Association between the timing of chewable complementary food introduction and functional speech disorders in children: a case-control study.

OBJECTIVE: To investigate the association between the timing of chewable complementary food introduction and functional speech disorders (FSD) in children, and to identify independent risk and protective factors with a primary focus on quantifying the effect of delayed chewable food introduction. METHODS: A case-control study was conducted including 90 children diagnosed with FSD and 90 healthy controls aged 2-8 years. Data were collected on demographic characteristics, electronic screen exposure, parent-child interaction, perinatal risk factors, and complementary feeding practices. Univariate and multivariate logistic regression analyses were performed to assess independent associations. RESULTS: Delayed introduction of chewable complementary foods (≥12 months) was the strongest independent risk factor for FSD (fully adjusted OR = 35.20, 95% CI: 10.15-122.04, P < 0.001). Prolonged screen exposure (>2 h/day) and perinatal high-risk factors were additional risk factors. Female gender and increased parent-child interaction (>2 h/day) were protective factors. Subgroup analyses confirmed the stability of the main association across gender, age, and screen exposure subgroups. CONCLUSIONS: Delayed introduction of chewable complementary foods beyond 12 months is a critical, independent, and modifiable risk factor for childhood FSD. Timely introduction of chewable foods before age 1 year, combined with limited screen time and enhanced parent-child interaction, may serve as a reference to lower FSD risk in early childhood.