Does your child have Speech Delay or a Stutter?

Is your little one not saying as many words as their peers or they have not progressed from babbling? Do you or others find it hard to understand what they are trying to say or do they find it difficult to get their words out easily?

Speech delay is a common childhood problem affecting around 1 in 4-5 children in the UK which can affect their social skills and educational journey, as well as their self esteem. Stuttering (also known as a stammer) is also quite common in young children, and this can disrupt speech flow. It is really hard when your child cannot communicate their needs easily and delayed speech can lead to behavioural challenges.

Thankfully the right nutritional input as well as other therapies might well play an important role in helping kids to develop better speech, language and communication skills. If you are worried about your child’s speech and language development in any way, then read on to learn about the key aspects of nutrition that research has found to help improve a child’s speech, communication and language trajectory.

How prevalent is speech delay?

There are around 1.9 million school pupils in England with identified SEN (18% of all pupils). Speech delay has historically been estimated to affect around 6% of children, but UK figures are now finding that speech, language and communication needs (SLCN) are now the most common primary type of Special Educational Needs (SEN) support and 22% of SEN pupils need SLCN support.

For context the number of pupils with SEN overall increased by around 3.3% between January 2018 and January 2019, while the number of children with SLCN increased by almost 6% during the same time period. Speech, language and communication delay seems to be more common in boys versus girls.

For children who struggle with communication via speech and understanding words many aspects of their lives are affected. Speech & Language UKs recent report in September 2023 “Listening to Unheard Children” reveals the following findings:

• They are six times more likely to be behind in English by age 11.
• They are eleven times more likely to be behind in maths by age 11.
• They experience more mental health issues.
• They are twice as likely to be unemployed in adulthood.

A referral to speech and language therapy may happen in a number of scenarios, including:

• No double syllable babble by 12 months of age
• Your little one is saying fewer than six words, or there is constant drooling, at 18 months.
• There are still no two- to three-word sentences by two and half years of age
• Speech continues to be unintelligible by 4 years old
• There is a regression in speech or communication skills
• Your child acquires a stutter or a lisp

There are many mechanical causes of speech delay from tongue tie, lip tie and cleft palate to consider which can often be released by a Tongue-Tie specialist or be assessed and supported by a Myofascial Therapy specialist. Overall low muscle tone may make it harder to form clear words. These aspects are important to check out if you have concerns about the clarity of your child’s speech.

What is stuttering?

Approximately an additional 3–5% of preschool-aged children will also begin stuttering at some point and it can suddenly come on or creep up slowly. A stutter or stammer can equally also vanish overnight or take time to disappear, and every child is different – three quarters of kids overcome their speech impediments and about a quarter have it for the very long term.

Developmental stuttering is the most common type of stuttering in kids. It usually comes on when a child is a toddler between the of ages 2 and 5. It may happen when a child’s speech and language development is a bit behind, or if they are struggling to express what they need or want to say. Sometimes it is when their brain is working faster than their mouth can keep up, and occasionally it can be stress/anxiety induced.

What factors can help or hinder speech development?

Interestingly breast feeding is thought to help prevent stuttering and helps with overall speech development, and this maybe because it encourages better oral motor skills. This does not mean that bottle fed children have a speech delay trajectory by any means. Interestingly very often babies with tongue or lip tie struggle to breast feed in the first place.

Chewing food is a super important skill too and is a key reason why it is important to encourage kids to eat home cooked food rather than soft baby puree and melt in the mouth snacks. The act of chewing food helps a baby and toddler to develop clarity of speech. Playing pipes as well as blowing bubbles and whistles can also all help to exercise the oral muscles.

Retained primitive reflexes

Retained primitive reflexes may play a role and the palmar grasp reflex which is meant to disappear by 4-6 months is important for hands and fingers to be mobile and flexible, as well as helping speech development. The palmar grasp reflex is the tight grip a baby makes with their fingers around your finger – this natural automatic response should naturally go, and you know if a child has this retained reflex if you gently brush a feather or pencil over the palm of an outstretched hand and see if the fingers try to curl up in response. Clapping, drawing, kneading play dough, ripping and crunching paper, digging soil with their hands, knitting and sewing as well as learning to play instruments can all help mature and release this primitive reflex over time. A specialist in retained primitive reflexes can explore other reflexes in more detail.

The role of infections

Infections might trigger stuttering too and research has found that streptococcus infections such as Scarlet Fever, Tonsillitis and Strep Throat can activate stuttering. If a child has a sudden onset of stuttering after having a throat infection, then it would be important see your GP or paediatric neurologist to assess for a possible strep infection with a neuroinflammatory autoimmune response. In cases of PANDAS, which is another autoimmune neurological response to strep, this infection can also lead to other symptoms like anxiety, OCD and tics as well as bed wetting and a decline in school work.

Recent studies have found that the Covid-19 virus may also lead to stuttering in some people as well as triggering other neurological changes. It is thought that this virus and the chronic inflammation and oxidative stress it can cause, may compromise the blood brain barrier and may affect a child or adult neurologically.

If the stuttering is infection mediated, then it is important to work on the underlying immune system and inflammation through dietary changes and targeted supplements as well as seeking medical support.

Another immune factor to take into consideration is ear infections (otitis media) which can affect hearing as well as well as intelligible speech. Working on a child’s underlying immunity can help to prevent ear infections and this may help to clear the eustachian tubes. Sometimes undetected food allergies or sensitivities can also lead to “glue ear” and a tendency to ear infections. Some people report that cranial osteopathy can help with a child’s aural health, especially if they are prone to ear infections or glue ear.

