The Experience Miracles Podcast

Understanding + Addressing Speech Delay in Children

Jul 30, 2024

Speech Delays in Children: Neurological Root Causes and Drug-Free Solutions

Episode 31, Experience Miracles Podcast | Host: Dr. Tony Ebel, DC, CACCP, Pediatric Chiropractor & Founder of PX Docs | Published: July 30, 2024 | Duration: 50 min

Key Takeaways

  • Speech is a sequential three-step neurological process, sensory input, integration (brain processing), and motor output. Most therapies target the output stage alone, but the root cause of nearly all speech delays is upstream dysfunction at step one or step two.
  • Subluxation, neurospinal misalignment that interferes with nervous system signaling, is the primary physical driver of speech delays. When subluxation compresses the brainstem or upper cervical spine, it can disrupt all three stages of speech simultaneously.
  • The vagus nerve is 85% sensory and a significant portion of its motor fibers are specifically tied to speech formation and execution. Vagus nerve dysfunction can impair input, processing, and output of speech all at once.
  • Birth interventions, forceps, vacuum, C-section, cord wrapped, are the most overlooked trigger of speech delays, present in over 90% of cases Dr. Tony Ebel has seen, including children with non-verbal autism. These physical interventions directly injure the nerves and brainstem structures that control speech.
  • Developmental sequence matters more than developmental calendar. If a child has unresolved gross motor delays, the brain will not advance to speech, cognition, and communication until those earlier stages are addressed first.

What Causes Speech Delays in Children?

Speech delay is not primarily a muscle problem, it’s a neurological one. Speech functions as a three-step process controlled entirely by the nervous system: sensory input (auditory signals entering the brain), integration (the brain processing and organizing that input), and motor output (the muscles of the mouth, jaw, and vocal cords forming words). When any step in this sequence is disrupted by nervous system dysfunction, the downstream stages cannot function correctly, regardless of how much muscle-based therapy a child receives.

The most common physical cause is subluxation: misalignment in the upper cervical spine and brainstem that interferes with neural signaling. According to Dr. Tony Ebel, DC, CACCP, over 90% of children with speech delays, including those with non-verbal autism, have a history of birth interventions such as forceps, vacuum extraction, or C-section. These physical forces directly injure the nerves and brainstem structures that govern all three stages of speech. Vagus nerve dysfunction, which often results from the same birth trauma, compounds the problem because the vagus nerve is 85% sensory and plays a direct role in speech reception, processing, and execution.

For parents whose children are plateaued in speech therapy or have regressed after initial gains, this neurological framework explains why: standard therapies address the output end of the process while the root cause, subluxation and nervous system dysregulation, remains unresolved. Addressing that root cause is what unlocks real progress.

Why Speech Delays Are More Than a Muscle Problem [00:01:00 – 09:45]

Dr. Tony Ebel, DC, CACCP: We are diving deep into speech delays here today, and we’re going to go through the whole spectrum, all the different levels of speech delays. If your child is struggling with mild to moderate speech delays in terms of fluidity, efficiency, and formation of words and sentences, and you’re in speech therapy and you’re working on that, this episode is for you. It’s also for you if your child is at the far end of that spectrum.

I don’t really like to talk about mild, moderate, or severe, because when it’s your kiddo struggling with anything, there is no “little bit,” there is no “mild.” It’s our child. Any struggle is a really big deal to us. If we have a child going through level three autism, which generally comes with non-verbal communication, maybe a few words, but really mostly non-verbal, we’re talking about that on this deep dive episode as well.

Like we do on all of these solo episodes, we’re going to dive deep into not just what the symptoms and the struggles are. You know those. You live those. What the conventional system and the internet won’t tell you, and this is really a great episode to share with your speech therapist, occupational therapist, and therapy team, is what we call The Perfect Storm and the bigger picture: the science behind all these neurological challenges in kids.

We’re going to go step by step through almost the mechanics of speech, and very few people out there take it this deep. They stop at the muscles. And that’s what I want to say right out of the gate with this: whether we’re talking about weak core, low tone, or speech delays, a lot of times we think it’s just a structural or muscular motor problem, either gross motor (the big muscles) or fine motor (the small ones involved in speech). But that’s not entirely true. There’s a deeper layer going on. There’s a deeper root cause and dysfunction within the nervous system.

