Warning signs

In children

• —Substitutes sounds when speaking (says "tat" instead of "cat", for example)
• —Consistently leaves out or replaces consonants
• —At age 4, people outside the family still struggle to understand what they're saying
• —Nasalises sounds with no identified medical cause

In adults

• —Sudden change in articulation, often after a stroke or injury
• —Speech feels slower, slurred, or takes visible effort to coordinate mouth movements

In children

• —At age 2, still not combining two words ("want water")
• —Vocabulary well below what's typical for their age
• —Relies mostly on gestures to communicate, rather than words
• —Difficulty understanding simple everyday instructions

In adults

• —Difficulty finding the right word mid-sentence
• —Understands less than they used to, or loses the thread of a conversation easily

In children

• —Gets hoarse often, without having a cold
• —Shouts or strains their voice while playing, persistently

In adults

• —Hoarseness that has lasted more than two weeks
• —Vocal fatigue by the end of the day (teachers, singers, anyone who talks a lot on the phone)
• —Voice cuts out or "breaks" for no apparent reason

In children

• —Chokes or gags frequently on liquids or solids
• —Refuses foods with a particular texture
• —Still has trouble chewing properly past age 2–3

In adults

• —Frequent choking when eating or drinking, especially after a stroke or neurological condition (dysphagia)
• —Sensation of food getting stuck in the throat

In children

• —Frequently repeats syllables or words ("I I I want")
• —Visible blocks when trying to start a word
• —Prolongs sounds ("mmmmum")
• —Starts avoiding speaking in certain situations because of it

In adults

• —Stuttering that started in childhood and still affects daily life
• —Very fast, hard-to-follow speech, often without being aware of it (cluttering)

In children

• —Reading is very slow and laboured for their school year
• —Swaps letters or sounds when reading and writing ("b"/"d", for example)
• —Consistently refuses or avoids reading activities

In adults

• —Reading and writing difficulties from childhood that were never assessed, and still weigh on daily life or work