Should Children Struggling with Behavioral Health also have a Speech Evaluation?
A parent's focus is often on finding the right counselor, psychologist, or pediatrician when their child is struggling with anxiety, depression, or low self-esteem, and while that is absolutely important, there is another piece that is sometimes overlooked: communication.
If a child is anxious, withdrawn, frequently frustrated, or has behavioral issues, it is worth asking some additional questions, such as: Could there also be an underlying speech or language difficulty contributing to what we are seeing?
The connection between mental health and communication is stronger than many people realize, and in some cases, a speech and language assessment can uncover challenges that are fueling their emotional struggles. If you believe speech or language difficulties may be affecting the mental health of a loved one, contact Great Speech today.
When Mental Health Symptoms May Actually Be Communication Frustration
Children do not always say, “I don't understand what you’re asking” or “I can’t find the words”. Instead, it may look like:
- Meltdowns during homework
- Refusing to participate in class
- Avoiding social situations
- Acting out when asked questions
- Saying very little in group settings
A child who is struggling to process language (receptive language difficulty) may appear inattentive or oppositional. If they struggle to organize their thoughts into words (expressive language difficulty), they may shut down or even become visibly anxious when put on the spot.
Those repeated moments of feeling misunderstood can shape a child’s self-image in a negative way over time. They may begin to believe that they are bad at school, awkward, or not smart when in reality they just need communication support. This emotional weight can look very similar to anxiety or depression.
Mental Health Challenges in Children Are Common
Statistics from the CDC state that approximately 1 in 5 children in the United States, aged 3-17, has a mental, emotional, or behavioural disorder in a given year. Those numbers tell us how important it is to look at children’s emotional well-being as a whole. Anxiety, depression, ADHD, and behavioural disorders can show up in many ways, including:
- Irritability
- School avoidance
- Social withdrawal
- Emotional outbursts
- Difficulty focusing
- Low self-esteem
What is less commonly discussed is how often communication difficulties exist alongside these diagnoses.
Speech and Language Disorders Are Also Common in Children
The NIDCD reports that about 1 in 14 children ages 3-17 has had a disorder related to speech, language, or swallowing within the past year. Some of these include:
- Articulation disorders
- Expressive language disorder
- Receptive language disorder
- Stuttering
- Childhood apraxia of speech
- Dysarthria
- Social communication disorder
When you look at both statistics side by side, the overlap becomes harder to ignore.
The Overlap Between Mental Health and Communication
Children with communication difficulties are more likely to experience anxiety and depression compared to their peers. This does not necessarily mean that speech issues cause mental health struggles, but it does highlight something important: when a child struggles to communicate, the world can feel confusing, isolating, and overwhelming, and that emotional toll adds up.
You can read more into this topic on our blog titled How Virtual Speech Therapy Can Reduce Anxiety, Stress, and Loneliness
Social Communication and Peer Relationships
Friendships in childhood are built on conversations. Kids negotiate rules during play, share stories, joke, disagree, and work out misunderstandings. These interactions need strong social communication skills.
When a child struggles with the following, it can impact their ability to connect with their peers:
- Understanding social cues
- Taking turns in conversation
- Explaining their ideas
- Staying on topic
- Repairing misunderstandings
Research has shown that children with language impairments are more likely to experience difficulties with their peers and social inclusion than those who do not, and these are known risk factors for emotional challenges later in life as well.
If a child is reporting loneliness, being left out, or dreading school, a speech and language evaluation with a speech therapist can help determine whether social communication challenges are part of the picture.
Difficulty Expressing Emotions
For mental health treatment to be effective, children need to:
- Describe their feelings
- Explain what happened
- Reflect on their thoughts
- Problem solve-verbally
- Advocate for their needs
But what if the child does not have the communication skills to do that?
A child with expressive language challenges may feel big emotions but lack the words to describe them. Instead, they may cry, yell, or even withdraw. It may appear like they are being defiant, while they are really showing signs of communication difficulties.
Improving language and communication skills through speech therapy can directly support a child's ability to participate in helpful counselling.
Should Every Child With Mental Health Challenges Have a Speech Assessment?
Not every child struggling with mental health challenges will automatically need a speech assessment. However, many children who are struggling emotionally may benefit from one, especially if there are signs that communication difficulties could be contributing to their stress.
Mental health concerns such as anxiety, depression, behavioural challenges, or school avoidance can sometimes mask underlying communication difficulties. A child who appears defiant may actually be confused or embarrassed. A child who seems withdrawn may be avoiding situations where they fear being misunderstood. A child who struggles to express themselves in therapy may not yet have the language skills to fully describe their thoughts or feelings.
A speech assessment is worth considering if a child:
- Has delays with speech milestones
- Has trouble clearly expressing their thoughts
- Struggles to follow directions
- Avoids speaking in class or social settings
- Has trouble making or keeping friends
- Becomes frustrated when trying to communicate
- Has academic difficulties tied to reading, writing, or comprehension
Speech evaluations with Great Speech look at much more than just pronunciation. It also examines:
- Receptive language (understanding)
- Expressive language (verbal)
- Social communication skills
- Emotional vocabulary
- Language and communication tools needed for academic success
Sometimes the evaluation will confirm that the child’s communication skills are age-appropriate and that reassurance can be helpful in narrowing the focus to mental health treatment alone. However, in other cases, it identifies gaps that may be quietly contributing to the child’s emotional distress.
It is not about over-analyzing the child; it is about being thorough to give them the best possible outcome to live happy, successful lives.
We’d Love to Help
If something has been weighing on you about your child, whether it's a shift in their mood, growing frustration, pulling away socially, or simply a quiet sense that something isn't right, it's okay to listen to those feelings. Parents know their children better than anyone and you don't need to have all the answers before reaching out.
Sometimes it helps to just talk things through with someone who understands communication development, and we can help you sort out what's typical, what might need support, and what your next step should be. That's exactly what our free introductory call is for. No pressure. No commitment. Just a real conversation about your child and what you are noticing.
If you’re wondering whether a speech assessment could make a difference, schedule that call. Even gathering information can bring relief, and if support is needed, you’ll already have taken the first step.