Why Developmental Sequence Matters More Than Calendar Age [00:10:00 – 17:00]

We’re going to break down exactly what speech delays are. We’re going to talk about the milestones, the calendar, the timeline. But most importantly, I want to teach you a different perspective on developmental milestones altogether, because what throws a lot of professionals and parents is that they’re obsessed with the calendar: by 12 months, your child is supposed to do this; by 18 months, they’re supposed to do that.

What is way more important than the calendar and their age is something called the sequence. You’ll hear us talk about the neurological hierarchy or sequence, or, because I grew up playing baseball, I often use the metaphor “batting order.” The sequence matters more than the age because there are so many factors for your child.

What if they were born eight weeks early? What if they were seven pounds versus ten pounds? These things matter significantly. If a child was born early, or if a child had a stressful birth, and this is the number one most overlooked trigger of speech delays, birth interventions like C-section, forceps, vacuum, or cord wrapped, those are all neuromechanical, neuromuscular, physical injuries. Those interventions become injuries to the nerves and muscles that control speech. That child may be the same age as another child on the calendar, but developmentally they’re going to be delayed.

So at PX Docs, we don’t have those developmental milestone charts on our walls. We don’t say your child is supposed to do this by then. We don’t treat every child the same. Your child gets a personalized, individualized assessment and understanding of where they are.

How Speech Works: The Three-Step Neurological Process [00:17:00 – 30:00]

Here’s how speech works. It is a sequential three-step process. Of course, speech involves the lungs, the vocal cords, and the muscles. But before the motor muscles of speech, the output muscles that actually form and create words and sentences, can do their job, there is a sensory input. There is a sensory-receptive aspect of speech where auditory and cognitive signals must first be received by the brain.

Put one word on step one of speech: input. The nerd term is “afferent”, incoming signals. First, you have to have clean, clear information coming into the brain and nervous system, efficiently and effectively. If there is any interference on the auditory, receptive, sensory input side of this, there will be problems with number two and number three.

Second, once the brain and nervous system receives that auditory sensory input, it has to integrate and coordinate it. There’s decision-making within the brain. That’s step two: integration. And then third, the brain sends signals through the central nervous system to the nerves and muscles that actually form, execute, and create speech. Step three: output.

“Speech is a sequential three-step process, input, integration, and output. The root cause of speech delays almost every single time is further upstream. The dysfunction is either on the sensory input at step one or the integration and coordination at step two.”

Now here’s what makes this clinically useful. The severity of a child’s speech delay tells us something about where in this three-step process the dysfunction is sitting.

If a child’s subluxation is severe enough to interfere with step one, the auditory perceptive input, they won’t have speech at all on the output end. You can’t get to step two or step three if step one is offline. That tends to be the most significant cases, including non-verbal.

If a child has words, has expression, but their speech delay is more like a time delay, they take longer to take in, process, and respond, that’s a sign of subluxation at step two. The integration and coordination layer is where the inefficiency lives.

And if a child’s auditory perception is there (you can tell they’re picking up what you’re putting down), but they can’t relay it back out clearly, that points to interference between step two and step three. The final stage of the nervous system coordinating the tiny, intricate muscles of the vocal cords just isn’t fluid.

That’s why, for a lot of mild to moderate speech delays, professionals look at things like tongue and jaw function, oral ties, and muscular output problems. But often the reason the muscles are producing delayed, disorganized speech is because the interference is one level deeper, within the nervous system, within step two as it relates to step three.

How Subluxation and Vagus Nerve Dysfunction Drive Speech Delays [00:30:00 – 38:00]

Subluxation, vagus nerve dysfunction, nervous system dysfunction, dysregulation, and dysautonomia, I want you to think of those as kind of all one thing. Just interference and dysfunction within the nervous system. The function of the nervous system is to perceive, coordinate, and then express. So the nervous system runs all three layers of speech.

Subluxation is misalignment and reduced range of motion, altered neuromuscular function within the neurospinal system and brainstem. It can set up shop anywhere within the body. Anytime you have subluxation, you’re going to get in the nervous system’s way. And other professionals don’t quite know to find it because they don’t know quite about it. If you don’t know to look for something, you’re certainly not going to find it.

