Speech Disorders/Speech Disorder in Toddler


My son is 34 months old and I have been concerned about his speech. He can say a lot of words but it doesn't seem like he understand what he is saying if that makes sense. He can recite certain theme songs of shows word by word, same with some songs. Recently he started to sing "Every breath you take" and he literally knows all the words. But when it comes to comprehending it just not there. You can ask him a question and he will either stare or walk away.He can state when he is hungry, or wants a drink. He is very affectionate and knows some sign language to say what he wants. I have taken him to see his pediatrician a few months ago. He spent a few minutes talking to him. He didn't say much but what he did say was clear, and in full sentences. The pediatrician played it off as him being shy. I want to get a second opinion but worried that it is all in my head.

Hi Melanie,

Your question is not part of my specialty, but I was still taken in by your story.  I just think, what would I think and do if it were me.

I don't want to second guess your Pediatrician either, since he obviously has the training and experience, that I do not have.

There could potentially be several causes for this slow development in hearing, speech or comprehension.  We can't be sure either, that the speech disorder is not related to trouble hearing or other psychological factors.  Just no way for us to guess.

If it were me, I would find a good Speech Language Pathologist or "SLP" that specializes in working with children.  As always, the best way to find any doctor or health professional would be to get a referral.  Do you have other family or friends with children that might be able to recommend a good SLP?  I would make an appointment right away and have them take a look at your child.

It also may not be a bad idea to check with a child psychologist as well.  There may be mental struggles that your child is dealing with inside his head, that not even an SLP can figure out.  

Please let me know what you find out and if there is any progress.

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Jonathan - Patient Point of View


My area of expertise from the patients point of view would be TMJ plus the speech challenges that these jaw and bite problems sometimes represent. Over the years I have seen a multitude of dentists, orthodontists, oral surgeons, speech therapists, neurologists and other health professionals who all had an opinion about my bite problem. I am not a doctor, but would purely be a patients point of view type person. I "get it" when people say they tried to explain to their dentist what their bite problem is and that they are misunderstood. I can listen to people's trials and tribulations and there is a good chance I have been down that road before. I can make suggestions as to what people can do at home, or what questions to ask their doctor or dentist when they visit. ////// I come from a family of dentists. My first house growing up was one of those residential/dentist combination homes and I was around the dental practice all the time. My teeth had always been perfect, and in many respects they still are. I have never had a cavity and my teeth are straight. About 25 years ago, I had my wisdom teeth out and since then my bite has never felt "normal." I have learned a lot over the years as I tried to figure out my problem from the Dentists, Speech Pathologists and assorted doctors that I have visited. I will try and recall information or experiences that may be helpful to you.


Twenty-Five years ago after my wisdom teeth were removed, my bite did not feel right and then had trouble speaking. For whatever reason, the first sensation I remember was not that my bite was off.....but rather that my normal tongue and speech patterns had been impeded. The years of searching for proper treatment has underscored the importance of understanding the relationship between dental and speech methodologies.///// To this end, and to further my research, I recently attended the American Speech-Language-Hearing Association Convention (ASHA) in Atlanta. At ASHA I learned about a specialty within Speech Pathology termed “Orofacial Myology”. In laymen's terms Orofacial Myology Disorder (OMD) deals with the establishment of correct functional activities of the tongue, lips and jaw. OMD is a motor speech disorder that impacts the normal flow of speech, chewing or swallowing.///// If you believe that your struggles with your teeth also present speech, chewing or swallowing challenges, you may want to seek out a licensed Speech Language Pathologist.....preferably one that has training with Orofacial Myology Disorder.

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Abridged Version of a Letter I Sent to a Health Care Professional (3/14/13): "..In my early 20's I had my wisdom teeth out. Almost immediately within a few days, something did not feel right in my mouth. I had trouble speaking. When I raised my tongue to try and touch my palate, I felt mostly just teeth. It is very cumbersome to talk and my bite also became a little bit off. If feels almost as if someone put a fork in my mouth and said "now try and speak." Very difficult. My articulation is fine, so to an observer I sound normal. But it takes a monumental effort, so I hate situations like talking on the phone or when somebody asks me to "tell them a story." ..I spent years going to different dentists, who lumped me into their generic version of what they knew about TMJ. They just automatically gravitate to what they have heard about TMJ and assume I am either stressed, or just imagining it. Years later, I look back at all those dentists and doctors and I am amazed at how little they really knew about my condition. I have seen the best dentists, including my dad who is a Orthodontist in New York, to TMJ Dentists in Atlanta and Florida. No one ever suggested that Speech Pathology may be a direction I should explore. ..And I was frustrated by the fact that several MRI's over the years, showed nothing. How could the MRI’s show nothing, and at the same time, I know something does not feel right? I do wear a night guard to sleep in, but it does not fix the trouble that I have when I try to talk. ..I went with a Speech Pathologist friend of mine to the American Speech Language Hearing (ASHA) Convention last October in Atlanta...There was a Speech Pathologist at ASHA who was saying that sometimes when you have your Wisdom Teeth taken out "late" that it could possibly cause damage to the Trigeminal Nerve and surrounding muscles.” POSTSCRIPT: At ASHA, I discovered OROFACIAL MYOLOGY (OMD) which is a specialty in Speech Pathology that addresses Oral Muscular Issues.

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