Child does not speak at 2 years old: causes, treatment

Article:

Speech development disorders occur in 25% of cases.
The pathological condition is observed mainly in boys. Mostly up to 3-5 years. At the same time, the frequency of the disease (to call the condition conditionally) is 4 times higher than in girls. What this is connected with is not known for certain. It is assumed that the reason is the later general psychological and physical development of boys. The severity of the pathology varies from case to case. This may be an expression disorder. In this case, the child does not speak poorly, but a meager vocabulary, a small number of intonations and voice modulations predominate. It’s not always about pathology at all. There may be personality traits or a temporary period that will pass by itself later as general mental development progresses.

The causes of the disorder are both natural, social, and pathological, caused by physical and mental diseases.

It is always necessary to treat a patient if he speaks poorly. But in different cases the treatment will be different. It is necessary to contact a child psychologist, speech therapist, or pediatrician. You may need the help of a teacher or speech pathologist.

Pathology options

There may be several options. Classification is mainly carried out according to the age of the young patient.

Up to a year

The absence of coherent speech before the age of one year is quite normal. In this case, the person usually does not speak at all. Or he pronounces individual sounds, developing the speech apparatus. There are other options as well. For example, a child does not speak, but repeats words. This indicates accelerated psycho-speech development. There are also quite meaningful words, but often the pronunciation is incorrect. All the described conditions are completely normal physiological phenomena. No special treatment is required.

Up to 3 years

Almost 80% of cases occur under the age of 3 years. As a rule, the child already speaks, but does it poorly. Vocabulary suffers. Attenuated expression is observed. It is expressed in a lack of intonation and weak modulation of the voice. There are more difficult cases. For example, a person does not speak at all, is silent. Or he expresses himself with sounds. Another option is also possible. There is no phrasal speech, that is, thoughts are expressed in torn, separate words. Without the ability to construct sentences. Or the phrases are composed incorrectly, with errors. Such cases require diagnosis. Treatment is prescribed as needed, based on the nature of the disorder.

Up to 5 years

Lack of meaningful speech before age 5 is a clear sign of a disorder. It’s hard to say how hard it is. If the problem is actually organic diseases: Down syndrome, mental disorders, everything becomes obvious. It is much more difficult to identify pathologies of the speech apparatus or social factors: improper upbringing, lack of social contacts. Diagnostics is always required. Treatment - as quickly as possible. After the age of 5, it becomes more difficult to develop literate speech. This will take months of hard work with a speech therapist, speech pathologist and psychologist.

From 5 to 7 years

The last phase of development. Lack of speech is pathological. We need to find out the reason.

Types of speech dysfunction are distinguished conventionally. There are fractional classifications; a generally accepted distinction does not yet exist. In any case, the earlier the correction is started, the higher the chances of full recovery, development of correct speech, normalization of expression, expression of thoughts.

Delayed psycho-speech development

Delayed psycho-speech development (DSRD) is the consequences of deviations in the development of the central nervous system and brain, which manifest themselves in the form of disturbances in the rate of mental development of the child (his memory, attention, speech, thinking, emotional-volitional sphere).

Delayed psycho-speech development is often diagnosed at the age of 2-3 years, although the first signs can be detected as early as 4 months. But the later the diagnosis of SPR is made, the more difficult it will be to get rid of it in the future.

There are very important signs of the presence of SPD that parents can detect on their own. Children experience increased salivation, often have a slightly open mouth, they are unemotional or, conversely, hyperactive and aggressive, and are poorly developed physically. Key symptoms indicating possible PVD are:

• 4 months - the child does not respond to your words and gestures, does not smile.
• 8-9 months - the child does not babble.
• 1 year - the child practically does not make any sounds, and by 1.5 years he does not say the simple words “mother”, “give”, and does not understand speech addressed to him.
• 2 years - does not repeat new words, uses very few words in his speech.
• 2.5 years - uses only about 20 words, does not understand the names of body parts, objects, cannot form a simple phrase.
• 3 years - the child cannot repeat a phrase after an adult or form an easy sentence, speaks too slowly, or vice versa quickly, “swallowing” their endings.

If you notice similar symptoms in your child, do not let the situation take its course - contact a pediatric neurologist as soon as possible to establish a specific diagnosis. The earlier the child’s age, the greater the chances for a successful comprehensive recovery and proper development of the child in the future.

Why do children speak poorly?

There may be several reasons. Conventionally, they can be divided into organic and social.