Now I really want to talk about the role of the vagus nerve. Speech therapists who are listening in, you definitely know this nerve, because the vagus nerve is primarily sensory. It’s the most important nerve when it comes to speech, autism, and developmental delays.

The vagus nerve is 85% sensory. So it plays a huge role in the sensory and receptive component of speech, step one. It plays a huge role in the coordination, integration, and efficiency of speech as well, step two. But there’s actually 15% of vagus nerve fibers that are motor, that are output. And a large percentage of that 15% is specifically related to speech formation and execution, step three.

Here’s the bottom line: when there is vagus nerve dysfunction, it can mess with all three components of speech at once. It can throw off step one, sensory input. It can throw off step two, integration and processing. And it can throw off step three, the actual motor execution and formation of speech.

“Subluxation alters or interferes with communication between the brain, the nervous system, and all the pieces and parts of the body, including the muscles that would formulate and create speech. So if there is neurological communication interference, there will be actual communication interference for your child.”

Birth Trauma and Other Triggers: What’s Really Causing This [00:36:00 – 41:00]

So what would cause subluxation, vagus nerve dysfunction, and nervous system dysregulation in the first place? Birth trauma and birth interventions are the number one cause.

Look at where speech comes from, the mouth, the jaw, the vocal cords, the nerves that control and coordinate the perception, integration, and execution of speech. They all exist right there in the neck and brainstem region. If we physically misalign, alter, or injure those nerves and that region, of course we’re going to have subluxation and neuromuscular dysfunction. We’re going to interfere with the signaling and processing of that three-step coordination of speech.

We now know statistically, there are meta-analysis studies, that more birth interventions means more problems, especially neurosensory and neurodevelopmental delays. Forceps, vacuum, C-section (especially forceful C-section), cord wrapped, breech position, any sort of physical intervention to the baby’s neck and brainstem. This all gets normalized. And then everyone says, “Don’t worry, they’re going to be okay.” But we know the correlation.

In 85 to 90% of the cases of speech delays we’ve seen, mild, moderate, severe, including non-verbal autism, over 90% of the time we see birth intervention to some degree. That means 5 to 10% of the time we don’t. In those cases, when we dive deep into the case history, there was usually a significant amount of emotional trauma during the pregnancy or early childhood. There was a significant amount of toxins, antibiotics, and other medical interventions that create inflammation and throw the vagus nerve offline. And sometimes it’s something as simple as a lot of falls and bumps during early gross motor development, hitting their head on the coffee table, falling off the couch, which can create this subluxation and misalignment within the neck and nervous system.

“Over 90% of the cases we’ve seen of speech delays, mild, moderate, severe, including non-verbal autism, involve birth intervention to some degree. The answers are right in front of us, but it’s all been normalized.”

Swimming Upstream: Why Gross Motor Delays Must Come First [00:41:00 – 44:00]

Often the biggest remaining piece to get speech, socialization, and communication online is to swim upstream and address gross motor delays. Speech is what we call a fine motor or advanced nervous system development function. It’s one of the last things to turn on and come online for your child’s brain and nervous system.

If your child had very obvious gross motor delays, delayed walking, delayed crawling, or especially skipped crawling altogether, that’s directly relevant to their speech timeline. And hear this: even if today they can crawl, walk, and run, but they’re all discombobulated and uncoordinated in how they handle gravity and move their body, that means there is still gross motor dysfunction and interference.

The way God designed brain and nervous system development is very much like project management. The brain will not be able to get to speech, communication, socialization, cognition, or emotional and behavioral regulation if it’s still stuck on an earlier stage of development. We sometimes call these kiddos the “drunken bull”, discombobulated, falling all over the place. That gross motor inefficiency will leave a speech delay in play, because neurodevelopment is sequential and the brain won’t get to advanced functions until it feels like it’s done with gross motor development.

So if your child is going through speech delays, sensory issues, and behavior or emotional regulation challenges, don’t forget to look upstream with your providers. Look at the gross motor and overall nervous system function as well.

What to Do Next: Getting a Nervous System Evaluation [00:44:00 – 50:00]

If this conversation is getting you to say, “That’s it, I need to find out,” then that’s the action you take. Go find out.

This deeper level of root-cause neurology is something that only neurologically focused chiropractors do. When a PT, OT, or speech therapist evaluates a child with speech delays, they don’t examine the brainstem, the neck, and the neurospinal system. But that is the foundational hub of all the other motor functions of the body. If we don’t address the primary issue first, everything downstream is secondary or tertiary, and we’re never going to get all the way better and get it to stick.

