Speech and language disorders may occur separately or together. When talking is hard for a child, they may be experiencing a speech sound or articulation disorder. They may have difficulty producing one or many different sounds or sound combinations. Family members or friends may have difficulty understanding their speech or refer to it as baby talk. A child may leave out a sound or substitute one sound for another. This may not be cause for concern but it could be if it persists past the age when they would be expected to produce such sounds correctly. Other children who have difficulty may repeat sounds or words or phrases when they speak. Or they may have a hard time getting the words out and take long pauses between their words. You may also notice a tense neck, face or shoulders when they try to talk. When these behaviours persist and distract the listener, they may signal a stuttering or a fluency disorder. A child with unusual voice qualities such as hoarseness or breathiness, or who uses a very loud or soft voice, might be demonstrating a voice disorder.
If a child has difficulty expressing ideas or needs, they may be reluctant to talk or become easily frustrated. This may signal an expressive language disorder or you might hear your child confusing the pronouns him and her. For example a child might say, him hit me or they may frequently use vague words like stuff or thing instead of specific labels. This could be cause for concern if other more specific words are not used at all. When a child frequently has difficulty following directions, or understanding what others are saying, they may be showing signs of a receptive language disorder. They may hear or see a word but not understand its meaning.