Organic

Among these, lesions of the brain and hearing organs predominate. Less commonly, developmental disorders of the speech apparatus.

• Encephalopathy

A characteristic pathological process for children under 3-5 years of age. Accompanied by general disorders of higher nervous activity. Intelligence and memory decrease. In addition to speech dysfunction, behavioral problems or hyperactivity and attention deficit disorder (ADHD) are observed. Or lethargy, drowsiness, weakness. Both options are dangerous. Without special treatment, it is impossible to achieve functional restoration. They will continue to fade, development will slow down significantly. It is necessary to contact a neurologist.

• Birth injuries

Head injuries (TBI) and other options. Also asphyxia, for example, when the neck is compressed by the umbilical cord. Variations are possible. Birth injuries cause persistent disturbances in the functioning of cerebral structures. At best, only speech will be impaired. More severe problems, including secondary dementia, are also possible. Although there will be no organic underdevelopment in the clinic.

• Prematurity

Babies born prematurely are at greater risk. Because the brain continues to develop and form, without the help of the mother's body. Without excess nutrients and oxygen. The body has to produce everything on its own. Consequently, the resource that children born at the right time have is spent. Such children become sickly, they are weaker than their peers and often begin to speak later. You can cope with this situation, especially if you adhere to a normal regime, create the right diet and regularly exercise your brain. According to the age.

• Intrauterine hypoxia

Happens more often than you might think. If the baby inside the womb does not receive enough oxygen, the brain suffers. The process is possible both during pregnancy and in the last trimester. Right before labor is resolved. Both options are equally dangerous. In the first case, the fetus is guaranteed to get problems. At the very least, it will be bad to speak. Disorders such as encephalopathy and hypothalamic syndrome are also possible. In the second case, death from hypoxia is possible. Childbirth in cases of acute oxygen deficiency is resolved by cesarean section.

• TBI

Acquired, for example, in the early years: concussion, hematoma and other forms. Accompanied by severe damage to cerebral structures.

• Autism

Mental illness. Severe forms of autism are characterized by a complete absence of speech. The child speaks poorly or does not speak at all. 3 years - no question. The child is 7 years old - the function still does not develop. In milder forms, individual phrases are possible, but only in certain situations when biological needs are affected. High-functioning autistic people, such as those with Asperger's syndrome, do not suffer from such disabilities. However, they have problems understanding emotions and expressing them. Therefore, speech may be poor in modulation and intonation, which is quite normal for such patients.

• Down syndrome, separately there is oligophrenia in varying degrees

Recovery is impossible, but some measures are being taken to adapt. People with mild mental retardation develop most easily in this group. There is sufficient vocabulary and opportunities to use it.

• Hearing loss

A condition in which the patient hears in only one ear. In this case, the child speaks very poorly, although the intellectual component is normal. The reason is that the young patient simply does not hear correctly what others are saying. The more pronounced the disorder, the worse the speech. You need to work with a speech pathologist and audiologist.

• Inflammatory diseases of the brain

Meningitis or encephalitis. It is quite difficult to meet the second one in a city. Rural residents risk several times more, since natural areas are infested with ticks. Possible tick-borne encephalitis. Meningitis can become a complication of inflammatory and infectious diseases. In any case, urgent treatment is needed with antibiotics and anti-inflammatory drugs. Under the supervision of infectious disease specialists and neurologists.

• Congenital anomalies of the speech apparatus

For example, a short frenulum of the tongue. Require surgical treatment. At least if the child cannot adapt to the deviation.

Social

Reasons that are due to parental influence and environmental influence.

• Overprotection

If in this case the question arises, why does a 4-year-old child speak poorly, the answer is because there is no need for it. Plus, there is no normal example. Therefore, a young patient needs to be looked after moderately, speak correctly, and not babysit. Because when he hears incorrect examples, he adopts them.

• Insufficient guardianship

Back side. Again, there is no normal speech example, there is not enough verbal practice.

• Lack of social connections

It is found in the so-called Mowgli children. Speech is a socially determined mechanism and method of communication. Without other people it does not develop. Formation of skills after 7 years is very difficult. Pedagogical neglect also occurs in urban environments. Suffice it to recall high-profile cases when parents locked their children in basements for years.

Doctors are studying all the reasons. Based on the provoking factor, treatment is selected.

What environment will positively help a child quickly form correct speech?

