What Physical Problems may Affect Speech and Language Development in Boys?

Several physical characteristics of fragile X syndrome may specifically affect speech and language. Early recurrent episodes of otitis media (middle ear infections) are reported for many boys with fragile X, often before the age of six months. Fluctuating hearing loss may result, which can cause difficulty in hearing sounds, the phonetic features of language. The loudness of some boys' speech may be a result of this hearing loss.

Oral sensory-motor problems and hypotonia (low muscle tone) may cause difficulty with drooling, imprecise articulation, and difficulties with rapid sequences in speech. These sequencing problems may be a type of dyspraxia, where the child cannot program the proper motor movements of tongue, lips, and teeth to make the correct sounds. Voice quality is often reported to be hoarse, breathy, and low in pitch, which may be due to issues of low muscle tone.

A high, arched palate and occasional cleft palate (in 5% of boys) are reported by researchers. Usually the high palate does not affect speech, but may cause crowding of teeth.

Gail Harris-Schmidt, Ph.D., CCC-SLP
Saint Xavier University
Chicago, Illinois

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