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Enlarged Adenoids

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Q: We will be taking our 3-year-old daughter to an ear, nose, and throat specialist. She is a noisy sleeper, has some apnea and a lot of night awakenings, and is a mouth breather and drooler. Her speech seems delayed. She says about 90 words (but not clearly) and puts two words together. Do enlarged adenoids affect speech development and hearing?

A: One of the critical things a parent must do in the effort to seek help for a young child is to be able to describe accurately and with precision the specific behaviors that the child exhibits. It is in this way that any specialist, whether it is a medical doctor, a speech therapist, or language pathologist, can best assess the situation. As you know, a very young child cannot speak for herself, and the way she behaves in a strange office will be very unlike her normal behavior at home.

I open with this in answer to your question because it is clear that you have spent extensive time both interacting with and observing your daughter. This will go a long way in attaining for her the support or intervention she may need.

While I am not a medical specialist who can speak with expertise to a direct connection between enlarged adenoids and speech or hearing, I can say that some aspects of your child's language development, as you describe them, are within normal range. For example, we expect that at around 2 1/2 years old, children will begin to string two to three words together to form simple sentences just like those in your examples. However, at this age, I would expect to see a larger vocabulary word bank. Vocabulary knowledge is one of the most critical pieces of strong language development. It empowers children by allowing them to express themselves more fully, to think more deeply, and to understand what others are saying more completely. Furthermore, it is at the top of the list of prerequisites for success in later learning to read. By the age of 3, a child should be using around 300 words expressively and should be able to understand at least twice or even three times that amount.

I think that your willingness to seek help from a specialist is a good one, although there may be no cause for alarm. Your visit may both calm any fears you are experiencing as well as answer some questions you have.

About the Author

Susan Canizares holds a PhD in language and literacy development.

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