrician at the Royal Children’s and The Mercy Hospitals in Melbourne.

During her training Michaela specialised in developmental and behavioural paediatrics, but since then she has continued to work both acute and outpatient settings, seeing children of all ages, including babies.

Michaela’s areas of interests include developmental delay, speech delay, failure to thrive and growth concerns, Autism, ADHD, constipation, encopresis and enuresis, behavioural problems, anxiety, eczema, asthma and urinary tract infections.

Natalie is a paediatric Speech Pathologist with over 20 years experience. She been working in the Victorian Paediatric Rehabilitation Service at The Royal Children's Hospital and Monash Children's Hospital for the past 10 years and previously worked in the acute hospital and community health settings. In February 2020, along with joining The Children's Private Medical Group, Natalie will begin working for the Acute Speech Pathology department at The Royal Children's Hospital.

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