In my first year as an Integrative Educational Therapist, naively thinking I was going to specialize in just reading, I had the opportunity to work with 3 children who had mild to severe speech issues.

All of them made incredible progress with their speech which was a surprise even to me. Their parents had sought out my services for other reasons and were pleasantly surprised that the speech issues had significantly improved or even disappeared.

How did that happen? An integrative approach that addressed everything from toxicity to gut health to brain connections.

What’s the Deal with Speech Issues?

The National Institute on Communication Disorders estimate that approximately 1 in 12 children now have some type of speech challenge.

There are several types of speech issues but understanding the difference between speech and language is helpful in distinguishing the different types of breakdown.

Speech itself is the mechanical process that creates specific sounds depending on how the tongue, lips, jaw, teeth and cheeks as well as the throat work together.

Language is how the brain processes the information that the ears hear. With speech issues, many children have good receptive language, meaning they can comprehend, but their expressive language which is the ability to communicate is where there is breakdown because this is a more complex task cognitively and with regards to the oral-motor aspect.

Speech and Writing Issues Share Common Areas of Breakdown

It’s not uncommon for children with dyslexia to have or have had speech issues and interestingly speech is similar to writing. Just as many children with speech issues can understand everything someone is saying but struggle with expressive language, the same often occurs with stealth dyslexia. These are the kids that can read moderately well but writing and output of ideas on paper poses the same challenge as kids who have difficulty expressing themselves orally.

This is why I compare listening and reading to breathing IN (the easier part of language processing) and speaking and writing as breathing OUT (a more complex, active task).

Both oral and written communication requires planning, sequencing, motor planning and prioritizing which is quite different from the memorization that we can rely upon when reading or simply listening to the spoken word.

If you suspect or know your child has a speech issue, your doctor may tell you all kids are different and your child will catch up and not to worry. They may refer you to a Speech Language Pathologist, or recommend your child have a hearing test or be assessed for auditory processing disorder but this will usually not be sufficient.

Types of Speech Issues

There are many types of speech issues that can arise with some challenges potentially overlapping. In either case, there are underlying factors that once addressed can often result in significant improvement to total recovery from speech challenges.

I can’t stress enough the importance of early intervention and that may mean listening to your mama’s intuition rather than that of an expert if you suspect something is just not right.

Below are a list of some common speech issues:

Apraxia: Total lack or near total lack of age appropriate language and communication. Apraxia involves the inability to effectively speak or articulate due to motor and coordination issues.

Expressive Language Disorder: This is different than apraxia in that the motor coordination of the mouth is fine, but rather there is a breakdown with communication and expressing thoughts through language in the brain. Expressive language disorder is not uncommon among those with dyslexia, dysgraphia and learning disabilities related to language. These kids may be mistaken for quiet kids, mumblers or kids who are just shy.

Mutism: This is when a child is either unable (like apraxia) or unwilling (selective mutism) to speak.

Stuttering: This is when there is an interruption in the natural fluency of speech whereby a child may repeat certain sounds over and over before saying the next or there may be pauses before continuing.

Echolalia: This is where a child repeats words or phrases that someone else has said. This is not uncommon among children on the autism spectrum.

With all speech issues, speech issues may have been there all along or there may be a sudden regression.

In either case, there are often positive outcomes when an integrative approach is adopted. Sudden regressions should not be considered normal with speech. When a child was speaking and then suddenly regresses there is often an environmental factor that has provoked this regression such as head injuries, a toxic exposure, illness or trauma.

It’s important to know that simply because a child struggles with expressive language or articulation, they may and often do have excellent receptive language – meaning they can understand what others are saying very well but have a hard time responding.

