When should your child see a speech pathologist?
Monday 24 August 2020
Learning to eat, speak and use language make up a huge amount of baby and child development. They’re really important skills and take years of practise to master.
Even in the womb, a baby will begin moving its mouth and hands in ways that will later help them learn how to suck, swallow and pick up food, while with their developing ears, they are becoming familiar with the language they can hear coming through their mum’s tummy.
But feeding, speaking and using language are complicated processes. Some babies and children can have issues with feeding or speaking that crop up either straight from birth or as they grow older and start activities like school. If they’re not addressed, these issues can have lifelong effects.
Speech pathologists specialise in helping people who are having difficulties with feeding, speaking and language development. We spoke with Megan Free from the Speech Pathology team at Gold Coast University Hospital’s Child Development Service, about when a parent or caregiver might seek out the help of a speech pathologist.
Feeding issues in babies and children
Many people don’t know that speech pathologists can help with feeding troubles, as well as speech. Having trouble getting your newborn to feed well? Struggling with solids? Or, do you have a very picky eater on your hands? Megan says these are all areas with which a speech pathologist can help out.
“We start from birth with children who may have difficulties with their early feeding,” says Megan. “Later on, you can find difficulties with eating and drinking at any stage.”
So how do you know if your bub or child should see a speech pathologist for feeding issues? Megan says the signs to look out for vary at different ages and stages of development.
Difficulties with infant feeding
Whether they are breastfed, or bottle fed, when a baby is born, they have to learn a whole bunch of new skills to be able to eat. A baby’s first days and weeks see them learning how to latch, suck and swallow in order to get the milk they need to survive.
But, while you might think it should be the most natural thing, getting milk into a baby isn’t always easy. Megan says there are a variety of reasons that babies might have difficulties feeding.
“These issues can be related to prematurity or related to structural differences such as a cleft palate or a range of other factors,” she explains.
When it comes to helping babies who are having difficulty feeding, Megan’s team works alongside other healthcare professionals.
“We work hand-in-hand with our colleagues, nurses and lactation consultants,” says Megan. “Generally, speech pathologists support the feeding relationship through not only looking at a child's individual feeding skills but also the way in which a parent feeds their child and how these interact.”
Speech pathologists can assess what’s happening physically for your baby if they’re having trouble feeding. They’ll look at how they use their lips, mouth and tongue when they’re eating, how these areas have physically developed and whether they’re having any issues with skills like sucking and swallowing.
At around 6 months of age, you can start introducing simple family foods (solids) to your baby. Once again, there’s a new set of skills for them to learn including touching and picking up food, bringing food to their mouth, eating using utensils, exploring flavours and textures, chewing and swallowing.
If you’ve noticed your child is having trouble eating different foods, a speech pathologist might be able to help.
“For little ones, you might have realised your child isn’t transitioning onto the foods you would expect. You might notice they’re coughing and gagging when eating,” says Megan. “Some children have difficulty with a safe swallow, so they might have food or liquid going down the wrong way.”
Megan says a speech pathologist can use a number of tools and techniques to help when babies are having trouble eating different foods.
“It might be changing the types of foods that are offered to make it easier for the child to chew,” she explains. “Or it might actually be building skills in the way the child chews, so teaching them the oral motor skills to handle the food that the parents are offering them.”
Navigating picky eating
Do you have a fussy eater on your hands? Megan says that while most toddlers or children will go through phases of being picky about what foods they do and don’t want to eat, for some kids, being very selective about eating can become a bigger problem.
“Parents and carers generally have a good sense when there is something wrong, particularly if they feel that their child’s health might be impacted either nutritionally or with their growth,” she says. “If they have that gut instinct feeling that their child should be eating a lot more or they're fussier than average children – knowing that lots of toddlers go through a very fussy stage and that’s normal – it’s important to know they can get help with that.”
There are a lot of reasons children might become very selective about what they eat, and Megan works with both children and their parents or carers to address them.
“We can take a desensitisation approach for those children who have sensitivities to foods, sensory sensitivities around food, or fear around food,” she says. “We often also work with the parents around reducing their anxiety about feeding their children. The goal is for families to go back to enjoying mealtimes with their kids again.”
