By Barbara Smith Decker
More Talk about TalkAbout 10 percent of children have some kind of communication disorder, including speech, language or hearing problems. For more information about these disorders and how to spot them in your child, go to:
Common Speech Problems
Babies can communicate pleasure or discomfort from the moment they’re born. But they learn to actually talk through interactions with their family and other social contacts. By listening to words and observing people’s actions, children come to understand that words have meaning and they develop a sense of how words fit together.
How can you encourage your child’s speech? Talk to her! Children practice what they hear. Talk about what your child is doing and what she sees. Listen attentively with interest and love to her efforts to speak. Rather than pointing out bloopers, model correct speech. For example, if your child says, “baby wobin,” respond by saying, “Yes, that is a baby robin.”
Try not to push your child to talk, slow down or repeat what he’s saying. Children develop at different rates – and they all need to learn at their own pace.
Learning to speak and to use language follows a natural progression of steps (see the accompanying chart on speech milestones). Proper speech/language development depends on mastering a wide range of listening skills, social cues, comprehension, reasoning skills, adequate attention, memory functions, word knowledge and grammar. And these are all the building blocks to later reading and writing.
Developmentally healthy children respond to sounds, make eye contact and involve others in looking at objects with them, such as a ball or a book.
“Language development by age 1 is often considered a ‘wellness’ indicator of a young child’s developmental progress,” says Dr. Lynn Wegner, head of the American Academy of Pediatrics’ Committee on Developmental and Behavioral Pediatrics. “The majority of children do not outgrow speech or language disorders. Most language specialists recognize that early language delays may herald later language irregularities, so early identification and intervention are imperative to prevent further deterioration and allow improvement in communication abilities.”
Some parents may think that younger children develop language skills more slowly because they rely on older siblings to get them what they want. “This is an old wives’ tale and probably one of the reasons that children with delayed expressive skills don’t get referred promptly,” says Wegner, adding that if parents notice an older child “interpreting” for a younger one, it bears looking into. Of course, some children will allow an older sibling to talk for them because of personality or style. But, generally, younger children – who develop specific skills differently from firstborn or only children – show earlier use of pronouns and easier acquisition of conversation skills because of their interactions with older brothers and sisters.
When to Seek an Evaluation
Speech and language delays and disorders can significantly impact a child’s personal, social, academic and work life if not detected and treated early. Speech/language problems may be caused by a number of factors. These include, but are not limited to, the following:
• hearing impairment
• oral motor development
• the state of a child’s brain and central nervous system
• problems with physical, intellectual and psychological development; and
• emotional problems.
Early evaluation of children under age 3 who are at risk – including babies in neonatal intensive care units, children with chronic ear infections or those with a family history of delayed speech or developmental disorders – can prompt treatment that prevents further delays and corrects problems.
Have your child evaluated if he does not respond to simple commands, questions, greetings or his name; does not engage in “pretend” play; is frustrated in his attempts to communicate; doesn’t produce any words or speech between 12 and 18 months; appears delayed when compared to peers; or is hard to understand, particularly by unfamiliar listeners.
“Parents should first discuss any concerns about speech/language development with their child’s pediatrician, who can make the initial referral for a comprehensive evaluation,” says speech/language pathologist Jennifer Bartlett. “Some pediatricians may suggest waiting until a child is 2 years old to see if he outgrows the problem, but if your child has not met general speech/language milestones and you have cause for concern, trust your instincts and request that your child be referred to a speech/language pathologist.”
If there is a history of ear infections, hearing should be tested by an audiologist prior to a speech and language evaluation. If other factors are contributing to speech and language delays, the speech/language specialist conducting the evaluation may refer the child to a neurologist, psychologist or otolaryngologist (ear-nose-throat specialist).
“We don’t always know why children have speech and language delays, but early detection and intervention is critical to helping children reach their potential,” says Bartlett. Most states have early intervention programs (birth to age 3) that provide evaluation and treatment services. The criteria for this support may vary, but the services typically include speech/language, physical, occupational and developmental therapies. Once a child turns 3, services can be accessed through the local public school system.”
Beyond Baby Talk, by Kenn Apel, Ph.D., and Julie Masterson, Ph.D., American Speech-Language-Hearing Association, 2001. Discusses key influences on language development and offers excellent communication tips that stimulate good speech and language skills.
Look Who’s Talking! How to Enhance Your Child's Language Development, Starting at Birth, by Laura Dyer, MCD, Meadowbrook Press, 2004. A comprehensive look at how children learn to talk and how parents can help their kids in a positive, healthy way.
Help Your Baby Talk, by Robert E. Owens Jr., Ph.D., with Leah Felden, Perigee, 2004. This book introduces Owens’ “Shared Communication Method,” giving parents playful techniques to help their baby learn to talk and to understand language.
American Speech-Language-Hearing Association– Answers FAQs, lists accredited professionals and offers support and resources. Web site is the premier site for information on language acquisition, delays and disorders.
Division for Children with Communication Disorders– Offers extensive resources and research on specific disorders.
National Information Center for Children and Youth with Disabilities – Provides information on early intervention services (birth to age 3) and school services for older children.
On the Web
American Academy of Pediatrics Section on Developmental and Behavioral Pediatrics – offers extensive information about both normal and disordered development.
The Stuttering Foundation of America– provides free online services and support.
Barbara Smith Decker is a freelance writer specializing in health and medical issues, and the mother of three children.