If a two-year-old child does not speak or demonstrates poor speech abilities, you should pay attention to such environmental parameters as:

• active communication between family members;
• the presence of sufficient communication between the child and his peers (or slightly older children);
• absence of constant distracting noise (loud TV, computer, etc.).

It is necessary, first of all, to provide a high-quality language environment in which the child can easily perceive the speech of others, understand it and, accordingly, reproduce it independently.

How does the pathological condition manifest?

1. Scream. Normally, a baby cries after birth. Not counting the cases when he is in a life-threatening condition. For example, with hypoxia and other intrauterine pathological processes.
2. Pre-speech development. Happens up to a year. It goes through several phases from humming and babbling to full speaking by the age of one year.
3. First words. From one year to two people has an active vocabulary. Approximately 10-15 words, made of open syllables. Mom, dad and others like that. Normally, he should use them with an understanding of what and why. If this is not the case, there may be a delay in developing the skill. Need help from a speech therapist-psychologist.
4. Lack of response to sound. Especially at the age of more than a year. Auditory pathologies are quite possible. For example, hearing loss. Lack of sound perception in one ear. Or even complete deafness. The question remains open; diagnostics are needed.
5. Meaningless repetition of words, so-called. echolalia. In this case, the child speaks poorly or does not speak at all. Repeats what he heard, but without understanding the essence of the statement or a single word, which clearly indicates a delay. The brain, cognitive or intellectual components do not necessarily suffer.
6. Misunderstanding of verbal instructions. Up to three years this is quite normal. At two years old, a child is poorly oriented in the concepts of “I” and “Not I.” From the age of three this is no longer normal.
7. Complete absence of speech by age two. It also occurs in healthy people. Sometimes such children not only catch up, but also surpass their “normal” peers.
8. Inability to form sentences. The problem is that individual words are pronounced normally, sometimes even accurately and correctly. But the ability to construct coherent sentences is absent, which indicates an obvious pathological process. Most likely, the reason is social. Disorders of the speech apparatus are less common.
9. Communication by gestures. Gestures, explanations using other means. The patient should be assessed for hearing loss or deafness. This is often how children try to communicate with others and these are their first “words.”

Symptoms are present to varying degrees in all patients with language impairment. It is also possible in healthy people. Therefore, it is clear to say that the child has a speech development disorder is premature. At least according to the symptoms. Focused assessment is needed.

Norms of speech development

Let's look at the basic norms of speech development in children. Many parents believe that before their child speaks his first words (often around the age of about a year), it is useless to talk to him, since he still does not understand anything and cannot yet learn anything. But this is an extremely erroneous opinion, because speech development begins from the first days of a baby’s life.

The first stage of this process is screaming . While the baby was in the mother's belly, all his needs were satisfied instantly. But, finding himself in a completely different environment, he needs to find a way to somehow express himself and give a signal that his needs are not satisfied (wet, want to eat or sleep, sad, etc.). That is, a cry becomes a signal of discomfort at the level of an unconditioned reflex.

The second stage is humming . It usually occurs at the age of one to two months and accompanies the child in the first six months of life. These are different variations of sounds: a-a-gu, gee-s, ge-e, a-gy, etc. With the appearance of a significant adult, the child’s chatter becomes much more active, he looks into your eyes, waits for your answer and is already trying to build a full-fledged verbal dialogue. It is very important to maintain this “dialogue” and talk with the child as much as possible.

Babbling is the third stage of speech development. A child begins to babble at approximately 6-7 months of age. The baby begins to pronounce individual syllables “ba”, “ma”, “ta”, etc. - at first once, very rarely and as if by accident. Gradually, syllables are heard in his speech more and more often, they are repeated in the form of chains: ba-ba-ba-ba, ma-ma-ma-ma.

The stage of first words begins at 11-12 months of a child’s life. He begins to associate words with objects in the environment, words are filled with meaning for him. By this time, the child has already formed an active (from 3 to 10 spoken words) and passive (up to 20 understood words) vocabulary. By the age of 1.5 years, the vocabulary increases to 40-70 words, and at 2 years the baby already uses from 150 to 300 words. The child begins to speak in sentences. At first they consist of two words (mama give, lalya boo, etc.), and then of three or four.

It is always worth understanding that each child develops individually, and if there are short-term delays in passing the stages of speech development, this is not yet a sign of deviations. But, if the delays are quite long or some stages of development are completely absent, this is a significant reason to contact a specialist.

