Abstract

Approximately 8% of children between the ages of 3 and 17 will exhibit a speech problem. Primary care providers are likely to encounter the following three types of speech disorders: (1) speech sound disorders, i.e., the misproduction of speech sounds and word shapes; (2) fluency disorders, i.e., interruptions to the smooth flow of speech; and (3) voice disorders, i.e., decreases in the quality of the laryngeal sound stream. Children with speech sound disorders, stuttering, or voice disorders are often viewed more negatively both by their teachers and by their peers; these conditions can have lifelong social, academic, and occupational impacts. Healthcare providers should identify children in need of a speech evaluation by asking about how their speech compares to that of their peers, the sounds the children use, how well they are understood, the level of effort that speaking seems to require, the rate of progress observed, and whether or not frustration or embarrassment is evident (in the children or the parents). In some cases, invasive interventions such as surgery are warranted. However, the vast majority of speech problems can be addressed through therapy provided by a well-trained speech-language pathologist. Outcomes are better when assessment and intervention occur promptly.

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