Psychotherapy is indicated for children with elective mutism. It is also recommended when the delay in speaking is accompanied by undue anxiety or depression. In autistic children, progress has been made in speech acquisition with behavioral therapy that includes operant conditioning. In this strategy, you'll be based on your child's speech or gestures.
Say what your child says and add a word. If your child says “ball”, you can say “I want the ball”, “my ball”, “yellow ball”, throw ball, or anything else that contains the word ball with another word. You could even use two or three different examples. If your child still doesn't say anything, you can take advantage of his gestures.
Whenever he points to something or makes a gesture to try to communicate something to you, say the word that accompanies that gesture. You can name what you're pointing or looking for, label the emotion you're feeling, or anything else you feel your child is trying to communicate. If your child's doctor tells you not to worry (that your child will catch up over time), but you're still worried, you can ask for a second opinion. You can ask your child's doctor to refer you to a developmental specialist or to a speech-language therapist.
You can also contact an early intervention program to be evaluated if your child is younger than 3 years old, or the local school district if he is 3 years old or older. If what your child says (expressive language) is the only delay, you may be given suggestions to help your child at home. Formal speech therapy may also be recommended. Many children who need speech therapy have an articulation or phonological processing disorder.
The typical time to correct a difference in speech is 15 to 20 hours (Jacoby et al, 200), and the typical frequency for joint treatment is twice a week for 30-minute sessions (ASHA, 200). Based on this information, it could be assumed that if the disorder were mild to moderate, with the child constantly attending treatment and families practicing their homework between sessions, the total duration of treatment could be about four to five months. The actual treatment time will also depend on the number of sound errors that are being addressed in the treatment plan. The more erroneous sounds there are, the longer the treatment lasts.
The doctor must provide the team with information about the cause of the speech delay and be responsible for any medical treatment available to correct or minimize the disability. In general, the more severe the mental retardation, the slower the acquisition of communicative speech. The medical history should include any maternal illnesses during pregnancy, perinatal injuries, infections or asphyxiation, gestational age at birth, birth weight, health history, use of ototoxic drugs, psychosocial history, language (s) spoken to the child, and family history of significant illnesses or delays in speaking. A speech-language pathologist plays an essential role in formulating treatment plans and goals.
The widespread delay in all aspects of developmental milestones suggests that the child's speech delay is mental retardation. It is difficult to obtain exact figures that document the prevalence of speech delay in children due to terminological confusion, differences in diagnostic criteria, the unreliability of unconfirmed parental observations, the lack of reliable diagnostic procedures, and methodological problems in sampling and retrieving data. Speech is the motor act of communication through the articulation of verbal expression, while language is the knowledge of a system of symbols used for interpersonal communication. The health care team may include the doctor, a speech therapist, an audiologist, a psychologist, an occupational therapist, and a social worker.
For the research review, the ASHA (American Speech, Language and Hearing Association) defined intensity as the amount of time spent on each treatment session, frequency as the number of treatment sessions over a given period of time (normally one week) and duration as the duration of treatment received (regardless of whether the child attended therapy for two or six months). Knowing a little bit about speech and language development can help parents determine if there are reasons for concern. While late-developing children will eventually develop normal speech, a child with an expressive language disorder won't do so without intervention. Children with an expressive language disorder (expressive developmental aphasia) do not develop the use of speech at their usual age.
The concern is well-founded, because a number of developmental problems accompany the delay in the onset of speech. Mental retardation is the most common cause of speech delay and accounts for more than 50 percent of cases. A comprehensive developmental assessment is essential, since delayed speech development is the most common early manifestation of global intellectual decline. .