Children most at risk of speech issues are children with:

ASD
Auditory Processing Disorder
Developmental Delays
Gross motor delays
Sensory processing disorder
Dyslexia and other learning disabilities

What These Kids Experience

Children with speech issues who are able to communicate their challenge or who could not communicate but overcame their speech issues will often say:

“I didn’t know how to move my mouth to say the words.” – Child with Apraxia

“Organizing my words or thoughts felt impossible.” – Child with Expressive Language Disorder

“It was so hard to control the muscles in my body as well as my mouth.” Child with Apraxia

“I was overwhelmed because I understood and took in everything!” – Child with Sensory Processing Disorder and mild ASD

“It felt like my brain was forcing me to do things I couldn’t control.” -Tourette’s and Echolalia

“I felt so frustrated and alone and misunderstood.” – Mutism

The Causes to a Complex Issue

Speech difficulties are complex but with an integrative approach it doesn’t have to be overwhelming.

Addressing the causes in a strategic approach is critical and this requires some good detective work. Just like addressing dyslexia and other neuro-developmental issues, we need to look firstly at the bio-chemistry of the body and how that is impacting the brain, language centre as well as the muscles and coordination.

Next, we need to look at everything from oral issues like palate, tongue ties (common in 11% of all babies), brain organization in terms of areas of immature development, brain hemisphere imbalance as well as cerebellum development.

The Biological Causes of Speech Issues

#1 Toxicity is King with Speech Issues

The most common factor that I see in my practice with speech issues and that accounts for the increasing numbers in speech issues is toxicity. I can’t tell you how many clients see massive gains with articulation, increased vocabulary and better expressive language as well as better non-verbal communication once we identify and address toxicity.

Mold, aluminum, pesticides like Glysophate, mercury, lead and so much more are major causes that can go undetected for years. These toxins impair brain development, detoxification, mitochondrial function and so much more.

How Toxicity Impacts Gene Expression

These toxins can not only cause impairments with the brain and motor development and coordination, they can also slow down detoxification and even switch on certain genes that can exasperate speech, cognitive and motor development and so much more.

When there are defects in detoxification pathways such as deficiencies in the master anti-oxidant glutathione, N-acetyl-cysteine or vitamin E, these children then also become more vulnerable to accumulating everyday toxins that others are able to clear from their bodies.

Heavy metals are notorious for not only causing impairments in brain development but also for impacting methylation pathways which impacts gene expression, detoxification, cell repair etc.

Heavy Metals & MT Proteins

In fact, the research of Dr. S. Jill James at the University of Arkansas found that children with ASD have lower levels of glutathione than their neurotypical peers.

Metallothioneins (MTs) are proteins that are rich in cysteine and can ultimately bind metals. The work of Dr. William Walsh and Dr, Anjum Usman uncovered mutations in the MT protein in those with ASD. Not only does this affect cognitive development but these mutations can cause severe sensitivities to toxins like heavy metals.

The conclusion from this research is that environmental toxicity has a major influence on gene expression. Even more hopeful is this research found genes are not the true culprit but rather the MTs that are switched off by toxicity and other environmental factors. Fortunately, natural approaches can stimulate the production of MT proteins.

MTs are critical because they are an essential part of brain development as well as maturation of the gut and immune system. The reason children don’t develop autism later is because by three years of age the brain, gut and immune system have developed enough to not be as deeply affected by the toxins at the cognitive level which can contribute to the symptoms of autism in earlier years. The developing brain is most vulnerable to brain damage in the first three to four years.

The Importance of Minerals and Anti-Oxidants

Increasing anti-oxidants in order to detoxify metals and other toxins is key. However, optimizing mineral levels is a critical first step since toxicity and other stressors will deplete minerals and these children often already have depleted mineral levels. We do not want to mobilize metals out of the cells until we have optimized mineral levels first and regulated the nervous system. Failing to do so is often why detoxes go wrong. Starting with drainage is key.

#2 Nutritional Deficiencies

The impact of nutrition in speech and developmental issues has been widely researched but can spark strong emotions of guilt, shame or even feeling attacked for a child’s challenges.

So let’s be clear – there are a lot of layers to developmental issues and when discussing the role of nutrition, it’s important to acknowledge kids eat restrictive or poor diets for numerous reasons such as socio-economic factors, picky eating driven by sensory issues or mineral depletion, gut microbiome imbalances that drive hijack tastebuds and drive cravings and let’s not forget soil depletion.

But, we cannot address what we don’t acknowledge and nutrition plays a vital role.

