Last updated on Feb 23rd, 2021 at 12:21 pm

*Originally published in January 2008

According to experts, 5 – 10% of children under the age of 3 are affected by speech problems.
Speech therapist, Vicky Macrides from the Rehab Matters Centre in Rivonia, explains that speech and language disorders are generally only identified once a child has had a full assessment.
“Children are often referred to a speech therapist by teachers who feel that a particular child’s speech or language seems to be limited, inadequate or different from that of his peers.” Parents also often take their child to a speech therapist for an assessment when they notice he is not communicating like his siblings did at the same age.

Causes of speech problems

There are many factors that can predispose a child to speech or language problems. “Factors like premature birth, difficulties with feeding or sucking during infancy, recurrent ear infections and a family history of learning disabilities or speech and language difficulties, are some of the factors that alert us to the possibility that a child might have a speech or language disorder,” says Macrides.

Physical causes of speech problems

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  • Hearing or auditory perceptual difficulties
  • Middle ear infection
  • Speech difficulties can also be caused by problems such as actual difficulties with the lips, tongue, palate or teeth, which will make it difficult for a toddler to form words properly.
  • Poor muscle control of the articulators (the tongue, the teeth and the lips)
  • Difficulties with muscle planning and low muscle tone.

Different speech difficulties in kids


It’s normal for a toddler to stutter between the ages of 3 and 4 years. “This is an age where there is typically a growth spurt in terms of vocabulary and children are learning to cope with a great deal on a linguistic level,” says Macrides.
However, if your child is still stuttering after the age of 4 years, you should have his speech professionally assessed.

Speech therapist Adelle Schwark from the Glenoaks School in Kensington adds that there is a period of ‘normal non-fluency’ when children tend to stutter. “You need to ask yourself whether or not your child’s stuttering is causing him frustration or hindering communication. If you’re worried about his speech, you should consult a speech therapist.”

Causes of stuttering
There is still much debate among theorists as to the cause of stuttering, but most experts agree that stuttering is normally caused by a combination of factors:

  • Genes are thought to play a part.
  • Developmental factors also contribute. Schwark explains that preschoolers develop socially, emotionally, cognitively, physically and linguistically at a rapid rate. “This fast development can lead to stuttering in children who are predisposed to the problem.”
  • Environmental factors may contribute to stuttering if a child is already predisposed to the problem. For example: if a child is put under pressure to talk or if parents have certain expectations, which can increase the child’s anxiety levels, he may stutter.
  • A child can even develop a tendency to stutter if he has had a traumatic or stressful experience.
  • Neurological factors may be a cause. A child’s neural pre-wiring or ‘make up’ may prevent him from speaking without some kind of interference.

How to support your stuttering child

The most important thing you can do is to reduce the demands you make on your child’s speech, says Schwark. You can achieve this by doing the following:

  • Slow down your own speech.
  • Speak in short, simple sentences when you talk to your toddler.
  • If your child asks you a question, pause slightly before answering him.
  • Stop and look at your child when he talks to you. If you aren’t able to look at him, tell him he should carry on talking and reassure him that you are listening to him. Try not to finish your child’s sentences or interrupt him.
  • It’s important that you communicate with your child. Acknowledge his speech problem by telling him that he seemed to get a little stuck in a certain part of the sentence. However, make sure that when you say this, he knows that you heard what he said and not just how he said it.


Children usually lisp if their tongue thrusts between their teeth due to poor placement or control. This is sometimes genetic or can also be due to poor speech planning and low muscle tone.
Macrides adds that a lisp can also be the result of a developmental delay, missing front teeth or a physical or structural difficulty, which makes it difficult to say the ‘s’ sound.

Toddlers who lisp often have other problems with fine muscle coordination. Since the tongue is a muscle, children who have difficulty with the planning and execution of fine muscle movements will experience similar difficulties with their tongues.

How to support your child if he lisps

  • Model the correct articulation. If he says, “The thun is bright today”, you can say, “Yes , the sss-un is bright today.” You shouldn’t tell your child he didn’t pronounce the ‘s’ properly because he may interpret that as disinterest in what he is saying.
  • If your child is still not pronouncing the ‘s’ sound correctly by the time he is in Grade R, you should consult a speech therapist.
  • It’s normal if children aren’t able to say ‘s’ by the age of 3 years.
  • Before trying to help your child with his lisping difficulties, you should take him to a speech therapist for an assessment, recommends Macrides.