The Frequency of Speech Disorders and Its Relationship With Nutritive and Non-Nutritive Sucking Behaviors in 3-5 Years Old Children in Bushehr City, Iran

Objective Speech and language disorders are considered as one of the most important public health problems that have many secondary complications, especially on the quality of life of childhood and adolescence. This study aimed to investigate the frequency of speech disorders and its association with parents, reported sucking behaviors of children including breast feeding, bottle feeding, using a pacifier, finger sucking, and other sucking behaviors in 3-5 years old children in Bushehr City, Iran.
Materials & Methods This is a cross-sectional study conducted on 3-5 years old children in Bushehr City, Iran during 2015-2016. Using two-stage sampling method, preschools and kindergartens were randomly selected in the first stage and children were selected by systematic random sampling method in the second stage. Their parents completed a self-administered questionnaire to collect information on children’s feeding during infancy and sucking behaviors, start and stop age of breast- and bottle-feeding, pacifier use, finger sucking and other sucking behaviors. Evaluation of speech problems was conducted at each preschool with subsequent scoring by a speech therapist and her assistant using phonetic information test. The obtained data were analyzed using descriptive statistics (mean, standard deviation and frequency) and Independent t test (for comparing quantitative variables between two groups of children with and without speech disorders), Chi-square test (to examine the relationship between demographic variables and speech disorders) and logistic regression (to compare speech disorders between different groups of children in terms of sucking habits). SPSS version 18 was used for analyzing the data. In all analyzes, the significant level was considered as 0.05.
Results Total of 222 children, aged 36 to 72 months were assessed (49.5% girls and 50.5% boys). Mothers, (72.5%) and fathers, (68%) education level was mostly university degree. The frequency of speech disorders was 9.5%. In speech production, 20 (9%) children had mild disorder, 1 had moderate disorder, and 201 (90.5%) children were normal. Speech production organs were normal in all children. Totally, 212 (95.5%) children were breast fed and 125 (56.3%) were bottle-fed. The majority of children (50.9%) had exclusive breast feeding. Children were breast fed for mean±SD duration of 16.08±8.06 months and were bottle-fed for 15.93±10.2 months. Eighty-three (37.4%) children had used a pacifier for an average±SD of 10.84±9.09 months; 22 (10%) children were reported to have sucked their fingers. Mean±SD onset age of finger sucking was 9.59±7.9 months and the age of finger sucking cessation was 15±8.28 months. The majority of children (4.5%) had sometimes sucked their fingers. Only 7 (3.2%) children had a sucking history other than finger and pacifier sucking. There was no significant difference between children with and without speech disorders regarding the age of mother (P=0.09), children’s weight (P=0.48) and when attended the kindergarten (P=0.95). Also, there was not any significant relationship between child’s sex (P=0.25), maternal education (P=0.80), father's education (P=0.33), history of acute otitis media (P=0.72) and history of hospital admission in the first month of birth (P=1) with speech disorders. There was no significant relationship between bottle-feeding (P=0.49), using pacifier (P=0.48), sucking objects (P=0.50) and breast feeding (P=1) with speech disorders. The only significant relationship was found between finger sucking and speech disorders (P=0.043). The odds of speech disorder was 3.36 fold more in children with finger sucking compared to other children (95%CI: 1.09-10.31).
Conclusion The frequency of speech disorder in preschool children in Bushehr is higher than the global figures reported. The results suggest a significant relationship between finger-sucking behavior and speech disorder in 3-5 years old children in Bushehr. This highlights the importance of prevention and early treatment of childhood finger sucking habit in preschool children