When families come in for speech therapy, one of the common things I hear is, “he can say sounds, but he can’t use those sounds in words”. Or - another version - he can say “bye” but not “ball” (even though they use very similar sounds).

How does this happen? Why does this happen? 

And the short answer is: we don’t really know: speech development is a brain thing that we’re still discovering. Unsatisfying, I know. For me too.

But the longer (slightly more satisfying) answer goes something like this:

When a child is learning to speak, there are some things that need to be firmly in place in order for clear speech to develop. If any of these things is out of place, we’ve got issues. Let’s take a closer look:

1. Oral Structure and Function. 

This seems like an obvious one, but it isn’t always. Sometimes structural and functional ‘glitches’ are hiding from us in plain sight. It might be something as dramatic as an unidentified cleft or something as innocuous-seeming as thumb sucking or picky eating. When kids aren’t talking, we always want an experienced eye to take a closer look at how the body and the mouth are developing.

1. Hearing. 

This is suuuuuper important and something that often gets overlooked. Whether your child has wax build up or chronic fluid in their ears, if your child isn’t hearing well, it can affect speech development. A lot. Even a mild hearing loss - if it’s timed just wrong - can impact a child’s ability to speak clearly. (It can also affect a child’s ability to listen, but we’ll talk about that another time.)  If you’re worried about your child’s speech and language development, a full audiological evaluation is an easy first step to ruling out hearing loss as the reason why. Get one.

1. Phonological rules

What the heck are these anyway? Simply put, phonological rules are the ways in which our brain makes sense of different types of sounds. For example, some sounds are made with the lips, some with the tongue: your brain keeps track of that. Some sounds are long and some are short (think about the difference between an /s/ and a /t/): your brain keeps track of that. Some sounds are made with voice and some without (think about /v/ and /f/ or any of the vowels): your brain keeps track of that.

What happens in many young children, though, is that sometimes their brains create faulty ‘rule’ around sounds (often because their motor system - see below - can’t quite keep up with the demands). So, lots of kids will substitute a ‘short’ sound in for a longer sound. This means that the word “sun” might come out like “tun”. Some kids will move sounds around, so that the word “kite” comes out like “tight”. 

Some of these rules are common among children of certain ages. Some of them aren’t. A major part of a pediatric speech therapist’s job is to know the different types of rules that kids’ brains come up with and to know which ones are more or less typical.

1. Motor learning

This is where things get really interesting (for me, anyway!). Once we are able to hear sounds, and once our brain has formed a phonological rule for those sounds, then our brains have to program a set of neuronal firings to stimulate muscles that bridge the connection between a sound representation and an act of speech production.

WHAT?!?!?!?!?!?!?!?!?!?!?!

The brain has to reach into areas of itself that deal with hearing, memory, meaning, language, and motor movements (among others).

And putting a speech act into motion requires a level of brain integration that some kids can’t quite coordinate yet. The signal can get ‘lost’ as it travels among brain areas. Sometimes the sound might come out clearly and sometimes it won’t. Some words get ‘learned’ and others don’t. 

Are you getting the picture? It’s COMPLICATED! Lots of moving parts. Literally and figuratively.

The good news is that brains can get rewired. We can form new neuronal connections and pathways and we can correct ‘faulty’ ones. That’s essentially what we’re doing in therapy with young kids: rewiring brains. (WOW, right?!)

So, back to our toddler who is old enough, but who’s not saying ‘mama’. 

It’s not personal.  But it is worth taking seriously. And it’s worth asking someone who knows what they’re doing (aka: a pediatric speech language pathologist/speech therapist) what’s going on. 

If you have questions about your child’s speech development, please reach out. We specialize in early language development, and we’re here to help.