What I highly encourage you to do: get to a nervous system-focused chiropractor, get to a PX Docs provider. Here’s the three-step process you’ll experience.

Step one: That doctor listens more intently and actively than any doctor you’ve ever met. They will dive deep into your child’s case history and ask questions no other provider has asked, because we have to look deeper into the case history to find the triggers of what’s really causing the speech delays.

Step two: The scans. We’re not just looking at muscle function, we’re looking at nervous system development, dysfunction, and dysregulation. We can find vagus nerve dysfunction on our INSiGHT scans, our thermal, EMG, and HRV scans. These are visual, they kick out reports and neurometrics, and we can actually quantify the severity of nervous system dysfunction and subluxation. And we can locate it. With speech delays, that examination is going to focus strongly on the upper cervical, cervical, and brainstem area, where the vagus nerve and the sensory integration and expression nerves and muscles that are involved in speech reside.

Step three: A full report of findings, here’s what we found, here’s the care plan, here’s your child’s personalized, individualized plan.

When you address subluxation and clear that interference to the nervous system, step one comes back online, step two comes back online, step three comes back online. Parents tell us all the time: “We’d been doing speech therapy for so long, getting some mild to moderate gains or plateaued altogether. The moment my child started getting adjusted, the results started coming.” That’s what we call the one-plus-one-equals-11 effect. Chiropractic care addresses the root cause. Then therapy takes root and becomes so much more effective.

If you don’t address that first one, subluxation and vagus nerve dysfunction, the second one is very limited in what it can do.

“If we’re trying to work on a secondary issue instead of a primary, we’re never going to get it all the way better and get it to stick. Get to a nervous system-focused chiropractor. That’s where the scans and the exam can actually find this stuff, and that’s where you get the care that can release this tension and restore this function.”

Frequently Asked Questions

What is the real cause of speech delays in children?

The root cause of speech delays in almost every case is nervous system dysfunction, not muscle weakness. Speech is a three-step neurological process, sensory input, brain integration, and motor output. When subluxation or vagus nerve dysfunction interferes with any of those steps, the downstream stages break down. Most therapies address the output (muscles) without identifying the upstream neurological disruption driving the problem.

Can birth trauma cause speech delays?

Yes, and it’s far more common than most parents are told. Over 90% of children with speech delays, including non-verbal autism, have a history of birth interventions such as forceps, vacuum extraction, or C-section. These physical interventions can injure the nerves, brainstem, and upper cervical spine that govern all three stages of speech. Dr. Tony Ebel explains that the physical forces of birth trauma directly create the subluxation that disrupts nervous system signaling involved in speech.

Why is my child plateaued in speech therapy?

If a child is plateaued or making only slow progress in speech therapy, it usually means the root cause, subluxation and nervous system dysfunction, hasn’t been addressed yet. Therapy targets the output stage of speech (the muscles), but if the neurological interference at the input or integration stage remains, progress is limited. Neurologically-focused chiropractic care addresses that foundational layer so therapy can be far more effective.

What is the vagus nerve’s role in speech?

The vagus nerve is 85% sensory and directly controls the receptive and processing components of speech. A significant portion of its remaining motor fibers are specifically tied to speech formation and execution. When there is vagus nerve dysfunction, often caused by birth trauma or subluxation in the brainstem, it can disrupt all three stages of speech simultaneously: input, integration, and output.

How do gross motor delays affect speech development?

The brain develops neurologically in a sequence, not just by calendar age. Speech, socialization, and communication are advanced downstream functions, the brain won’t fully activate them until earlier gross motor milestones are resolved. If a child skipped crawling, had delayed walking, or still moves in a disorganized, uncoordinated way, that gross motor dysfunction will keep a speech delay in place. Addressing nervous system and gross motor development upstream is essential for unlocking speech progress.

How do I find a PX Docs provider who addresses the root cause of speech delays?

Visit the PX Docs Directory to find a trained, nervous system-focused pediatric chiropractor near you. PX Docs providers use INSiGHT scans (thermal, EMG, and HRV) to locate and quantify subluxation and vagus nerve dysfunction, then build a personalized care plan for your child.

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