Speech and Language Disorders: Why More Kids Are in Therapy and What Parents Can Do

By Noelle Salmi


When Los Altos resident Susie Larson’s son Matthew was a year old, his speech consisted of grunts. On the advice of a pediatrician, Larson waited three months. But when the time passed and the boy’s speech had still not progressed past the grunting stage, she took him for an assessment at Early Start, a program administered by the Regional Centers of the California Department of Developmental Services.


What Are the Speech and Language Developmental Milestones for your Child? Find out here.

The specialists there told Larson that her son’s speech delay was within the normal developmental range. She could wait a few months to see whether his speech would improve, and, if not, could seek another evaluation at that time.


Like an increasing number of Silicon Valley families, Larson chose not to wait – opting instead for early intervention. She enrolled 18-month-old Matthew in five hours per week of speech therapy.


Causes of Speech and Language Disorders

T-FAMILY: Verdana">Throughout Silicon Valley, parents and speech/language pathologists say they are seeing more children in speech and language therapy than in years past. One reason is a sad reality: Ever more children are being diagnosed with autism and other disorders on the spectrum, such as Pervasive Developmental Disorder (PDD) and Asperger’s syndrome. Failure to reach typical speech and language milestones are common with autistic spectrum disorders and may often be the first visible indication of them.

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T-FAMILY: Verdana">Professor Gloria Weddington, who has been teaching in the Department of Communicative Disorders and Sciences at San Jose State University for 35 years, says the number of children diagnosed with autistic disorders has risen dramatically in recent years. She estimates that these children make up 20 percent of the clients in the university’s speech and language clinic.

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T-FAMILY: Verdana"> Language disorders – which include delayed speech, limited vocabulary, difficulty acquiring syntax and grammar, or limited comprehension – can also arise from other neurological conditions such as cerebral palsy, birth trauma or other serious developmental issues, says Bishop Graham, a speech/language pathologist in San Francisco.

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Speech disorders involve difficulty producing the sounds that make up language and include stuttering, lisping, inability to articulate certain letters or the cutting off of word parts. While language disorders are usually accompanied by speech problems, speech disorders can occur alone. In such cases, speech difficulties may be caused by hearing problems, physical impairments or other delays in motor skills, and may be more readily corrected through therapy than language disorders, says Graham.


Outside the realm of autism, the incidence of speech and language disorders in children has not changed in recent years, say experts. They believe the increase in the number of children receiving therapy is due to public awareness. Parents today have better understanding of the value of having kids assessed and treated.
Says Weddington, “Education campaigns have been conducted to parents, teachers and the general public. In the past, you’d find the physician saying, ‘Just wait and see.’ But we now know that early intervention seems to be the key.”


Demands of School

Pressures of school – from fear of labeling to academic expectations – are also driving parents to have their children assessed and treated during or even before they enter preschool.


A Los Gatos parent named Laurie, who did not want her last name used in this article, had her son’s speech assessed at the Stanford University Medical Center Speech and Language Clinic when he was 2 years old. The clinicians told Laurie her son was developmentally normal, and simply a slow, or “lazy,” talker. Although she had the option of waiting, concerns about kindergarten loomed in her mind.


Laurie says work colleagues and friends told her and her husband, “‘If there is an issue, you need to find out what the issue is and knock it out before he’s in kindergarten.’” Laurie explains, “With the public schools, in order to get services for speech, the child is under a ‘special education’ hat. A lot of people don’t want their kid labeled that. I know I certainly don’t want mine.”


So Laurie chose to pay for her son’s speech therapy.


“Because my child does not have a developmental issue, this is all pretty much paid for through my own pocket, without any health benefit,” she says.


Sessions with a private therapist cost the family $24 for 15 minutes; her son receives 60 to 90 minutes of therapy a week. (See sidebar: The Cost of Help)


Laurie also mentions the rigors of kindergarten as a reason to keep her son in therapy, even though, at 4, he is now speaking nearly on par with his peers.


“I’m just grooming him for kindergarten, in all honesty,” she says. “I think kindergarten is different than when we were kids. And I think that there are higher expectations for the children, so I didn’t want him to have any hindrances in speech. I wanted to make sure that when he gets in there, he’s just able to communicate.”


