Understanding the Oral Language Links to Dyslexia

“Goo-goo”.

“Ma-ma.”

“Da-da.”

 “Ba-ba.”

Parents can’t wait until their infant begins to communicate with sounds. The “oohs and aahs” that adults make when an infant starts to blow bubbles and make ba-ba sounds are cute.

So are the initial tries of infants and toddlers saying Mama and Dada followed by ba-ba for a bottle.

But did you know that at this stage (2-24 months), children are showing their awareness of the connection of sounds to meaningful communication? They are intentionally using sounds to talk with their parents. They start with vowel sounds (oh, ah) and expand over the next 2-3 months with other vowels and some consonants, such as mu and bu. They are learning how moving different mouth muscles can create new sounds. They are also learning why saying the sounds in a specific order is important.

By 12 months, the infant should be babbling; by 24 months, toddlers should have a minimum of 25 words. It can be much more, up to over 200 words and some word combinations. By 4 to 5 years of age, children should be able to pronounce every consonant and vowel.

But 8-9% of children struggle at this point. They have one of two speech disorders (and may have both).

Articulation Disorders

 With articulation disorders, children have difficulties pronouncing the sounds in words correctly, like saying gog for dog or wabbit for rabbit.

Every child will have some articulation issues when first learning the sounds and pronouncing words. It is not uncommon for a child to be eight years of age when they have finally mastered all the pronunciations. But don’t wait that long if the articulation issues are more prominent and affect social interactions with family, peers, or in school.

Speech sounds may be dropped, added, distorted, or substituted

According to CHOP.edu, Signs of an articulation disorder can include the following:

• “Leaving off sounds from words, such as saying “coo” instead of “school.”
• Adding sounds to words, such as saying “puhlay” instead of “play.”
• Distorting sounds in words, such as saying “thith” instead of “this.”
• Substituting sounds in words, such as saying “wadio” instead of “radio.”

Phonologic disorders

When listening to children under five years of age, certain sound errors are more common and should disappear at different ages. Examples consist of

• Correcting “f” and “s” by 3 years of age
• Correcting “v” and “z” by 3.5 years of age
• Correcting “ch,” “sh,” and “j” by 4.5 years of age
• Correcting “th” by 5 years of age.

Examples, according to CHOP.edu, of phonologic disorders are

• “Saying only one syllable in a word, such as saying “bay” instead of “baby.”

• Simplifying a word by repeating two syllables, such as saying “ba-ba” instead of “bottle.”
• Leaving out a consonant sound, such as saying “at” or “ba” instead of “bat” or saying “tar” instead of “star.”
• Changing certain consonant sounds, such as “tat” instead of “cat.”

According to Marquette.edu,

 “In one sample of children, 75% of preschool-age children with speech sound disorder and language impairment developed dyslexia (Lewis et al., 2000), and 18% of preschool-age children with isolated speech sound disorder (absent of language impairment) developed dyslexia. “

It is important to listen closely during visits of patients in the 18-month to 5-year age range to catch both articulation and dyspraxia issues, as well as developing problems with processing the sounds in words, which would be a phonologic disorder.

Waiting until they start school to address articulation and phonologic disorders means catching up while also learning new information, namely connecting sounds with symbols (letters). This academic learning will go much faster than these children can keep up since they are trying to remember and apply what a speech therapist may be teaching them but also how the teacher is now expecting the students to be able to make those connections.

Trying to double-learn may lead many children to develop self-esteem issues, anxiety, and academic shutdown since they don’t want to read or speak in class with these speech sound problems.

It is better to be proactive by referring patients who might have speech sound disorders sooner rather than later. Using a school-based resource may work, although there might be discrepancies where the child doesn’t make severity cutoff levels. The other option is to refer the child to a hospital-based or community-based speech therapist who would have more flexibility in determining if therapy would be useful.