Megan says that working with a child who is selective about food can have a huge impact on the whole family.
“When you're eating multiple times a day, which for most families with little kids is at least five episodes of eating a day, that can cause huge stress for families,” she says. “It can also cause a lot of guilt for parents around eating and growth, and taking that guilt away is usually a huge thing for families.”
Speech and language development
Child speech pathologists also work with children who have trouble speaking or using and understanding language. Parents of these children might have noticed that they are not starting to speak or make noises around the right age, having difficulty with speech sounds or word pronunciation, stuttering, or having trouble understanding or using language in words or sentences.
“We do treat stuttering, but speech pathology goes beyond just how a child speaks,” says Megan. “We look at language, we target literacy – both reading and writing, social skills, listening and using their voice.”
Megan says that it’s really important for parents or carers who are concerned about how a child is speaking or using language to get help early.
“The effects of early difficulties in speech or language can have lifelong consequences,” she says. “We know from all of the research that the earlier you start to address them, the better.”
But how do you know if your child’s speech is developing typically, or if they might need some help from someone like Megan? Megan says it can be tricky to tell, but that’s where expert speech pathologists can come in.
Having trouble with speaking and sounds
It’s important to remember that children learn to speak at different rates, and it can take years for a child to be able to make every sound properly every time they speak.
“We know that every child will learn language and start talking at different ages,” says Megan. “It's perfectly normal for a child who is three to not be able to pronounce their ”th” sound, for example, that develops much later. It can really be hard for parents to know if there's a problem because every child is different.”
Megan says that parents and carers will often notice that their child’s speech isn’t developing at the same rate as other kids around them, they’re not able to do what their siblings were doing at the same age, or they’re not ticking off the milestones they’ve read about. This can also be picked up by child health nurses, childcare centre or school staff. While parents might not want to compare their child to others, noticing if their child is running late with their speech and language development can a valuable sign that it’s time to seek help from a speech pathologist.
“Talking to a speech pathologist can really give parents clarity around whether it’s something that we need to be providing early intervention for, or if it is something that is just within that normal range of typical development.”
If you’ve noticed your child speaks with a stutter, a lisp, or is having trouble saying certain sounds, it’s worth seeing a speech pathologist straight away.
Developing oral language skills
While most people might think a speech pathologist just works with speech issues like having a stutter, Megan’s team also help children who have trouble using and understanding language.
“We do a lot of work with children who might be having difficulty understanding instructions or listening, and children who are having difficulty putting their words together and building sentences and stories,” says Megan. “This is different from a child who pronounces words in the wrong way. Building oral language skills is a really essential skill in early childhood development.”
For these children, the therapies Megan recommends can involve the child and the whole family.
“We might be working with the child to build nice sentences, or we might be working with the family, the parents, and the other key people in the child's life to help them know how to build a communication-rich environment,” she says. “We can support them to respond to their child and how to model language for their child. Particularly for very little ones, it is often more about modifying the environment to support language development.”
You know your child best – don’t wait to seek help
If you have any concerns about how your child is speaking, using language or feeding, Megan recommends seeing a speech pathologist about it sooner rather than later.
“In general, we don’t support the ‘wait and see’ approach,” says Megan. “We don’t encourage parents to wait, particularly if they have that gut feeling that there might be something going on for their child or their child might need just a little bit of extra help.”
“Communication is essential for lifelong success. It's essential for education, for learning, for career opportunities and for developing self-esteem and relationships with other people. So, if we can avoid any long-term consequences of a language disorder or a speech sound disorder, we want to do that as early as possible.”
So, if you have a concern, what should you do?
Families can ask for a referral to a speech pathology service at their local Hospital and Health Service, from a GP or a child health nurse. You can also access private speech pathology practitioners that can see children without a referral.
For Megan, helping children with their feeding, speech and language development is a joyful job.
“It's such rewarding work to help a child communicate to their fullest potential,” she says. “that's a basic human need; to be able to express yourself and be able to be heard. And that's what we do every day.”