Speech-language disorders

Q: What are Speech and Language Disorders?

A: Both children and adults can have speech and language disorders. They can occur as a result of a medical problem or have no known cause

Speech Disorder - When a person is unable to produce speech sounds correctly or fluently, or has problems with his or her voice, then he or she has a speech disorder. Difficulties pronouncing sounds, or articulation disorders, and stuttering are examples of speech disorders.

Language Disorder - When a person has trouble understanding others (receptive language), or sharing thoughts, ideas, and feelings completely (expressive language), then he or she has a language disorder. A stroke can result in aphasia, or a language disorder.

Q: What types of speech and language disorders affect school-age children?

A: Children may experience one or more of the following disorders:

  • Speech sound disorders - (difficulty pronouncing sounds)

  • Language disorders - (difficulty understanding what they hear as well as expressing themselves with words)

  • Cognitive-communication disorders - (difficulty with thinking skills including perception, memory, awareness, reasoning, judgment, intellect and imagination)

  • Stuttering (fluency) disorders - (interruption of the flow of speech that may include hesitations, repetitions, prolongations of sounds or words)

  • Voice disorders - (quality of voice that may include hoarseness, nasality, volume (too loud or soft)

Q: Do speech-language disorders affect my child’s learning ability?

A: Speech and language skills are essential to academic success and learning. Language is the basis of communication. Reading, writing, gesturing, listening, and speaking are all forms of language. Learning takes place through the process of communication. The ability to communicate with peers and adults in the educational setting is essential for a student to succeed in school.

Q: How might a speech-language disorder affect school performance?

Children with communication disorders frequently do not perform at grade level. They may struggle with reading, have difficulty understanding and expressing language, misunderstand social cues, avoid attending school, show poor judgment, and have difficulty with tests.

Difficulty in learning to listen, speak, read, or write can result from problems in language development. Problems can occur in the production, comprehension, and awareness of language sounds, syllables, words, sentences, and conversation. Individuals with reading and writing problems also may have trouble using language to communicate, think, and learn. 

Q: What do Speech-Language Pathologists (SLPs) do when working with preschool children who have speech-language needs?

A: Speech-language pathologists help in a variety of ways when working with preschoolers with language disorders. They work directly with children and their parents, caregivers, and teachers. SLPs help people understand the important connection between the words that we say and our ability to read and write later on. SLPs help children improve their understanding and use of language.

They help children:

  • follow directions

  • talk about and ask for things

  • form short sentences and ask and answer questions

  • tell stories and describe pictures and events

They also help children with beginning reading and writing skills. They build children's awareness of written words in books and in the environment.  SLPs talk to parents, caregivers, and teachers about ways to help children improve and enhance their language skills. They help parents understand how to work with their children at home and in everyday activities.

Q: What Is Language? What Is Speech?  Is there a difference between the two?

A: Language is different from speech. Language is made up of socially shared rules that include the following:

  • What words mean (e.g., "star" can refer to a bright object in the night sky or a celebrity)

  • How to make new words (e.g., friend, friendly, unfriendly)

  • How to put words together (e.g., "Peg walked to the new store" rather than "Peg walk store new")

  • What word combinations are best in what situations ("Would you mind moving your foot?" could quickly change to "Get off my foot, please!" if the first request did not produce results)

Speech is the verbal means of communicating. Speech consists of the following:

  • Articulation - How speech sounds are made (e.g., children must learn how to produce the "r" sound in order to say "rabbit" instead of "wabbit").

  • Voice - Use of the vocal folds and breathing to produce sound (e.g., the voice can be abused from overuse or misuse and can lead to hoarseness or loss of voice).

  • Fluency - The rhythm of speech (e.g., hesitations or stuttering can affect fluency).

When a person has trouble understanding others (receptive language), or sharing thoughts, ideas, and feelings completely (expressive language), then he or she has a language disorder.

When a person is unable to produce speech sounds correctly or fluently, or has problems with his or her voice, then he or she has a speech disorder.

Here are two examples:

Example A: Kelly's 4-year-old son, Tommy, has speech and language problems. Friends and family have a hard time understanding what he is saying. He speaks softly, and his sounds are not clear.

In example A, Tommy has a speech disorder that makes him hard to understand. If his lips, tongue, and mouth are not moved at the right time, then what he says will not sound right. Children who stutter, and people whose voices sound hoarse or nasal have speech problems as well.

Example B:  Jane had a stroke. She can only speak in one to two-word sentences and cannot explain what she needs and wants. She also has trouble following simple directions.

