Are those "folk tales" about children's language development reliable?

Author: Yang Feng, deputy chief physician of Shenzhen Second People's Hospital

Reviewer: Jing Jin, Professor and Chief Physician, School of Public Health, Sun Yat-sen University

In the daily work of the language disorder clinic, we often hear some "folk legends" about children's language development. So are these legends reliable? Now we will analyze them one by one, hoping to clarify the facts and not let these legends mislead parents.

Folk legend 1: If a child speaks late, it means "a noble person speaks slowly and his golden mouth is hard to open"

This is the most common legend. Many parents (especially the elderly) often say to their children who speak late: "The child understands everything, it's okay, it's hard for a noble person to speak slowly!"

In real life, there are indeed some children who speak late, but their parents, while being anxious, often give themselves spiritual comfort. In fact, there is a limit to the saying "a noble person speaks slowly and it is difficult to open his mouth."

According to the report "Study on Vocabulary and Grammar Development of Children Aged 2 to 3" completed by Shanghai Children's Medical Center, the survey results of more than 720 healthy children aged 24 to 47 months are as follows.

(1) If the spontaneous vocabulary of a child at 24 months is less than 30 words, and the structural expressions of a boy at 30 months are less than 3 and those of a girl at 30 months are less than 5, then it is considered language delay.

(2) Children whose spontaneous vocabulary is less than 50 words at 24 months of age, or whose structural expressions are less than 5 for boys and less than 8 for girls at 30 months of age are considered to have language delay.

It can be seen that if a child does not reach the language ability of the corresponding age group, there may be a risk of language delay. Continuous language lag may affect the child's future reading and writing ability, academic performance, peer relationships, personality development and other aspects. Therefore, parents must not take chances, but should pay attention to children's early language development.

If a child shows any of the following symptoms, it means that the risk of language disorders is high and the child should seek medical attention from a professional medical institution in a timely manner.

Children aged 0 to 1 rarely make sounds and are too quiet.

At 1 year old, he can't say any words.

A 2-year-old can actively express fewer than 30 words.

At the age of 3, the child is still unable to understand and use simple questions.

At the age of 4, there are still many speech errors and others often have difficulty understanding them.

Children aged 5 to 6 still have difficulty understanding and retelling longer stories, and their narrative or conversational abilities are insufficient.

Any regression in language ability or stuttering for more than 6 months.

Folk legend 2: If a child doesn’t speak or speaks unclearly, just cut the tongue tie

When children do not speak or pronounce words clearly, many parents take them to the hospital's dentistry department to check their tongues (frenulum), hoping to "cut it off." They also say, "Other children's tongue ties were cut off and they learned to speak in a few days. They speak much more clearly afterwards."

This statement is actually unscientific, because language is actually a skill that is gradually mastered through continuous learning, rather than a problem with the pronunciation organs. For example, if children want to learn English, they must have an English language environment. If a child can learn English by "cutting the frenulum of the tongue", this is obviously absurd.

The so-called "lingual frenulum (tongue muscle, tongue root)" refers to a soft tissue frenulum under the tongue. Under normal circumstances, the lingual frenulum is attached to the posterior part of the midline of the tongue. If the lingual frenulum is attached forward or even to the tip of the tongue, it is called lingual frenulum shortening deformity (Figure 1).

In fact, the attachment of the tongue tie has little effect on the child's language development. Even if the tongue tie is too short, it will only affect the clarity of some pronunciations, mainly the tip of the tongue (the tip of the tongue needs to be raised when pronouncing), such as "d, t, n, l, z, c, s" and other consonants. It will never cause the child to "not speak" or "can't speak clearly", and it will not cause the child to stutter. If the tongue tie is confirmed to be too short and it does affect the child's eating and pronunciation, it can be corrected through simple frenulum correction. If the child's pronunciation can be restored quickly, no treatment is needed. If the child has developed bad pronunciation habits, then the child still needs professional speech training.

Copyright images are not authorized for reproduction

Folk legend 3: It’s okay for children to stutter, it will get better in a few days

When parents discover that their children stutter, they are often very nervous. At this time, we often hear the elderly say confidently: "It's okay for children to stutter. You had the same problem when you were a child. It will be fine in a few days!"

Is this really the case? The answer is: sometimes, but not always. Research data show that about 10% of children will have interrupted, repeated, and unsmooth speech when they are 3 to 5 years old. We call this stuttering. The main reason for children's stuttering is that the children's language-related central nervous system is insufficient in processing complex language information. When they want to express a lot of complicated things, they will have "stuttering". This situation will generally disappear on its own with the development of the child's central nervous system and language ability. However, about 1% of children will continue to stutter, or stutter intermittently, and even develop into stuttering. There is an essential difference between stuttering and stuttering. Stuttering is a stage phenomenon of language development in some children, which generally does not last more than 3 months; or it is a short-term language slur when people are emotionally excited or nervous, which will disappear when the emotions stabilize; while stuttering is a language disorder caused by physiological, psychological and environmental factors, which can last a lifetime.

When a child stutters, parents can observe for a period of time (no more than 3 months). Parents do not need to be nervous, let alone pay too much attention to the child. Even the so-called "patient and kind reminders" should not be too much. This is because the stuttering of many children is closely related to the "kind attention" of parents (especially mothers). On the one hand, mothers are generally more careful and can easily detect their children's language problems. They are overly nervous because they are worried that their children will be discriminated against by their peers. Some parents may think that they are "controlled" well and will not be discovered by their children. In fact, the sensitivity of children is far beyond our imagination. Parents' "disguise" can not escape the eyes of children at all. The psychological connection between children and mothers is so close that the nervousness of mothers will greatly affect him (her), causing children to be more nervous and concerned about their "stuttering" problems. On the other hand, some mothers may think that they are very careful about the way they do things, do not "scold" or "urge" their children, and "respect" their children's self-esteem. They "gently remind" or "comfort" their children patiently, and tell their children "don't be anxious, speak slowly", thinking that this can help their children. However, they do not know that this "kind attention" will also increase the psychological burden of children and cause the stuttering phenomenon to worsen.

So, what are the risk factors for stuttering? There are mainly the following aspects.

1. Gender: Males are at a higher risk of stuttering than females.

2. Family history: There is a family history of stuttering within three generations in both lines of both parents.

3. Stuttering first occurs after the age of 4.

4. Duration of stuttering: stuttering occurs repeatedly and lasts for more than 3 months.

If a child has more than two risk factors, or if there is a clear trend of worsening, he or she should consult a professional medical institution in time and seek guidance and help from a speech therapist.