Language training: when is therapy necessary? Baby and family

Lispel, stuttering, selective mutism – more and more children have speech disorders and receive speech therapy. The Munich pediatric audiologist Dr. explains Barbara Arnold

Prevents disorders: reading aloud promotes language development

Miss Dr. Arnold, according to the survey of a health insurance company, one in three preschool children in Germany has a language disorder. This high number is correct?

No. The number is around eight percent. However, the proportion is often higher in conurbations and cities such as Munich. The reason is that there are many multilingual children here who are not always optimally supported linguistically at home.

Speech disorders have increased in recent years?

That is discussed. One thing is certain, however: Many children with mild speech disorders who would not have had therapy earlier are now more likely to be recognized and treated. One reason for this is that the entry criteria for language are very strict for school enrollment. Preventive examinations at the pediatrician are also narrower. In addition, educators have a shouldered look at today the language. They make parents more aware of abnormalities. The sensitivity to language disorders in kindergarten age has increased.

So that means that more and more children do not have speech disorders. Only the perception has changed.

You can’t say that. There are several factors that contribute to the fact that there are more children with speech disorders. These are, for example, the improved chances of survival for premature babies over the past 20 years. Many of these children have developmental disorders, which include language disorders. Another aspect is the increasing migration to Germany in the past 20 years. We have many children with a non-European background who first have to get used to a new language. Otherwise, the number of people with speech disorders has increased only slightly, if at all. This is where the parents’ focused attention comes into play.

Do parents have a good sense for the language development of their offspring??

Most parents perceive very precisely whether their child is developing normally or not. This is done by comparing children of the same age in crawling groups or in the playground. Parents can see relatively quickly whether their child is lagging behind in language. Only experts can tell whether the language development of the youngsters is only delayed or whether they are actually developing a language disorder.

What should make parents pay attention??

An important criterion is early language understanding. For example, a toddler with a delayed start of speech understands the job "Get the ball" and brings the ball to mom. A speech-impaired child, on the other hand, often has an understanding problem and does not respond to the request. Of course, it must also be excluded here that the child hears poorly.

What other signs indicate that a child is developing a speech disorder?

At the age of three months, the little ones usually look at people, fix them and smile. However, some babies do not turn to other people, turn their heads and are not keen on communication. You should watch that. Some of them develop linguistic abnormalities later, others are autistic, but this cannot be determined so early.

As a mother, can I be sure that the pediatrician has a good eye on the language development of the offspring?

Yes. Pediatricians as well as pediatric audiologists and phoniatrists have standardized, age-specific language tests with which they can check a child’s language skills during the preventive medical check-ups. One example is the active vocabulary test for three to five year olds. Here the doctor shows pictures and the child says what he sees on it. It starts with simple objects such as the star and the clock or activities such as cycling or combing to words that are difficult to pronounce such as helicopters. In addition to the vocabulary, the articulation, i.e. the pronunciation of sounds, can also be observed. If the pediatrician or phoniatrist detects a speech disorder, he prescribes speech therapy.

Speech therapists accuse paediatricians of waiting too long too often. How do you see that?

There are, of course, pediatricians to whom this applies. It must also be seen in this context that pediatricians are heavily budgeted when it comes to prescribing speech therapies. This means that they are only allowed to prescribe a certain number of logopedic therapies per quarter, otherwise they will be taken into recourse and have to pay for the treatment. The tendency to wait and see is ultimately due to the health insurance companies.

What do you advise parents who are worried and don’t want to wait any longer??

For a second opinion, contact a phoniatrist, pediatric audiologist, pediatrician or speech therapist.

It makes sense to treat a language disorder as early as possible?

Generally, yes. However, only children from three years of age are suitable for working directly with a speech therapist. There are two measures for younger children that parents of children with speech problems should take. On the one hand, participation in the Heidelberg parent training is recommended. Here parents get suggestions on how to linguistically support their little one in everyday life. It is also important to have your hearing checked early. Because despite an inconspicuous result in newborn hearing screening, children may have developed a hearing disorder due to tympanic effusions. And children learn to speak better when they hear well.

Language disorders and peculiarities


A child involuntarily repeats syllables such as "Babababall", it stretches sounds like about "Ffffffuchs" or if it can utter a word only with effort, it stutters. It loses control for a moment about the flow of speech, even though it knows exactly what it wants to say.

Depending on the situation or person, with the the little one speaks, the stuttering is differently pronounced. Experts recommend doing speech therapy as soon as possible so that the child concerned does not develop a fear of speaking in the first place. Because shame, anger, helplessness or lack of self-confidence can be the result. However, it is not always possible to completely cure stuttering.

So-called developmental liquids that some children have between the ages of three and six sound like stuttering, but are only a temporary phenomenon. Children are unable to put their bubbling thoughts into words, since their tongue and lips are not yet adequately developed by the motor. The result: the little ones mess up. If the liquid persists for more than half a year or if parents notice that their child is suffering, they should contact their pediatrician.


When children lisp, when speaking the "s" the tongue against the teeth or even slips between the teeth. The technical term, sigmatism is a typical phenomenon during language acquisition that shows almost every child.

At the age of five, however, the little ones should be able to make the sound correctly. If this is not the case, lisping is considered a speech disorder and speech therapy is necessary. The cause is often too loose tongue and mouth muscles. During therapy, children therefore do exercises to strengthen them before working on the correct sound formation.

Selective mutism

At home, the children speak like a waterfall. They don’t get a word out in the daycare. This is selective mutism. Researchers describe it as a permanent, recurring silence in certain situations and towards people who do not belong to the closest family. It occurs even though the ability to speak is basically there.

Anglo-American studies show that about 0.7 percent of all children are affected, including many more girls than boys. The silence usually occurs at preschool age, usually around three years old. The reasons behind this are often unclear: the child may not be able to express himself properly and this is embarrassing, and genetic causes are also discussed.

It is important that children receive help early, then the chances of success are very high. So if parents are asked by their teachers that their child is silent and the silence lasts for more than four weeks, they should arrange for a speech therapy examination. Selective mutism falls under the language development delays. The health insurers undertake the therapy. The speech therapist (e.g. speech therapist, speech impaired teacher) should definitely have experience with selective mutism.


If a child acquires two languages ​​in parallel because the mother and father have different mother tongues or the family lives in a foreign-language country, one speaks of bilingualism or bilingualism.

This is usually not a problem for the little ones, it even has a positive effect on their mental development. However, it is important to:

Each parent should speak to their child consistently in the language they are most proficient in. Otherwise, the youngsters develop a so-called double semilingualism – they are not really good at any of the languages.


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Christina Cherry
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