Key nutritional shortfalls related to speech delay and stuttering

Nutrition-wise, studies have found that kids who stutter are lower in core minerals across the board, including calcium, magnesium zinc, potassium, chromium & molybdenum. At NatureDoc we can run hair elements testing to establish which specific minerals need supporting.

Low magnesium status seems to be the most common mineral deficiency we find in kids that stutter and this is found in green leafy veg, nuts, seeds and dark chocolate. A regular nice warm bath with Epsom salts added or magnesium supplements can also help.

Vitamin B1 or thiamine is also an important nutrient where low levels have been associated with stuttering. It helps overall with neurological development as well as helping carbohydrate to be metabolised well. Vitamin B1 is found in wholegrains, meat, fish, poultry, eggs, milk and other dairy, green veggies and beetroot and pulses. It can also be supplemented for a few months to help a child catch up as it only added in small amounts in some kids’ foods like cereals and baby porridge.

Maternal Vitamin B12 intake when pregnant is also a factor to consider and this can affect speech as well as overall development and learning. One study found that the children of women who consumed the least vitamin B12 rich foods such as meat, fish and eggs and/or supplements led to increased likelihood of poor vocabulary at 2 years, a reduced ability at blending words to make sentences by around 3 years, poor speech fluency at 6 years, and poor mathematics comprehension all the way through primary school. Even if you are a plant-based family it is possible to catch up over time by taking vitamin B12 supplements.

Acetylcholine is an important brain neurotransmitter for overall mood, learning, short term memory and motivation and is also important for speech development. Dietary sources of choline that helps to make acetylcholine include liver, eggs, sunflower seeds and peanut butter as well as silken tofu. Our gut bacteria also play a role and lactobacillus strains are the building blocks for making acetylcholine. This is one of the reasons why live yoghurt and kefir are so important and might be why dairy-free kids often seem to be a bit slower in their speech development and learning.

Omega 3 from oily fish, such as salmon, sardines, mackerel and shellfish as well as walnuts, chia, flax and hemp is a well-researched essential fatty acid which helps with general overall neurodevelopment including acquiring speech and language skills. Anecdotal stories say that this has helped quite a bit with stuttering and is worth pursuing as it is such important brain food, and also helps with eye development. If your child does not eat much or any oily fish, then it would be prudent to trial 3-6 months of a good quality omega 3 fish oil.

A low Vitamin D status is commonly found in kids with a stutter or a stammer as well as functional language difficulties. Vitamin D is Mother Nature’s natural steroid reducing inflammation in the body. There is a vitamin D receptor on every cell in the body including the cells in the neurological system and brain. We get vitamin D from sunshine as well as eating outdoor reared meat, eggs and oily fish.

Round up

I hope that these tips help your little one with their speech and language development. Every child is different and the underlying causes of speech delay and stuttering are complex. However, nutrition is a key area to look at if your child is struggling with their speech and communication in any way, and it can be helpful to run some nutrition tests to check for deficiencies. Since you need to feed your child at least three times a day anyway, at the very least these dietary tips can easily be incorporated into your daily lives. If you would like to investigate testing and supplementation further then do be in touch with my paediatric nutritional therapy team.

References

• National statistics on special educational needs in England: what do they tell us about speech, language and communication needs? July 2019
• Speech and language therapy interventions for children with primary speech and language delay or disorder
• Speech and language delay in children
• Maternal prenatal vitamin B12 intake is associated with speech development and mathematical abilities in childhood
• Biochemical studies in stuttering in children
• The concentrations of bio-elements in the hair samples of Jordanian children who stutter
• A consideration of thiamin supplement in prevention of stuttering in preschool children
• A study of the effects of thiamine on children with speech non-fluency
• The Oxford-Durham study: a randomized, controlled trial of dietary supplementation with fatty acids in children with developmental coordination disorder
• Effect of Omega-3 and -6 Supplementation on Language in Preterm Toddlers Exhibiting Autism Spectrum Disorder Symptoms
• Polyunsaturated fatty acids supplementation can improve specific language impairment in preschool children: a pilot study
• Streptococcal Infection as a Major Historical Cause of Stuttering: Data, Mechanisms, and Current Importance
• Stuttering and Word-Finding Difficulties in a Patient With COVID-19 Presenting to the Emergency Department
• Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study
• COVID-19 severity impacts on long-term neurological manifestation after hospitalisation 
• Olfactory transmucosal SARS-CoV-2 invasion as a port of central nervous system entry in individuals with COVID-19
• The S1 protein of SARS-CoV-2 crosses the blood–brain barrier in mice
• Autoimmune Encephalitis Concomitant with SARS-CoV-2 Infection: Insight from 18F-FDG PET Imaging and Neuronal Autoantibodies
• A diagnostic marker for speech delay associated with otitis media with effusion: the intelligibility-speech gap
• Hearing Loss and Learning Disability-Reply
• Acetylcholine and affective disorder
• The Role of Acetylcholine in Learning and Memory
• Distinctive pattern of serum trace elements and vitamin D levels in adolescents who stutter
• Assessment of Vitamin D Level in Preschool Children who Stutter
• A Comparison of Vitamin D Levels in Chidren with Language and Speech Disorders and Healthy Children in the Turkish Population