The pandemic has greatly altered what we as a society once perceived as “normal”. The instability and uncertainty that has been a rampant consequence of the pandemic, particularly the lockdown, has most gravely affected young children – notably, children in early childhood, aged three years and below.
Children of this age are experiencing a critical period in early childhood that is imperative to their effective growth. During this development stage, they absorb a lot from their surroundings and parents are required to closely monitor these experiences to ensure they develop certain physical, emotional, and social skills. One major component of this development is their speech, their ability to communicate and articulate.
However, speech appears to be an element that has been greatly affected by the current state of the world; a world where children are not given the same opportunities as before when it comes to socialising and interacting with other humans and being in spaces occupied by other people. This lack of social education is compounded by extended screen time well beyond what is recommended.
Ages 0-3 are critical
University of Kelaniya Senior Lecturer, speech therapist, and researcher in augmentative and alternative communication and autism spectrum disorders Dr. Nimisha Muttiah shared that this current predicament that many children have found themselves to be in is not ideal.
“As a parent with a child in this very critical age range myself, it is clear to see that with this current environment, children are not getting their due exposure to the world, and you can see things like social anxiety becoming a major concern in children aged three and below,” she said. “Of course, they are somewhat comfortable with their peers; however, because of a lack of exposure, they’ve developed a certain level of anxiety around older adults.”
She stated that as a solution, it is still too difficult to suggest anything, especially considering the situation and health and safety concerns, but in her case, what she has adopted are methods to help them in their growth as much as possible. “We have attempted to create an environment where they feel like there is a society out there, having the children engage in WhatsApp calls with their cousins and other kinds of interactions to help keep them grounded,” she said.
Dr. Muttiah also spoke to the general level of awareness of speech impediments in Sri Lanka, explaining that the general practice adopted by most paediatricians when it comes to a young child who is experiencing difficulty articulating themselves is to just wait and see. She said: “Often, the approach is to wait and see – that is what a paediatrician would recommend to most parents. However, this could pose an issue, as we must also maximise on the early interactions and resultant development in that age range of zero to three.”
Dr. Muttiah also shared that language or speech disorders can also be present alongside emotional or behavioural disorders, such as attention deficit hyperactivity disorder (ADHD) and anxiety. Children with developmental disabilities including autism spectrum disorder may also have difficulties with speech and language.
“The care we provide as parents at this stage is very important in such a situation, because children with speech disorders may feel frustrated that they cannot understand others or make themselves understood – they may act out, act helpless, or withdraw,” she stressed. The combination of challenges they experience as a result can make it particularly hard for a child to successfully adapt to their various environments, be it school or the playground. Properly diagnosing a child’s disorder is crucial so that each child can get the right kind of help.
Awareness in Sri Lanka
With regard to the situation in Sri Lanka, and the general level of awareness on speech or language disorders that children may experience, Colombo South Teaching Hospital Consultant Child and Adolescent Psychiatrist Dr. Yasodha Rohanachandra stated that parents have a general lack of awareness about speech impediments and it is widely seen. “There is a myth that if your child is late to speak, they are just a very late bloomer and it is just a matter of time that they catch up,” she said, adding that this is not always the case.
Dr. Rohanachandra said this lack of awareness also tends to extend beyond parents to the healthcare and education sectors too, as not many hospitals have speech therapists on board. “Only major hospitals tend to have a speech therapist available for you to send your child for an assessment. Most times, especially in rural areas, children with difficulties do not undergo an assessment,” she noted.
She said that in many countries, schools employ a speech therapist who will be available to address difficulties experienced by children in their early childhood stage, adding: “However, here in Sri Lanka, due to a lack of such widely available resources, we do not have such a practice, but at the very least we should focus on educating the parents.”
She stated that a child’s experiences in the early months and years of their life affect their health, wellbeing, and coping skills for the rest of their life, adding that caring, nurturing, and safe parenting help ensure a child’s healthy development. Understanding child development can help parents know what to expect and what they can do to help their child grow in a healthy way.
