Speech Questions and Answers:
My child is not yet talking. How do I know if he needs help or if he is just a late talker?
A general rule of thumb about children's speech and language development is that most children use 20-50 single words by 18 months, 2-word combinations by age 2, and 3+ word phrases at age 3. There can be several reasons why children don't talk. Some of these reasons might be related to problems with hearing, muscle coordination, learning, or experience. The best way to find out if there is a problem is to have your child evaluated by a Speech-Language Pathologist.
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My child is 2 and I can't understand everything he says. Should we be getting speech therapy?
Speech sound acquisition is developmental. That means that some sounds emerge early and other sounds are not fully developed until age 5 or 6. At age 2, unfamiliar adults should be able to understand about 50% of what a child says. By age 3, a child’s speech should be understandable between 70% and 90% of the time. Some of the last sounds to emerge are the "r", "th", and the "s" sounds.
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My child is 3 and still uses a pacifier and sucks his thumb. Will this affect his speech development?
Yes, it can. Using a pacifier and thumb sucking can prevent the tongue from moving into a more natural position for both eating and speaking purposes. The muscles of the tongue may not get enough exercise and could be weaker than they should. Also, children who have their pacifier or thumb in their mouth don't spend as much time talking and don't get the practice they need to learn to speak clearly.
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My 3 year-old gets stuck on some of his words and repeats words frequently. How can I help him?
Most young children who are learning to speak show some disruptions of fluency. This is normal dysfluency and includes pausing and repeating whole words or phrases. Frequently an increase in dysfluency follows a period of rapid development in language skills. A Speech-Language Pathologist can identify whether your child is at risk for stuttering or if the dysfluencies are developmental and suggest ways that you can help increase your child’s fluency.
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My child can watch videos or TV shows for a long time but he seems to have trouble paying attention to other things like reading stories, playing with toys, and talking with me. Should I be concerned?
A short attention span can be a symptom of other learning problems and can interfere with a child's ability to learn new words, ideas, and concepts. Ask yourself these other questions: Can he follow simple verbal instructions? Will he sit down and look at a book with me? Can he choose a toy to play with and play with it for an age-appropriate time before moving on to another activity? Can he sit down with the family and finish a meal? Can he play successfully with other children? If you answer "no" to several of these questions, you may want to request a speech-language evaluation.
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How do I know if my child’s speech and language development is normal?
The following lists represent the average age that most children accomplish speech and language skills. These milestones represent a range of expectations for when your child may develop certain language structures; however, just because your child has not achieved one skill in the age range does not mean the child has a disorder. You have probably heard that most children develop speech and language skills at different rates and you should just “wait and see.” However, research indicates that early intervention is key in the remediation of speech and language disorders. If your child has not achieved most of the milestones that correspond with his age, a speech and language evaluation may be warranted. Contact our office as soon as possible to schedule an evaluation with a certified Speech-Language Pathologist.
Birth-3 Months
- Makes cooing sounds
- Smiles with excitement as caregiver approaches
- Cries differently for different needs
- Seems to recognize your voice and quit crying
- Displays startle response to loud sounds
3-6 Months
- Begins to babble using more speech-like sounds including p, b, and m
- Vocalizes pleasure and displeasure
- Laughs when playing with people and objects
- Exhibits vocal play such as squealing and making “raspberries”
- Begins producing double syllables (i.e., “baba”)
- Moves eyes in direction of sound
6-9 Months
- Looks at some common objects when their names are spoken
- Comprehends “no”
- Begins to use some gestures, plays pat-a-cake and peek-a-boo
- Uses a variety of sound combinations
- Uses varied intonation patterns
- Begins variegated babbling (i.e., mabamaba”) around 9 months
9-12 Months
- Uses most consonant and vowel sounds during play
- Jabbers loudly with a variety of sounds and intonations
- Turns head immediately to own name
- Gives objects upon request
- Understands about 10 words
- Begins using first true words
1-2 Years
- Points to some body parts on command
- Follows simple commands
- Understands simple questions and about 200 words
- Points to pictures/objects when named
- Produces 10-50 words by 18 months and begins to use 1-2 word utterances/questions
- Approximately 51% of the child’s utterances consist of nouns
2-3 Years
- Asks “wh” and yes/no questions
- Understands differences in meaning (i.e., big-little, up-down)
- Follows two-step commands
- Has a name for almost everything
- Has an expressive vocabulary of about 450 words by 30 months
- Combines 3-4 words
- Speech is understood by familiar listeners most of the time
3-4 Years
- Understands simple “wh” questions
- Talks about activities
- Comprehends up to 4200 words and uses 900-1000 words expressively
- Uses lots of 4-5 word sentences
- Usually talks easily without repeating syllables or words
- Speech is understood by people outside of the family
4-5 Years
- Speaks in complete sentences
- Can name items in a category
- Pays attention to short stories and can answer some simple questions about the story
- Uses a clear voice
- Remains on topic when telling stories
- Produces most sounds correctly except a few like l, s, z, r, ch, sh, th
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What are some red flags or warning signs that indicate a speech and language evaluation is needed immediately?
