Communication and Swallowing Problems

What is Speech Pathology

Speech pathology is a profession with a primary focus in helping people to communicate, whether it be verbally or non-verbally. Speech pathology encompasses all areas of communication including speech, language, signs, symbols and gestures, reading and writing. Speech pathologists are professionals who are trained to assess, diagnose and treat people who have difficulties with communication and/or swallowing and feeding. For more information visit the Speech Pathology Australia website.

What are the skills required for talking?

Expressive language is your child’s ability to join words to form sentences using the correct vocabulary and grammar. Expressive language is different to speech sounds and can be easily confused when listening to your child. Speech sounds are the way your child pronounces sounds in their words. Expressive language difficulties can affect your child’s ability to get their message across using spoken or written language.

Receptive language is your child’s ability to understand the words they hear and/or read. Different receptive language skills are expected at different ages. The symptoms of children experiencing difficulties with their receptive language skills can be varied and will depend on their age.

Articulation is the way we produce speech sounds. We use our tongue, lips, teeth, jaw and vocal folds to produce speech sounds. Children can experience a range of difficulties that will affect the way they produce their speech sounds.

Children can experience difficulties with their receptive language skills and expressive language skills and speech sound development or it can have difficulty in one of these areas only.

What is a communication disorder?

Delayed or disordered speech and language development can lead to a breakdown in communication with our children and impact how we connect and bond with them. Early assessment and intervention is therefore vital to ensure that children achieve their maximum potential in communication development. It also helps alleviate some of the associated difficulties of communication break-down such as frustration, withdrawal and socialisation difficulties.

Common Communication Difficulties

Language Delay:  language delay occurs when a child’s language is developing slower than other children of the same age, but it is following the typical pattern of development. For example, a child may be 4 years of age, but understanding and/or using language typical of a child who may be only 2.5 years of age. Children with language delays, typically present with the following:

  • are late talkers
  • have limited vocabulary development
  • find it difficult to express themselves
  • do not understand well or experience difficulty following directions


Speech Delay/Disorder:  Most children will make mistakes with their speech sound production at some point in their development. Different sounds are expected to develop at different ages. A speech sound delay exists when a child continues to make mistakes with a particular sound or group of sounds past the age expected.

Speech sound delays involve articulation errors (making the sound) and phonological process errors (sound patterns). A phonological delay will cause patterns of speech sound errors. Both speech sound delays and phonological delays can make a child’s speech difficult to understand.

Children with a speech delay/disorder, typically present with the following:

  • are difficult to understand
  • find it difficult to sequence sounds correctly
  • produce speech sound errors beyond the acceptable age. This may include sound substitutions, distortions and deletions.


Stuttering: Stuttering is a communication disorder in which the flow of speech is broken by repetitions (li-li-like this), prolongations (lllllike this), or abnormal stoppages (no sound) of sounds and syllables. Typically, these children know what they want to say but are unable to produce it because of the presence of these dysfluencies.

Literacy Difficulties: Reading is a complex skill that can dissociate to produce varying profiles of impairment (Bishop and Snowling 2004). The two most common forms of reading disorder are dyslexia, a specific difficulty with decoding print, and reading comprehension impairment, a specific difficulty with text comprehension. Typically, children will have difficulty in the following areas:

  • find it difficult to learn the decoding skills necessary for learning to read or the encoding skills necessary for learning to spell
  • may be able to read but find it difficult to comprehend the text

Voice Disorders: Voice disorders are medical conditions involving abnormal pitch, loudness or quality of the sound produced by the larynx and thereby affecting speech production. Voice disorders are present in children who:

  • have husky voices as a result of incorrect use of their voice
  • have unusual intonation patterns
  • use inappropriately loud or soft voices

What is a swallowing disorder?

Swallowing disorders, also called dysphagia (dis-FAY-juh), can occur at different stages in the swallowing process.


Feeding Difficulties: For a variety of reasons babies and children have problems with feeding and eating at mealtimes. Children with feeding and swallowing problems can present with a wide variety of symptoms. Not all signs and symptoms are present in every child. The following are signs and symptoms of feeding and swallowing problems in very young children:

  • problems with sucking and swallowing
  • refusing the bottle/breast
  • difficulty breastfeeding
  • arching or stiffening of the body during feeding
  • irritability or lack of alertness during feeding
  • refusing food or liquid
  • failure to accept different textures of food (e.g., only pureed foods or crunchy cereals)
  • long feeding times (e.g., more than 30 minutes)
  • difficulty chewing
  • food refusal or only accepts limited types of foods
  • coughing or gagging during meals
  • excessive drooling or food/liquid coming out of the mouth or nose
  • difficulty coordinating breathing with eating and drinking
  • increased stuffiness during meals
  • gurgly, hoarse, or breathy voice quality
  • frequent spitting up or vomiting

As a result, children may be at risk of:

  • dehydration or poor nutrition
  • aspiration (food or liquid entering the airway) or penetration
  • pneumonia or repeated upper respiratory infections that can lead to chronic lung disease
  • embarrassment or isolation in social situations involving eating
  • weight loss, less than normal weight gain or growth


The team at Bambini Speech Therapy have extensive experience treating children with communication and swallowing problems. If you have any concerns that your child may be presenting with some or all of the deficits listed above, please do not hesitate to contact Miriam on 0417 873 087 to make an appointment.



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