A 2017 Journal of Frontiers in Behavioural Neuroscience examined the

connection between processed foods and neuro-inflammation and it’s obvious impact on memory, learning and processing speed.

A couple years later, in 2019, a study by the Behavioural Health Journal cited numerous studies connecting nutritional deficiencies to speech and language processing challenges.

Countless studies have found that key nutrients required for language processing in the brain, or the oral-motor aspect of speaking can contribute to mild to severe speech issues.

These deficiencies can occur for a variety of reasons such as:

Multi-generational deficiencies
Poor maternal reserves at the time of conception, pregnancy or during lactation
Diets high in sugar, processed foods and low in healthy vegetables, meat, eggs, fruit, seeds and nuts
Malabsorption caused by leaky gut and an atrophied gut microbiome
Poor cellular uptake of nutrients

Poor dietary choices can often become quite severe as picky eating becomes a vicious cycle driven by an imbalanced microbiome which affects cravings and deficiencies which affect tastebuds. When this is compacted by sensory issues, severe deficiencies occur. This is why addressing picky eating is the first step in our program the Full Potential Academy.

Common Deficiencies that Can Impact Speech

Essential Fatty Acids

It’s no surprise that essential fatty acids can have the same positive impact on speech that they have on dyslexia since these two disorders share many commonalities.

Receptors for specific neurons in the brain are mostly composed of fats as well as the nerve cells in the body. The better the insulation (the myelin sheath which is composed of EFA’s), the better communication that occurs. Research has found that women who consumed higher levels of EFA’s during pregnancy had children with superior language skills.

Some excellent sources of EFAs are fish oil capsules (make sure it’s free of heavy metals), eggs, meat, turkey, flax seed, walnuts, pecans, pumpkins, etc.

Vitamin E

It’s been noted for some time that deficiencies in vitamin E can present as verbal apraxia. This is likely why developmental pediatricians are reporting incredible success with vitamin E to resolve apraxia. One study found that out of 187 children with verbal apraxia who received vitamin E and EFA supplementation, 97% of them experienced ‘dramatic improvements’ in speech, motor coordination, eye contact, social skills and imitation.

Sources: Vitamin E can be found in nuts, seeds, leafy greens, pumpkin, wheat germ, avocados and many other vegetables.

Choline

Choline is one of shining starts for speech issues. Its’ not only necessary for methylation (like detox and gene expression) but it assists with the production of the neurotransmitter, acetylcholine which is responsible for memory, executive function, attention and motor planning – all of which are essential functions for speech and language. Research has found that lack of choline in pregnancy and lactation can cause permanent cognitive limitations.

Sources: Eggs, liver, wheat germ, sunflower lecithin

B12

A deficiency in B12 can cause poor memory, developmental delay, reduced IQ, social delays, speech impairments and motor issues. B12 is critical to build the myelin sheath which is the fatty coating on nerves. When the sheath is well developed there is optimal signalling and processing speed for various neurological functions in the body. Thus optimal B12 can assist with improvement in language processing and acquisition. Additionally, B12 is required for methylation and the production of glutathione – the master detoxifier.

B12 deficiencies can occur due to vegetarian and vegan diets, pathogenic gut bacteria that consumes B12, gut microbiome imbalance since some B12 is also manufactured in the gut, as well as leaky gut and poor absorption due to the MTHFR gene mutation.

It’s difficult to accurately measure B12 with a blood test since the B12 levels in the brain may be lower. This is why assessing B12 with other means is important and why B12 supplementation can be such a game changer for those with speech issues. The research of Dr. S. Jill James at the University of Arkansas found that children with ASD have lower levels of glutathione than their neurotypical peers and that methylB12 can optimize glutathione levels.

Folate

Deficiencies in folate (not folic acid which is a synthetic vitamin and is toxic to those with the MTHFR gene mutation) can cause speech issues as well as general developmental delays and so much more.

Folinic acid (not folic acid!) can also alleviate speech and communication challenges.

Both of these forms of folate (folate and folinic acid) are often critical in those with speech issues as they often have the MTHFR gene mutation.

Sources: dark leafy greens, broccoli, liver, chic peas, black eyed peas

This is a B vitamin that when low can cause cognitive, motor and speech delays.

