General speech underdevelopment (GSD) in children: levels, signs and correction

Other names: Общее недоразвитие речи, ОНР, ОНР 1 уровня, ОНР 2 уровня, ОНР 3 уровня, ребёнок плохо говорит, системное недоразвитие речи

General speech underdevelopment (GSD) is a speech therapy conclusion given to children with normal hearing and intact intelligence, who have impaired all aspects of speech: sound pronunciation, vocabulary, grammar and coherent speech. Such a child begins to speak later than his peers, he has a poor vocabulary, he distorts words, does not coordinate them in sentences, and has difficulty retelling them. OHP is not a separate disease, but a description of a speech condition, which may be associated with dysarthria, alalia, consequences of perinatal damage to the nervous system, frequent illnesses and lack of verbal communication. Without correction, OHP often leads to difficulties in learning to read and write. With timely help from a speech therapist, most children significantly improve their speech by school.

🧾 МКБ-10: F80.9 🏥 Where it is treated: 6 All aspects of speech sufferHearing and intelligence are intactCorrection - before school

👨‍⚕️ Which doctor

Speech therapist, pediatric neurologist, pediatrician, ENT doctor

🔬 Diagnostics

Speech therapy examination, hearing test, examination by a pediatric neurologist, consultation with a psychologist

💊 Treatment

Regular speech therapy classes, speech therapy group in kindergarten, classes at home, treatment of associated disorders

📈 Prognosis

Favorable if started early and practiced regularly

⚠️ At risk

Perinatal damage to the nervous system, prematurity, frequent otitis media, heredity, lack of communication

⏱ When to see a doctor

Planned

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

Ребёнок перестал говорить слова, которые уже использовал
Не откликается на имя, слабо реагирует на звуки — нужно проверить слух
Нет зрительного контакта и интереса к общению
К 3 годам ребёнок не строит простых фраз
Судороги, эпизоды замирания
Частые отиты, храп и постоянно открытый рот

What is OHP and levels of speech development

The term was proposed in Russian speech therapy for children whose development of the entire speech system is impaired. The main condition is normal physical hearing and intact intelligence: if speech impairment is explained by hearing loss or mental retardation, they talk about other conditions. There are levels of OHP - from the complete absence of common speech to mild residual impairments. The level does not show a diagnosis for life, but the current state of speech: during classes, the child moves to the next level. Imprisonment is usually started at the age of 3–4 years.

Level I - no common speech, babbling words and gestures
Level II - simple phrases, gross errors in grammar
Level III - extensive phrasal speech with errors and poor vocabulary
Level IV - mild residual violations of vocabulary and grammar
Often accompanied by disturbances in attention, memory, and fine motor skills

Causes and risk factors

The speech centers of the brain mature in the first years of life and are sensitive to adverse influences. ONR often accompanies erased dysarthria and motor alalia associated with perinatal damage to the nervous system: hypoxia, prematurity, birth trauma, infections. Heredity is of great importance - speech disorders are often found in relatives. Frequent otitis media at an early age temporarily reduces hearing and interferes with the assimilation of sounds. Lack of communication, when little is spoken to and the baby spends a lot of time looking at the screen, aggravates the lag.

Hypoxia and birth trauma
Prematurity
Severe dysarthria, motor alalia
Hereditary predisposition
Frequent otitis and adenoids
Lack of verbal communication
Extended screen time at an early age

Signs of OHP

Parents usually notice that the child began to speak later than his peers and that speech develops slowly. The vocabulary is poor, the child replaces words with gestures or general words “this”, “that”, and confuses the names of objects and actions. He incorrectly changes words according to cases and numbers, omits prepositions, and shortens syllables. The pronunciation of many sounds is impaired, and similar sounds are difficult to distinguish by ear. Retelling and telling a story based on a picture are difficult. Unstable attention, rapid fatigue, and clumsiness of the fingers are often noted.

Late appearance of the first words and phrases
Poor vocabulary
Errors in word agreement
Skipping and rearranging syllables
Impaired pronunciation of many sounds
Difficulties of retelling
Poor auditory discrimination of sounds

What examinations are needed

The ONR conclusion is made by a speech therapist after a detailed examination of all aspects of speech: understanding, vocabulary, grammar, sound pronunciation, phonemic hearing and coherent speech. Be sure to have your hearing checked, as even moderate hearing loss can look like speech underdevelopment. The ENT doctor examines the ears, nose and throat, and evaluates the adenoids. The pediatric neurologist determines whether there are signs of dysarthria or other neurological disorders and, if necessary, prescribes additional tests. The psychologist evaluates attention, memory and thinking, and if there are communication problems, it is important to rule out autism spectrum disorders.

Speech therapy examination
Hearing test
Examination by an ENT doctor
Consultation with a pediatric neurologist
Psychological examination
EEG - according to the testimony of a neurologist

Correction and help at home

The basis of the correction is regular classes with a speech therapist, preferably several times a week. Work is going on in all directions: developing understanding and vocabulary, teaching grammar, producing sounds, developing phonemic awareness and coherent speech. Children with severe disabilities are helped by the kindergarten's speech therapy group. For concomitant dysarthria, speech therapy massage and articulation exercises are performed; for frequent otitis media and adenoids, treatment is performed by an ENT doctor. Drugs to “start speech” without specific indications are not recommended. The result largely depends on the daily work of the parents.

Talk to the child, comment on your actions
Read books and discuss pictures
Do not imitate, but calmly repeat the word correctly
Limit screen time
Develop fine motor skills: modeling, drawing, construction set
Do the speech therapist's homework

Services and prices for this diagnosis

Based on official price lists of Tashkent clinics. The exact cost is determined after examination.

🔬 Diagnostics

Первичная консультация педиатра Первичный осмотр отоларинголога

Frequently asked questions: General speech underdevelopment (GSD)

How does ODD differ from speech delay?+

Delayed speech development is usually noted in children under 3 years of age, when speech appears later than normal. The conclusion of ONR is given from 3–4 years of age if the delay persists and all aspects of speech are impaired: sounds, vocabulary, grammar. In fact, ONR is a more accurate description of speech disorders in a preschooler.

Will OHP go away on its own without classes?+

You shouldn't count on it. Without correction, OHP often persists into school age and manifests itself as reading and writing difficulties. With regular sessions with a speech therapist, many children make significant progress towards school. The sooner the work starts, the better the result.

Are medications needed for general speech underdevelopment?+

There are no medications that develop speech on their own. The basis of treatment is classes with a speech therapist and speech communication at home. Medicines are prescribed by a pediatric neurologist only for specific indications, for example, epilepsy. Nootropic courses without indications do not replace speech therapy work.

Can a child with ODD study in a regular school?+

Yes, most children with level III–IV SEN study in a regular school. It is important to continue with speech therapy as they are at higher risk of difficulties with writing and reading. Children with severe speech impairments may benefit from classes with speech therapy support.

Does the second language in the family affect the child’s speech?+

Bilingualism in itself does not cause speech impairment. A bilingual child may have a smaller vocabulary in each language, but the total is age-appropriate. If there are difficulties in both languages, you need to consult a speech therapist. It is better for parents to speak to their child in a language they speak fluently.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.