Criteria for Children at Risk for Speech and Language Problems


Speech and/or language problems in children at risk often are anticipated by the professional and can thus be treated only in the child’s development.  Early intervention leads to effective management of the problem and bigger, long-term problems are often by-passed.  Established and anticipated risk factors can be identified and used in the diagnostic assessment of the child’s speech, language or communication.

Children with an established risk have a known pattern of developmental delay associated with one or more of the following:

      • Chromosomal anomalies / genetic disorders e.g. Down’s Syndrome.
      • Neurological disorders e.g. intracranial hemorrhage.
      • Congenital malformations e.g. cleft palate, spina bifida.
      • Inborn errors in metabolism e.g. PKU.
      • Sensory disorders e.g. hearing impairment.
      • Atypical developmental disorders e.g. autism and PDD.
      • Severe toxic exposure e.g. Fetal Alcohol Syndrome.
      • Chronic medical illness e.g. diabetes.
      • Severe infectious disease e.g. HIV, Rubella.

Children can also be at risk for a developmental delay.  Risk factors can be environmental, biological or social in nature.  Categories include:

      • Prenatal or perinatal complications.
      • Asphyxia.
      • Very low birthweight (<1500g)
      • Small for gestational age (<10th percentile).
      • Low Apgar score.
      • Excessive irritability, crying, tremulousness.
      • Chronic otitis media.
      • Limited prenatal care.
      • Chronically disturbed family interaction.
      • Parent – child separation.
      • Parent has 4 or more pre-school children.
      • Adolescent mother.
      • Lack of stable residence, violence, poverty etc.
      • Concern by the mother about child’s development.
      • Caregiver mentally retarded or on illegal substances.
      • Family history of medical or genetic disorders.

If your child falls in the established risk category, it is crucial that you take him/her for a thorough speech and language assessment, as well as a global developmental assessment. If he/she falls in any of the at-risk categories, delays can occur and the child’s development must be closely monitored.  If any uncertainty exists, consult a developmental specialist (paediatrician, speech-language therapist, occupational therapist etc.).

Adapted from
Kibel & Wagstaff.  1991.  Child Health for All.  Oxford:  University Press
Owens, R. E. 1988.  Language Development – An Introduction.  New York: Macmillan Publishing Company.
Rossetti, L.M. 1996.  communication Intervention.  Birth to Three.  San Diego:  Singular Publishing Group.

Adapted from:  Rossetti, L.M. 1996.  Communication Intervention. Birth to Three.  San Diego:  Singular Publishing Group.


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