Sources: Pork, sunflower seeds, eggs, asparagus, salmon, acorn squash, brown rice

This is found in high levels in the cerebellum, the area of the brain that is highly involved with learning, coordination and motor skills.

Sources: Eggs, meat, bananas, fish, seeds, nuts and some vegetables.

Amino Acids

Amino acids are the building blocks of protein and are often deficient in children with developmental issues for various reasons.

Creatine, carnitine and carnosine are common amino acids that can assist with speech and language processing. It is highly recommended that you work with a natural health practitioner specialising in neuro-developmental issues when determining what supplements and amino acids are ideal for your child.

#3 Food Sensitivities

I’m not a fan of restrictive diets unless absolutely necessary and in the case of ASD and speech issues, I definitely recommend parents trial 8-12 weeks of a gluten and dairy free diet. For many years, a GFCF diet was controversial or ridiculed but there is now peer reviewed research to support the science of its effectiveness.

Studies have found that children with developmental issues like ASD often have a genetic predisposition to a gluten sensitivity. A large portion of kids with ASD and apraxia tested as having high antigliadin antibodies in conjunction with nutritional deficiencies triggered by leaky gut which was likely caused by the gluten irritating the gut lining.

Likewise, dairy has been found to block folate receptors which is particularly problematic for those with the MTHFR gene mutation since folate metabolism is already affected with this gene and can result in even lower levels of cerebral folate.

In a nutshell, both dairy and gluten are inflammatory to the brain – particularly in children with developmental issues. Not only can this diet improve speech, but cognition, behaviour, coordination, focus and digestion.

#4 The Gut Microbiome

Decades of evidence has shown that gut bacteria plays a profound role in brain development, speech, social skills and language processing. More than that, children with ASD and developmental delays have been shown to have a significantly altered gut microbiome compared to their neurotypical peers. In fact, the Microbiome Project as well as medical journals like the Lancet has determined that infant brain development is greatly impacted by the mother’s gut bacteria which she passes onto her child.

Clostridia is one of the most notorious pathogenic bacteria that is abundant in ASD children. Multiple studies have found that children with ASD tend to have 9 different strains of clostridia compared to their neurotypical peers. This bacteria can contribute to numerous physical health issues as well as motor issues and speech delays and other ASD symptoms.

#5 Mitochondrial Issues

Children with mitochondrial issues, which is common when toxicity is a factor, may have challenges with development, speech and motor coordination which can lead to weakness in the face and learning disabilities.

Addressing toxicity and supporting the mitochondria with a customized plan is key. Simple ways to support the mitochondria is a diet rich in anti-oxidants with healthy protein and fats, limiting toxins in and outside of the home and sufficient sleep.

For speech issues connected to stuttering and echolalia, addressing high glutamate levels is critical. One way to do this is by increasing glutathione which is often low in these children. Glutathione naturally lowers high glutamate and there are several ways to do this. B12 can optimize glutathione levels so increasing B12 rich foods is the best place to start. It may be necessary to work with a practitioner to determine if B12 supplementation is necessary and which form is appropriate.

It’s Rarely Just One Thing

As you can see, speech issues are rarely caused by one factor since many of these processes work together in the body and brain. Expressive language requires planning out thoughts and ideas, planning the sequence of movements of the mouth, tongue, cheeks and executing these movements to produce specific sounds. This is known as praxis in speech which requires a balance of neurotransmitters as well as energy from the mitochondria.

Low neurotransmitters like acetylcholine can contribute to speech issues but a healthy gut lining and microbiome is needed for our bodies to produce these neurotransmitters. Add in toxicity as a major factor in speech issues and that toxicity can cause genes like the MTHFR to express, which further hinders the detoxification process and thereby can cause mitochondrial dysfunction and we can see why an integrative approach that is targeted is critical for success.

In my next article, I will outline the various areas of breakdown that can occur with speech in relation to brain disorganization and weak connections and how brain integration therapy is another key therapy in overcoming speech issues.

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https://pmc.ncbi.nlm.nih.gov/articles/PMC6616660/

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