Dr. Rohanachandra added that in the early years of life, a child’s behaviour communicates their needs and how they change and grow, and therefore, listening to their child’s unique cues can help parents support them through their years of very rapid growth and development.
What can parents do?
With regard to speech, Dr. Rohanachandra said that a general guideline would be to keep an eye out for general milestones – for instance, if a child is able to say perhaps one word and is able to repeat it at the age of one, is able to string together a two-word statement by the age of two, and is able to share phrases to communicate by age three. Furthermore, Dr. Rohanachandra said that if by age four, your child is unable to communicate in a way that a stranger can understand them, it is advisable to take them to be assessed. However, she noted that these are only a general set of guidelines, and it is always best to get help as early as possible. If you have any concerns about your child’s development, you must talk to your healthcare provider.
Speaking to Brunch, child adolescent and counselling psychologist Dr. Kalharie Pitigala shared her thoughts on the matter, saying: “Speech impairment is not an easy thing for a child to deal with. It is a situation that needs a lot of support, and it has to be treated depending on the severity. Speech impairment may vary from stuttering to being mute, and the support required may differ depending on the condition.”
Similarly, Child, Adolescent, and Family Services (CAFS) Director Suhaila Shafeek-Irshard stated: “It is better to be safe than sorry, and being practical in figuring it out early can make a difference.” She said that “to this day, while things are a lot better in Sri Lanka with regard to awareness, there remain doctors and paediatricians who suggest the ‘wait and see approach’, which could potentially delay the treatment your child needs during that critical time in their development”.
So, she suggested that if you as a parent feel that your child needs additional support and may be experiencing some speech impediments, then you as a parent must make the executive decision to have them assessed.
Children with language problems often need extra help and special instruction, and if identified early, children can get the help they need from a speech language pathologist who can work directly with the children and their parents to help overcome any issues they experience. Children with specific learning disabilities, including language or speech disorders, may perhaps need special education services or accommodations at school. In order to provide children with everything they need, it is important that parents observe their behaviour and get the right advice on how best to help further their child’s development.
Children of this age are experiencing a critical period in early childhood that is imperative to their effective growth. During this development stage, they absorb a lot from their surroundings and parents are required to closely monitor these experiences to ensure they develop certain physical, emotional, and social skills. One major component of this development is their speech, their ability to communicate and articulate.
However, speech appears to be an element that has been greatly affected by the current state of the world; a world where children are not given the same opportunities as before when it comes to socialising and interacting with other humans and being in spaces occupied by other people. This lack of social education is compounded by extended screen time well beyond what is recommended.
Ages 0-3 are critical
University of Kelaniya Senior Lecturer, speech therapist, and researcher in augmentative and alternative communication and autism spectrum disorders Dr. Nimisha Muttiah shared that this current predicament that many children have found themselves to be in is not ideal.
“As a parent with a child in this very critical age range myself, it is clear to see that with this current environment, children are not getting their due exposure to the world, and you can see things like social anxiety becoming a major concern in children aged three and below,” she said. “Of course, they are somewhat comfortable with their peers; however, because of a lack of exposure, they’ve developed a certain level of anxiety around older adults.”
She stated that as a solution, it is still too difficult to suggest anything, especially considering the situation and health and safety concerns, but in her case, what she has adopted are methods to help them in their growth as much as possible. “We have attempted to create an environment where they feel like there is a society out there, having the children engage in WhatsApp calls with their cousins and other kinds of interactions to help keep them grounded,” she said.
Dr. Muttiah also spoke to the general level of awareness of speech impediments in Sri Lanka, explaining that the general practice adopted by most paediatricians when it comes to a young child who is experiencing difficulty articulating themselves is to just wait and see. She said: “Often, the approach is to wait and see – that is what a paediatrician would recommend to most parents. However, this could pose an issue, as we must also maximise on the early interactions and resultant development in that age range of zero to three.”
