Early Signs and Symptoms

• Limited or little babbling as an infant (void of many consonants). First words may not appear at all, pointing and "grunting" may be all that is heard.

• The child is able to open and close mouth, lick lips, protrude, retract and lateralize tongue while eating, but may not be able to when directed to do so.

• First word approximations occuring beyond the age of 18 months, without developing into understandable simple vocabulary words by age two.

• Continuous grunting and pointing beyond age two.

• Lack of a significant consonant repertoire: child may only use /b, m, p, t, d, h/

• All phonemes (consonants and vowels) may be imitated well in isolation, but any attempts to combine phonemes are unsuccessful.

• Prosody is unusual, there is equal stress and sometimes a monotone quality.

• Speech may change or disintegrate with many repetitions.

• Words may be simplified by deleting consonants or vowels, and/or replacing difficult phonemes (consonants and vowels) with easier ones.

• Single words may be articulated well, but attempts at further sentence length become unintelligible.

• Receptive language (comprehension) appears to be better than attempts at expressive language (verbal output).

• One syllable or word is favored and used to convey all or many words beyond age two.

• The child speaks mostly in vowels.

• Verbal perseveration: getting "stuck" on a previously uttered word, or bringing oral motor elements from a previous word into the next word uttered.

• Oral groping may occur when attempting oral motor movements or consonant/vowel production.

• Struggle behavior may occur when attempting to imitate or to speak (without dysfluency or stuttering).

• Deletions or replacements of consonants, vowels or syllables may occur at the end of a word, phrase or connected word levels.

• Vowel distortions or replacements occur which are not due to oral motor weakness.

• The ability to blurt out clear whole words, phrases or sentences may occur though there is difficulty imitating these same words "on command" or upon imitation.

• Difficulty with maintaining clarity with extended word length or complexity.

• Phonological processes are employed to simplify motor speech output.

• Late talking with above characteristics or errors may be present.

• Other fine motor challenges may be present.

• Echolalic utterances (the automatic repetition of words, phrases or sentences often without comprehension) might be perfectly articulated but novel attempts at words or combinations might be more effortful.

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