Like Laurie, Susie Larson also considered the kindergarten demands in her decision to enroll Matthew in therapy at such a young age.


“Some people had the impression that he would have been fine had I not done it,” Larson says. “But in this aggressive environment, I’m so glad I did it. Right out of the gate, once they hit kindergarten, everything is so pushed in terms of their social and academic schedules . . . Why not get the ball rolling on speech when it’s not an issue and you have the time to do it?”


Theresa Bade Lozac’h, a kindergarten teacher at The Nueva School in Hillsborough, says that many parents are aware and concerned about the pressure for children to learn to read at an early age.


“It used to be that pre-K and kindergarten were times for developing language  – instead of a time for trying to apply it in print. The idea that all children should read by age 6 is ridiculous.”


Lozac’h says that all the children she has taught who were enrolled in speech therapy did have distinct communication issues. She cautions against pushing speech therapy on a child when it’s not truly needed.


“Often children who receive ‘extra help’ – even from the best, most well-intentioned folks – intuit that there is something wrong or different about them and can have lower self-esteem because of it,” she says.


Early Detection and Intervention

T-SIZE: 10pt; FONT-FAMILY: Verdana">That said, if parents sense their child is having trouble making him or herself understood, they should speak with their child’s pediatrician, teachers, sports coach, music teacher or anyone else who is in a position to compare a child’s speech to that of his or her peers.

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If a child has a long-term developmental disorder, such as PDD or autism, communication issues may become apparent as early as 12 months of age. For example, the child may not maintain eye contact or may fail to use typical non-verbal communication such as smiling and pointing, says Patti Solomon-Rice, clinic coordinator at the Kay Armstead Center for Communication Disorders at San Jose State University. A parent who notices such unusual behaviors should discuss them with the pediatrician at the child’s 12- or 18-month check-up.


For children without underlying developmental issues, speech and language disorders may not be noticeable until later. Language disorders can sometimes be detected at around 18 months, at which point a child should have a single-word vocabulary and be starting to combine words.


Speech and articulation disorders are generally noticeable after 2 years of age. If by age 3, a child is just beginning to produce two- or three-word phrases or is much less intelligible than his or her peers, parents should consider a speech/language assessment, says Solomon-Rice.


T-SIZE: 10pt; FONT-FAMILY: Verdana">With both speech and language disorders, experts recommend early intervention. Brendan O’Connor Webster, executive director of the Center for Speech, Language and Occupational Therapy (offices in Los Altos, San Jose and elsewhere), explains that a speech disorder which is left untreated could affect a child’s personality and behavior development.


“A child who can’t be understood can start having behaviors that will act out what he wants, and he’ll learn that if he bites or hits or scratches, he’ll get what he wants, as opposed to saying, ‘Can I have the apple please?’” O’Connor Webster says.


Moreover, a child with an uncorrected speech disorder, such as mispronounced “r” or a lisp, may be teased and may gradually withdraw from communication.


 O’Connor Webster also notes, “There’s a very, very high correlation between early language disorders and later learning disabilities, including reading, spelling and writing – all the language-based academic skills.”


She recommends early intervention to build the inner structure of language that will be needed in later learning.


What Parents Can Do


O’Connor Webster directs parents concerned with speech and language issues to her clinics’ Web site (, where they can access information about typical milestones in speech and language development. Concerned parents can also look at the Web site of the American Speech-Language-Hearing Association ( for a similar developmental chart.


=MsoNormal style="MARGIN: 0in 0in 0pt">To help children develop normal speech, specialists recommend the common sense approach of speaking, listening and reading to one’s children. Parents should also understand that many children without disabilities also experience normal “developmental disfluencies” between the ages of 2 and 4, says San Francisco therapist Graham.

=MsoNormal style="MARGIN: 0in 0in 0pt"> 

=MsoNormal style="MARGIN: 0in 0in 0pt">For example, a child who is very excited about a recent trip to the zoo may appear to stutter, as her expressive language has not necessarily caught up with her motor skills. Graham counsels parents to not rush the child or finish her sentences, and to allow her enough time to communicate.

