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Dummies not the culprit for common speech disorders in children, according to study


Neelima Choahan


9/10/2018 3:36:04 PM

New research shows bottles, dummies, and thumb sucking in the early years of life do not cause or worsen phonological impairment, the most common type of speech disorder in children.

New research found no significant associations between nutritive or non-nutritive sucking habits and the presence or severity of phonological impairment.
New research found no significant associations between nutritive or non-nutritive sucking habits and the presence or severity of phonological impairment.

The study, published in Folia Phoniatrica et Logopaedica, analysed the sucking behaviour of 199 pre-schoolers to see if a child’s history of dummy use, bottle use, breastfeeding or thumb sucking impacted the presence or severity of phonological impairment.
 
Lead author Dr Elise Baker, senior lecturer at the University of Sydney’s Faculty of Health Sciences, told newsGP the parents were given a questionnaire asking them about the child’s nutritive and non-nutritive sucking habits.
 
‘We looked at their … dummy use, their thumb sucking, breastfeeding and bottle use,’ Dr Baker said. ‘We asked the parents, “Has your child used one of those four forms, and if so, for how long?”
 
‘We wanted to find out from parents, did they give their child a dummy? And if so, at what age did the child give it up or they take it off the child?’
 
Of the total sample, 134 children had phonological impairment and 65 had no identified speech impairments.
 
Dr Baker said while the use of dummies or pacifiers is a controversial topic, the study suggests they are not associated with the majority of speech problems in children.
 
‘We looked at relationships between having a problem and not having it, and we found there was no relationship,’ she said. ‘The rate of dummy use in both of those groups of children with a speech problem and without a speech problem was fairly similar.
 
‘The children who had phonological impairment who used a pacifier was 59.7%. Then [in] children who didn’t have a speech impairment, 54% of them used the dummy.’

Elise-Baker-Article.jpgDr Elise Baker says dummy or pacifier use is a controversial topic, but the University of Sydney study suggests they are not associated with the majority of speech problems in children.
 
Dr Baker said the researchers also analysed children with a severe and moderate speech problem to see if using a dummy made it worse, but found no correlation.
 
‘This common speech problem is not to do with the mouth, it is more to do with the mind – how children are storing words in their mind, and their understanding the sounds in the language and the rules for which sounds are used in the words,’ she said.
 
‘So it makes more sense that it aligns with it being a language-based speech difficulty, rather than something going on in the mouth.’
 
According to Dr Baker, phonological impairment occurs when a child has difficulty with learning how to use speech sounds correctly and in the right context.
 
‘A child who is first starting to talk won’t say “caterpillar” perfectly, they will reduce it or simplify it. They will either omit sounds in words or they will replace a harder sound with an easier sound,’ she said.
 
‘So a caterpillar becomes “tapiwa” … spoon, “poon”, and spaghetti, “getti” or “detti”.’
 
But Dr Baker said 75% of a three-year-old’s and a 100% of a four-year-old’s speech should be clear to a person who is unfamiliar with them.
 
‘Those easier ways of saying the word should be starting to disappear,’ she said. ‘And when they are not disappearing, that’s when we will diagnose and say there is a phonological impairment.’
 
Dr Baker said when conducting a brief speech screening to conclude whether a child’s speech development is acceptable, it can be helpful for a GP to talk with a child to determine what percentage of their speech they can understand as an unfamiliar listener, not how much the parent understands.
 
She said for children aged:

  • 24 months, 50% of speech should be intelligible
  • 36 months, 75% of speech should be intelligible 
  • 48 months, 100% of speech should be intelligible. 
‘If the GP is particularly familiar with the child, then they could ask the child’s parent about how well people unfamiliar with their child understand their child’s speech,’ Dr Baker said.
 
‘If a three-year-old child’s speech is difficult to understand, or a four-year-old is not completely intelligible, then referral to a speech pathologist would be recommended.’
 
The speech pathologist will conduct a more thorough assessment to determine if the child has a speech sound disorder or another type of communication disorder.
 
‘In addition, if a toddler [24-month-old] has less than 50 words in their spoken vocabulary and is not putting words together in little sentences, that is another trigger for referral to a speech pathologist,’ Dr Baker said.
 
‘Although some children who are late to talk catch up, late talking can be a symptom of an underlying problem that requires further investigation.’



dummy Phonological impairment speech disorders





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