I wrote previously about the first meeting with a doctor for a child who is being assessed for ADHD, and some of the tests that are often recommended after an initial evaluation. Commonly, an evaluation for problems with speech is considered. This is a popular recommendation by clinicians because the development of speech and language are indicators of a child's cognitive abilities and how the child is developing overall. The development of speech and language is also important to success in school, which many children with ADHD struggle with, so it's reasonable to screen children who are having problems at school for problems with language and speech. This screening can take several forms. The most basic language screening involves examining whether the child had achieved generally accepted milestones of speech development since early childhood.
Usually, by the age of ten months children can recognize the difference between friendly and unfriendly voices, and by 6 months they are usually babbling. By the end of the first year of life, most children have spoken their first words, and by age 2 ½ have uttered their first two word sentence. It's amazing how quickly children develop after this; by age 2 ½ most children can understanding 50 words and by 5 they understand 14,000, have ceased to stop like a baby, and can make themselves understood by most people who speak the same language.
So what does it mean if the child doesn't follow this path? As I mentioned earlier, the development of language and speech is an indicator of cognitive abilities, success in school, and overall development. If a child has a delay in language development, further exploration may uncover a developmental delay, a psychiatric disorder, or medical problem; all of which, for the most part, are more likely to improve if they are discovered early. There is some evidence that pre-school aged children with speech or language delays are at a higher risk of developing learning disabilities. Research has also suggested that children who have problems with phonology (the rules for producing sounds) may have lower-skilled employment than siblings without phonological difficulties. Children with language and speech disorders are reported to be more likely to have problems with reading, writing and underachievement in school. Some research also suggests that disorders of speech and language may increase the risk of having lower IQ scores that continue into adulthood. Problems with speech or language that continue chronically in children have been shown to increase the likelihood of behavioral problems.
Reading some of the findings of research on speech and language disorders, it's no wonder that a speech evaluation is commonly recommended in children who come to a psychiatrist for an evaluation whom parents, teachers, or even the children themselves think have ADHD. Like children with sleep deprivation, children with speech or language problems can have many of the behavioral and academic problems commonly associated with the diagnosis of ADHD. This is part of the reason why regular well-child visits with a pediatrician early in childhood are so crucial to uncovering medical, psychiatric, or development delays as early as possible. In my next entry I will discuss some of the specific speech and language disorders that have come to be recognized, but as always, I welcome your questions and comments.
Published On: April 24, 2008