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=MsoNormal style="MARGIN: 0in 0in 0pt">Other helpful parent strategies include not calling attention to or correcting errors of speech. Instead, parents should encourage proper speech through modeling, and by repeating and expanding on what the child says.

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=MsoNormal style="MARGIN: 0in 0in 0pt">Yet if a child is clearly aware of his or her difficulties and is actively trying to prevent them, parents should consider seeing a speech/language pathologist, who may recommend an assessment.

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=MsoNormal style="MARGIN: 0in 0in 0pt">Among kids who enroll in therapy, the majority have mild problems which are corrected within a relatively short period of time.

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=MsoNormal style="MARGIN: 0in 0in 0pt">“Most of them end up on the other side with no problems,” says Weddington.

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=MsoNormal style="MARGIN: 0in 0in 0pt">Beyond that, parents should just relax and do what generations of parents have done. Parents should spend time with their kids and make language available to them. Says Weddington, “I think sometimes we’re too anxious. You see children in some of the most impoverished places in the world – they’re talking.”

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MsoNormal style="MARGIN: 0in 0in 0pt">Resources

MsoNormal style="MARGIN: 0in 0in 0pt">Early Start. For information, contact the California Department of Developmental Services at You can also find a directory of regional centers on the site. For Santa Clara and Santa Cruz counties, contact the San Andreas Regional Center, 300 Orchard City Drive, Suite 170, Campbell, CA 95008. 408-374-9960. For San Mateo County, contact Golden Gate Regional Center, San Mateo field office, 3130 La Selva Drive, Suite 202, San Mateo, CA 94403. 650- 574-9232

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MsoNormal style="MARGIN: 0in 0in 0pt"> Kay Armstead Center for Communication Disorders. Contact the Department of Communicative Disorders and Sciences at San Jose State University, 1 Washington Square, Sweeney Hall 115, San Jose, CA 95192-0079. Visit the Web site at or contact the CDS department secretary Deanna Rodarte at 408-924-3688 or via e-mail at

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MsoNormal style="MARGIN: 0in 0in 0pt">Stanford University Medical Center Speech and Language Clinic,

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MsoNormal style="MARGIN: 0in 0in 0pt">Rehabilitation Services, Lucile Packard Children's Hospital, Stanford University Medical Center, 725 Welch Road, Palo Alto, CA 94304. 650- 497-8218. They can put you in touch with a pediatric speech-language pathologist.


Center for Speech, Language and Occupational Therapy (offices  in Los Altos, San Jose, Pleasanton, Fremont) 650-948-7189 ext. 102. Web site: Los Altos address: 1577 Carob Lane.  San Jose address: 602 East Santa Clara Street, Suite 200.

More Help


Several books about how children learn to communicate are available in libraries and bookstores. Frequently recommended is BabyTalk: Strengthen Your Child's Ability to Listen, Understand, and Communicate, by Sally Ward (Ballantine Books 2001).


The Hanen Centre offers seminars for parents of children with language delays. For information on the “It Takes Two to Talk” program, visit


The Cost of Help

While private therapy sessions can be expensive, ranging from $75 to $120 per hour, parents can also opt for group therapy sessions, which can be less expensive, at $45 an hour, for example.


In addition, school age children from all California schools are eligible for free therapy through the public school system – but only if their disorder is deemed significant enough to affect learning. A lisp, for example, would typically not qualify. Children younger than the age of 3 can access free therapy through Early Start.


Another lower cost option for kids who do not qualify for free therapy, or who wish to supplement that therapy, can be found through university clinics, such as the Kay Armstead Center for Communication Disorders at San Jose State University. The fee for a speech, language and hearing evaluation is $150.00 which consists of a three-hour comprehensive assessment. A semester of individual therapy, twice weekly for 50 minutes each, is $360. A semester of group therapy, twice weekly for 50 minutes each, is $100. A sliding scale is available for all services.

Continue> Speech and Language Developmental Milestones

Noelle Salmi is a freelance writer and mother of two based in the Bay Area.