What are the reasons for a child over four years old speaking unclearly?

Speech unclearness in a child over four years old may be caused by factors such as poor language environment, short lingual frenulum, or intellectual disability. A detailed analysis is as follows:

1. Poor Language Environment

If a child is exposed to a poor language environment during language acquisition—for instance, frequent exposure to multiple dialects or accents—it may lead to linguistic confusion in the brain, resulting in unclear articulation. Improving the language environment and having parents spend more time practicing speech with the child can help alleviate this symptom.

2. Short Lingual Frenulum

A short lingual frenulum restricts tongue movement, preventing the tongue from extending forward in the mouth or moving up and down properly. This limitation can result in unclear pronunciation or syllable confusion. It is recommended to seek medical treatment at a hospital, where surgical interventions such as lingual frenulotomy or frenuloplasty can improve the condition.

3. Intellectual Disability

When there is delayed intellectual development, it can affect the child's language expression abilities, leading to unclear speech or disorganized language logic. Treatment methods such as psychological therapy and behavioral therapy at a hospital can help improve symptoms.

In addition, unclear speech may also result from hearing impairment, congenital cleft lip and palate, or vocal cord abnormalities. Specific causes should be evaluated at a hospital's pediatric health department, and appropriate treatment measures should be taken after an accurate diagnosis is established.