(1) Speech is unclear and often unintelligible to others; (2) Misunderstandings are caused by the common substitution of one sound for another, such as saying “rabbit” for “pants”; (3) The child is perceived to speak with a loud tongue. (2) Voice/resonance abnormalities (1) Speech is very hoarse and affects the clarity of speech; (2) Voice is lower than that of children of the same age; (3) Speech is very hard or has veins exposed; (4) Speech is too loud or too small; (5) Speech does not have a high or low rise or fall, and is staccato; (6) Speech has a nasal sound. (3) Speech abnormalities (1) Speech is very laborious; (2) Strange movements such as blinking and wringing of hands when speaking; (3) Repetition or prolongation of certain sounds or words when speaking. The child does not have a vocabulary by the age of 2. 2. 3. 3 years old and still cannot understand what is being said. 4. 4. 3 years old and still cannot understand what is being said. 5. 5. 5 years old and often cannot tell the parents what is happening or speak in a fragmented manner. 6. 6 years old and still cannot understand long or complicated words. 7.