Dr. Muttiah also shared that language or speech disorders can also be present alongside emotional or behavioural disorders, such as attention deficit hyperactivity disorder (ADHD) and anxiety. Children with developmental disabilities including autism spectrum disorder may also have difficulties with speech and language.
“The care we provide as parents at this stage is very important in such a situation, because children with speech disorders may feel frustrated that they cannot understand others or make themselves understood – they may act out, act helpless, or withdraw,” she stressed. The combination of challenges they experience as a result can make it particularly hard for a child to successfully adapt to their various environments, be it school or the playground. Properly diagnosing a child’s disorder is crucial so that each child can get the right kind of help.
Awareness in Sri Lanka
With regard to the situation in Sri Lanka, and the general level of awareness on speech or language disorders that children may experience, Colombo South Teaching Hospital Consultant Child and Adolescent Psychiatrist Dr. Yasodha Rohanachandra stated that parents have a general lack of awareness about speech impediments and it is widely seen. “There is a myth that if your child is late to speak, they are just a very late bloomer and it is just a matter of time that they catch up,” she said, adding that this is not always the case.
Dr. Rohanachandra said this lack of awareness also tends to extend beyond parents to the healthcare and education sectors too, as not many hospitals have speech therapists on board. “Only major hospitals tend to have a speech therapist available for you to send your child for an assessment. Most times, especially in rural areas, children with difficulties do not undergo an assessment,” she noted.
She said that in many countries, schools employ a speech therapist who will be available to address difficulties experienced by children in their early childhood stage, adding: “However, here in Sri Lanka, due to a lack of such widely available resources, we do not have such a practice, but at the very least we should focus on educating the parents.”
She stated that a child’s experiences in the early months and years of their life affect their health, wellbeing, and coping skills for the rest of their life, adding that caring, nurturing, and safe parenting help ensure a child’s healthy development. Understanding child development can help parents know what to expect and what they can do to help their child grow in a healthy way.
Dr. Rohanachandra added that in the early years of life, a child’s behaviour communicates their needs and how they change and grow, and therefore, listening to their child’s unique cues can help parents support them through their years of very rapid growth and development.
What can parents do?
With regard to speech, Dr. Rohanachandra said that a general guideline would be to keep an eye out for general milestones – for instance, if a child is able to say perhaps one word and is able to repeat it at the age of one, is able to string together a two-word statement by the age of two, and is able to share phrases to communicate by age three. Furthermore, Dr. Rohanachandra said that if by age four, your child is unable to communicate in a way that a stranger can understand them, it is advisable to take them to be assessed. However, she noted that these are only a general set of guidelines, and it is always best to get help as early as possible. If you have any concerns about your child’s development, you must talk to your healthcare provider.
Speaking to Brunch, child adolescent and counselling psychologist Dr. Kalharie Pitigala shared her thoughts on the matter, saying: “Speech impairment is not an easy thing for a child to deal with. It is a situation that needs a lot of support, and it has to be treated depending on the severity. Speech impairment may vary from stuttering to being mute, and the support required may differ depending on the condition.”
Similarly, Child, Adolescent, and Family Services (CAFS) Director Suhaila Shafeek-Irshard stated: “It is better to be safe than sorry, and being practical in figuring it out early can make a difference.” She said that “to this day, while things are a lot better in Sri Lanka with regard to awareness, there remain doctors and paediatricians who suggest the ‘wait and see approach’, which could potentially delay the treatment your child needs during that critical time in their development”.
So, she suggested that if you as a parent feel that your child needs additional support and may be experiencing some speech impediments, then you as a parent must make the executive decision to have them assessed.
Children with language problems often need extra help and special instruction, and if identified early, children can get the help they need from a speech language pathologist who can work directly with the children and their parents to help overcome any issues they experience. Children with specific learning disabilities, including language or speech disorders, may perhaps need special education services or accommodations at school. In order to provide children with everything they need, it is important that parents observe their behaviour and get the right advice on how best to help further their child’s development.