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Questions & Answers - Speech & Language Concerns
I have a 2.5 year old son who has a great vocabulary, appears to
be meeting all the appropriate milestones, but has muffled speech. I
understand 95% of what he says. I think a stranger may understand
75% of what he says. He had chronic ear infections as an infant and
had tubes put in at 9 months. We just had his adenoids checked and
discovered they are blocked and quite large. My oldest son had
muffled speech at the same age, and also had large adenoids. My
oldest son's adenoids were removed and his speech improved
dramatically. We hate to put him under again, but wonder if the
muffled speech is related to the enlarged adenoids. Could he just
need some articulation exercises to improve the quality of his
speech?
As therapist's we don't begin to look at the
actual articulation/intelligibility of speech until
a child reaches the age of three. Since you describe
your son as currently being 95% intelligible to you
and 75% intelligible to strangers, this indicates
that at age 2.5 he is within the norm for his
articulation skills. Children with chronic ear
infections do sometimes have articulation errors
because when they had the fluid in their ears they
had a temporary conductive hearing loss and during
that time they pronounced words as they heard them,
perhaps substituting a "th" sound for an "s" during
that time. They may still continue to pronounce
words that way even when the fluid is alleviated
because that is the way they learned them and it
became a pattern. Having said that, since your son
received his tubes at age 9 months, well before he
probably began using too many single words, this
probably has no bearing on his speech unless he
continued to have problems with his ears after he
received the tubes.
Also, many two year old and older children
continue to have articulation errors that are
expected and considered "normal" since production of
speech sounds is developmental in nature and many
children continue to work on more difficult sounds
and blends up until age 8. Enlarged adenoids often
cause nasal blockage and in turn children will mouth
breathe excessively, often snore at night and may
have trouble smelling or even breathing properly.
Enlarged adenoids and tonsils can even be related to
sleep apnea in some cases. Because of the nasal
blockage, enlarged adenoids can cause children's
speech to sound as if they have a cold all the time,
which could be why your son's speech is sounding
"muffled" since you went through this experience
with your other child. I would definitely discuss
your options with your physician, mention your
concern about his speech and see what he/she
recommends. If you do not have his adenoids removed
or even if you do and you still have concerns about
your son's articulation skills at age 3, then you
might choose to contact your local preschool early
intervention provider or a local speech clinic to
have your son's articulation skills assessed. You
can check our
speech and language page for what is typical for
a child of 2.5. This is also a link for a
0-3 Early Intervention
Program in your area if you choose to contact
someone before your son turns 3.
In the meantime you and your family can continue to be good speech
models for your son by pronouncing words correctly for him. Don't draw
attention when he mispronounces a word, but simply pronounce it
correctly for him in a sentence back to him so he hears it correctly
i.e., "Yes, you are eating SPAghetti". You can exaggerate initial sounds
for him or make silly games of making sounds back and forth such as "PA,
PA PA", "TI, TI, TI", or the snakes goes "ssssssss" etc. You can use his
books or cut out pictures from magazines to make matching games of
pictures with similar sounds. Blowing bubbles is a great oral motor
strengthening activity and if you are using sipper cups, switch to a
straw cup whenever possible, since sucking through a straw is a much
more mature oral motor movement than suckling through a sipper spout
(which is more like a bottle).
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Questions & Answers - Speech & Language Concerns
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