Another cause of speech delay is severe environmental deprivation
Dr Flo, My seven-year-old son does not speak fluently; he only says some words in Kiswahili. I have been told this delay is normal. He is also very forgetful. His teacher has a problem with this since he is falling behind in class work. What is the problem? Please advise me on the way forward. Mwikali
Dear Mwikali, By four years, a child should have more words in their vocabulary than what can be counted (more than a thousand). He should also be able to tell a story, and make sentences with four to five words, identify colours and shapes, name some body parts and ask questions. At seven years, he should be able to read and write and tell time. Delays in development of speech could be due to oral-motor problems (structural problems in the mouth) like cleft lip and palate, or tongue-tie, which would impair word formation. It could also be due to hearing problems or due to neurological problems like cerebral palsy, brain injury, among others. It can also be due to developmental disorders like autism spectrum disorder and mental retardation. It could also be due to other disorders like auditory processing disorder (where there is a problem with understanding speech sounds) or speech apraxia (difficulty in carrying out speech movements). Another cause of speech delay is severe environmental deprivation – no one talks to the child for prolonged periods of time, or the child is neglected or abused. Forgetting easily may be due to a problem with understanding, paying attention or being easily distracted. Since your son has only a few words, he is behind his peers and he also forgets easily, he needs to be evaluated by a paediatrician, ENT specialist and by a paediatric psychiatrist so as to find out the exact cause of the problem. Depending on what the diagnosis is, you will be advised on the best course of action. He may also benefit from working with a speech therapist. At home, spend a lot of time communicating with your child. Talk to him, play games with him, read to him, sing with him, use gestures together with words; describe activities, items, and feelings. Look at him when talking to him and when he is communicating back, give him a lot of time to respond. Ask him questions and also encourage him to tell stories. Let him interact with other children his age.