The child should be referred as soon as possible if he/she:
- Is not babbling by 12 months
- Is not using single words by 16 months
- Is not spontaneously producing 2 word phrases by 24 months
- Uses language in a peculiar manner
- Lacks pretend play
- Repeats everything that is said to him (echolalia)
- Continues to use early forms of communication, such as gesturing, crying, and leading an adult to a desired object
- Does not look at you when talking and playing
- Does not orient when name is called
- Prefers to be alone and/or does not play in close proximity to other children
- Exhibits limited imitation (does not wave "hi" and "bye-bye")
- Does not respond to very simple requests, directions, and questions, such as "No," "Don't," "Come here,” "Do you want more?"
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What can I do to stimulate my child’s speech and language development?
A child needs to know that speech is important for expressing wants, needs, and feelings and for interacting with the environment. The following activities are suggestions on how to interact with your child in a way that will enhance his speech and language skills.
Talk
- Describe what your child is doing as he does it.
- Talk about how he might be feeling.
- Name people and everyday objects.
- Name colors and count objects.
- Talk about sounds around you and imitate them.
- Imitate your baby’s sounds.
- Encourage your baby to make vowel and consonant-vowel sounds (i.e., “ma,” “da”).
- Use clear, simple speech, which is easier for your child to model.
- Expand on the child’s utterance (i.e., child says “car” you say “blue car,” if child says “blue car,” you say “big blue car”).
- Ask questions that require a choice depending on child’s talking level (i.e. “Do you want juice or water?”).
Listen
- Acknowledge your child’s attempt to communicate.
- Do not anticipate his needs; let him try to communicate.
- Repeat what your child says. This indicates that you are listening and understand.
- Whenever possible, give him your full attention when he starts a conversation.
Read
- Frequently read to your child to facilitate literacy development and vocabulary growth.
- Choose colorful books with large, simple pictures.
- Make up your own simple story of the book using short sentences (depending on your child’s talking level).
- When “reading” to your young child, help maintain his attention by turning the pages quickly. Point to the objects/actions you are talking about.
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Are there specific parent training programs available that will teach me how to help my child communicate effectively?
Yes, parents are in the best position to effect change and promote the development of their children's communication skills. Our Center is pleased to offer the Hanen Program as one way to meet the escalating need to help parents facilitate their child’s language development using everyday routines and activities. Our certified Hanen Speech-Language Pathologist provides training for parents on an individual basis and in group settings. This is a unique partnership between the Hanen certified Speech-Language Pathologist and parents that creates an enriched approach to language learning for delayed and “at-risk” children and gives parents the skills they need to feel empowered. For additional information about the Hanen Approach, go to www.hanen.org.
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Why are communication disorders serious problems for older people? With the increased number of survivors of illnesses and accidents, speech and language disorders are common among older adults. These communication disorders vary widely and may include difficulty with speaking, hearing, understanding verbal messages, reading, and writing. The effects of these disorders may be frustrating and may lead to withdrawal and isolation. They require the understanding of family and friends as well as services from Speech-Language Pathologists.
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