Speech-language problems

Children who have or have been treated for certain cancers can develop speech-language problems. These can affect a child’s ability to talk, understand and use words, read, write and communicate well.

Speech-language pathologists are the healthcare professionals who assess and treat children who have problems communicating.


Communication problems can be caused by:

  • a lack of muscle control (called dysarthria)
  • an inability to perform the muscle movements necessary to form words (called apraxia)
  • difficulty producing sounds with the vocal cords (called dysphonia)
  • hearing loss that may delay speech and language development
  • language disorders that affect the ability to communicate with others – by speaking, reading or writing – and understand when others are speaking (called aphasia)
  • language disorders that affect the ability to produce language – using correct grammar and words – that people will understand (called expressive language disorders)
  • loss of memory, attention span, organizational skills or social skills due to problems in the brain (called cognitive communication disorders)


Some signs of speech-language problems include:

  • difficulty communicating in a way that wasn’t a problem before the child’s illness or treatment
  • difficulty articulating, such as distorting sounds, leaving out a sound, substituting sounds or putting a lot of effort into making the correct sound
  • having an abnormal quality in the voice that may make it monotone, too loud or quiet, sounding harsh, hoarse or raspy
  • difficulty following directions
  • not laughing at a joke, laughing at the wrong time or laughing just because everyone else is
  • needing to search to find the right word or using the wrong word, a related word or a made-up word
  • talking a lot more than before
  • repeating what has already been said
  • stuttering
  • being slow to answer questions
  • very carefully watching the face of the person talking
  • waiting to see what everyone else does before following directions
  • not being able to handle background or competing noise
  • not being able to sit through a TV program or movie that was enjoyed before
  • not being interested in reading or listening to a story that was enjoyed before
  • finding it hard to put ideas into words so that listeners have to ask questions to understand
  • losing language or speech skills that the child had already developed


Speech-language pathologists have a number of ways to test a child’s language function. These include a variety of tests and speech and language tasks as well as reports from parents, caregivers, teachers and other people who communicate with the child.

Managing speech-language problems

Once they assess the child, speech-language pathologists develop a program to support the child’s communication skills.

Speech-language therapy programs

The speech-language pathologist will play with the child and help them develop specific language skills by working through language or communication activities. This work may be done with an individual child or in a small group with more than one child. They can also suggest other ways for the child to communicate such as using a voice amplifier, communication board or other devices.

The speech-language pathologist will develop an ongoing program for the child. This includes planning future assessments, therapy and monitoring how the child’s communication skills change. The program will involve the child’s family and other important people such as friends and teachers. It may include developing new strategies to help the child communicate with them and help them understand and communicate with the child. The program will also help plan for and solve problems that may develop in places where the child will need to communicate, such as physiotherapy and school, on a bus or during different social activities.

Speech-language therapy before, during and after treatment

Before cancer treatment starts, speech-language pathologists may formally assess the child’s language skills. They can use the results to check against skills during and after treatment. Throughout the treatment, they may suggest strategies or aids that will improve the child’s ability to understand and communicate in the short term.

When treatment is finished, or during a long treatment, the speech-language pathologist may offer individual or group treatment sessions. These treatment sessions will help the child develop or keep language skills or get used to changing abilities. The speech-language pathologist will also talk to people close to the child, such as family members and teachers, and give them suggestions for how best to help the child continue to develop language skills.

Speech-language pathologists will monitor the long-term progress of a child’s language skills after treatment. They can help by recognizing and responding to any long-term side effects of treatment. The child may continue to work with a speech-language pathologist after treatment is over.

Finding a speech-language pathologist

Speech-language pathologists work in schools, hospitals or other places in your community. You can find out more by visiting Speech-Language and Audiology Canada (SAC).

Expert review and references

  • Pruitt DW, McMahon MA, Ried SR, et al . Rehabilitation of the child with cancer. Pizzo, P. A. & Poplack, D. G. (Eds.). Principles and Practice of Pediatric Oncology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2011: 44: pp. 1305-1321.
  • Speech-Language and Audiology Canada. Children. Speech-Language and Audiology Canada; 2013.
  • Speech-Language and Audiology Canada. What do Speech-Language Pathologists do?. Speech-Language and Audiology Canada; 2013.
  • Rehabilitation services: speech-language pathology. St. Jude Children's Research Hospital. St. Jude Children's Research Hospital. Memphis, TN: St. Jude Children's Research Hospital; 2014.

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