Diagnosis or how to identify the disorder

Diagnosing patients is a rather difficult task. Survey methods include the following:

Questioning a child. If he doesn't speak well, he needs help from a group of doctors. The first task is to exclude organic pathologies. To do this, you need to consult an otolaryngologist. An ENT doctor identifies pathologies of the ears (otitis), nasopharynx and oropharynx (adenoids, tonsillitis). Eliminates hearing loss. If it is impossible to determine the intensity of hearing on site, the child is referred to an audiologist.

The audiologist checks the patency of the auditory tract, uses a special apparatus, and draws a chart. It is easier to work with this data.

The child is then examined by a neurologist. Conducts basic examination, checks reflexes. Prescribes instrumental diagnostic methods. For example:

• duplex scanning of cerebral vessels to assess the intensity of blood flow in cerebral structures;
• if necessary, prescribes ECHO KG, ECG, and also electroencephalography to monitor the work of the heart (it is responsible for feeding the brain), brain activity.

If no organic pathologies are found, they look for mental disorders and problems. Clinical psychologists come into play. A series of tests are carried out, adapted to the child’s age. For perception, representation, speech. Everything that is involved in the speaking process and can be disrupted. In addition to the tests, the specialist talks with the child, finds out how poorly he speaks and what is the reason, and makes recommendations.

As a rule, in the matter of diagnosis one cannot do without a speech therapist-defectologist. His task is to study the speech apparatus. And then correct the violations and teach the patient to speak correctly.

The help of a psychiatrist is also necessary. Its task is to identify possible disorders of higher nervous activity: autism, mental retardation, and other types of dementia. All this is part of the psychiatrist.

If a child speaks poorly at the age of 5, consultation with all specialists will be required. Because complex violations are possible. In system.

Which doctor should I see next? Speech and intellectual impairments occur with endocrine disorders. Therefore, it would not be amiss to consult with an endocrinologist.

Treatment and correction of speech delay

The Bersenev Medical Center provides comprehensive treatment for delayed psycho-speech development in children. The clinic’s specialists draw up an individual program for the treatment and correction of mental retardation for each individual child. The program includes a set of rehabilitation activities carried out by a pediatric neurologist, massage therapist and speech therapist. A psychologist, a reflexologist and, of course, parents also take part in the treatment.

One of the main tasks of parents is to eliminate the causes that caused the delay in psycho-speech development (this applies to families with an unfavorable environment). Very important points in treatment are attentiveness to the child, moral support and patience, because correction of PVD is a complex and painstaking process.

If you detect the problem in a timely manner and contact a specialist, complete all the appointments and have a good attitude, you are guaranteed to have good results, high effectiveness of treatment, and the fact that ZPRD will not affect your child’s future in any way.

What to do if your child speaks poorly

Treatment required. The intensity and nature of therapy depend on the specific clinical case and the cause of the disorder. Here are some options:

• removal of adenoids, if a person cannot speak due to their growth;
• complex therapy of sore throat, inflammatory lesions of the pharynx;
• plastic surgery of the speech organs, for example, the frenulum of the tongue;
• correction of hearing loss, as an option - with the help of a hearing aid or internal cochlear apparatus;
• prescribing nootropic drugs and drugs for correcting cerebral blood flow and metabolism in cerebral structures;
• specific therapy for mental disorders, communication with the child, work with a speech therapist - the child should speak as much as possible, it is important to create the right verbal environment for him (adults should pronounce words correctly and interact with the patient as much as possible, placing all responsibility on the doctor is not a good idea, the effect will be much less).

As needed, exercises for the speech apparatus and physiotherapy are prescribed.

Why can a child of 2 years be silent or speak poorly?

Of course, the reasons why a baby may not talk or do it with great difficulty at this age can be caused by injuries, illnesses or developmental delays. However, experts identify 2 more reasons, not related to the above problems, why a baby may experience difficulties with speech formation:

• Lack of sufficient spoken communication. Speech therapists say that it is necessary to talk with the baby from the first days of his life. This should be done not only so that he hears words and sentences, but also to awaken his interest in speech. Subsequently, this will help to captivate the child, and he himself will strive to quickly master conversational skills.
• Slurred, fluent, or rapid speech in adults. If the child’s environment communicates too incomprehensibly for the baby, he simply will not be able to understand and repeat the words of adults. Parents should speak more slowly, more clearly and expressively, and not only in direct communication with the baby, but also when they are simply nearby.