In example B, Jane has a receptive and expressive language disorder. She does not have a good understanding of the meaning of words and how and when to use them. Because of this, she has trouble following directions and speaking in long sentences. Many others, including adults with aphasia and children with learning disabilities, have language problems.

Language and speech disorders can exist together or by themselves. The problem can be mild or severe. In any case, a comprehensive evaluation by a speech-language pathologist (SLP) certified by the American Speech-Language-Hearing Association (ASHA) is the first step to improving language and speech problems.

Q: How Does Your Child Hear and Talk?

A: The development of communication skills begins in infancy, before the emergence of the first word. Any speech or language problem is likely to have a significant effect on the child's social and academic skills and behavior. The earlier a child's speech and language problems are identified and treated, the less likely it is that problems will persist or get worse. Early speech and language intervention can help children be more successful with reading, writing, schoolwork, and interpersonal relationships. 

Listed below are developmental charts for children of different ages from birth to 5 years.  The information listed on the charts represents, on average, the age by which most monolingual speaking children will accomplish the listed milestones. Children typically do not master all items in a category until they reach the upper age in each age range. Just because your child has not accomplished one skill within an age range does not mean the child has a disorder. However, if you have answered no to the majority of items in an age range, seek the advice of an ASHA-certified speech-language pathologist or audiologist.

Q: What should my child be able to do?

A: 1 -2 years old

Hearing and Understanding

  • Points to a few body parts when asked.

  • Follows simple commands and understands simple questions ("Roll the ball," "Kiss the baby," "Where's your shoe?").

  • Listens to simple stories, songs, and rhymes.

  • Points to pictures in a book when named.


  • Says more words every month.

  • Uses some one- or two- word questions ("Where kitty?" "Go bye-bye?" "What's that?").

  • Puts two words together ("more cookie," "no juice," "mommy book").

  • Uses many different consonant sounds at the beginning of words.

2 – 3 Years Old

Hearing and Understanding

  • Understands differences in meaning ("go-stop," "in-on," "big-little," "up-down").

  • Follows two requests ("Get the book and put it on the table").

  • Listens to and enjoys hearing stories for longer periods of time


  • Has a word for almost everything.

  • Uses two- or three- words to talk about and ask for things.

  • Uses k, g, f, t, d, and n sounds.

  • Speech is understood by familiar listeners most of the time.

  • Often asks for or directs attention to objects by naming them.

3 - 4 Years Old

Hearing and Understanding

  • Hears you when you call from another room.

  • Hears television or radio at the same loudness level as other family members.

  • Answers simple "who?", "what?", "where?", and "why?" questions.


  • Talks about activities at school or at friends' homes.

  • People outside of the family usually understand child's speech.

  • Uses a lot of sentences that have 4 or more words.

  • Usually talks easily without repeating syllables or words.


4 - 5 Years Old

Hearing and Understanding

  • Pays attention to a short story and answers simple questions about them.

  • Hears and understands most of what is said at home and in school.


  • Uses sentences that give lots of details ("The biggest peach is mine").

  • Tells stories that stick to topic.

  • Communicates easily with other children and adults.

  • Says most sounds correctly except a few like l, s, r, v, z, ch, sh, th.

  • Says rhyming words.

  • Names some letters and numbers.

  • Uses the same grammar as the rest of the family.

Q: I’m not sure if my child has a speech-language need.  Can I have my child evaluated to determine if my child needs therapy?

A: Yes, at Sounds of Success Preschool and Learning Center, we can complete a speech-language evaluation to determine your child’s current speech and language abilities.  The Speech-Language Pathologists will also review the evaluation results with you and help you determine what “next steps” you can take for your child. 

Consultations are available for initial questions or to help answer further questions or concerns after evaluations are completed.

Q: How much does Speech-Language Therapy Cost?

A: On average, private speech-language therapy services cost about $100.00 per hour.  The cost of a speech-language evaluation can vary depending on the type of evaluation needed and the length of time it takes to complete the evaluation.  At Sounds of Success we strive to help all children and families receive the services they need.  Our rates for services are lower than other private practice clinics.  For all day preschool speech-language therapy service rates see our Tuition section or for after school speech therapy rates see our Speech Therapy section.

Q: What should I do if I have concerns regarding my child’s speech and language development?

A: If you have questions or concerns regarding your child’s speech and language development, please call us at (808) 488-2211 for more information regarding the evaluation and admission process.  We have speech-language pathologists (SLPs) on staff to help identify and treat speech and language disorders.