Otitis media is the inflammation in the middle ear that is usually associated with a buildup of fluid. The fluid may or may not be infected. The fluid dampens the vibration from the ear drum to the inner ear so that sound energy is lost. The result may be a mild or even moderate hearing loss. Some speech sounds, therefore, may be muffled or not heard at all. Compounding the problem is the fluctuating nature of the fluid. This fluctuation does not give the child a consistent signal for hearing speech sounds, hence interfering with the development of articulation.
Speech sounds also develop as the child progresses through the various feeding stages – sucking liquids, beginning soft foods, cup drinking, and chewing. The same muscles involved in eating are used for speech production. If a child has difficulty with this eating progression, there may be a delay in articulation. The skill required for more difficult eating assists the development of more complex speech sounds. For example, the lips are active in suckling and sucking from birth. The “lip” sounds - /m/, /p/, /b/ - are among the first sounds that children use when beginning to babble. AS the child handles soft foods, the tongue is more active and begins to move without the jaw. This sets the stage for the development of “tongue tip” sounds - /n/, /t/, /d/.
Sounds are not learned at once. Many studies have been done to determine the age that most children use speech sounds appropriately in conversation. There have been conflicting results! The American Speech-Language-Hearing Association (ASHA) states that “children should make all the sounds of English by 8 years of age. Many children learn these sounds much earlier”. The later developing sounds are typically thought to be /s/, /r/ and /th/ due to their motor complexity.
How do you know when to seek help for your child? Parents should understand what their child is saying most of the time. Even at age two, parents should understand their child 80% of the time. For speakers over age four, listeners other than parents should be able to understand what is being said (especially when the topic is known) or should be able to pay more attention to what the words mean than to how they sound. Most important, the child should be confident about speaking. If the child is becoming self-conscious about his or her speech, self-concept is beginning to be affected. These are all signs that a speech evaluation is warranted. You can initiate a complete speech evaluation by contacting me at AAC on the Lakeshore.