Speech Development in Children

poster 1Understanding normal speech and language development

  • It’s important to discuss childrens speech and language development, as well as other developmental concerns, with your doctor at every routine well-child visit
  • It can be difficult to tell whether a child is just immature in his or her ability to communicate or has a problem that requires professional attention
  • Pay attention to your childrens speech and language development and seek help if you have any concerns

Children’s normal speech and language development milestones

Before 12 Months

  • It’s important for kids this age to be watched for signs that they’re using their voices to relate to their environment
  • Cooing and babbling are early stages of speech development
  • As babies get older (often around 9 months), they begin to string sounds together, incorporate the different tones of speech, and say words like “mama” and “dada” (without really understanding what those words mean)
  • Before 12 months, children should also be attentive to sound and begin to recognize names of common objects (for example bottle, binky, etc.)
  • Babies who watch intently but don’t react to sound may be showing signs of hearing loss

By 12 to 15 Months

  • Children this age should have a wide range of speech sounds in their babbling (like p, b, m, d, or n), begin to imitate and approximate sounds and words modelled by family members, and typically say one or more words (not including “mama” and “dada”) spontaneously
  • Nouns usually come first, like “baby” and “ball”
  • Your child should also be able to understand and follow simple one-step directions (“Please give me the toy,” for example)

From 18 to 24 Months

  • Though there is a lot of variability, most toddlers are saying about 20 words by 18 months and 50 or more words by the time they turn 2
  • By age 2, kids are starting to combine two words to make simple sentences, such as “baby crying” or “Daddy big”
  • A 2-year-old should also be able to identify common objects, common pictured objects, indicate body parts on self when labeled, and follow two-step commands (such as “Please pick up the toy and give it to me”)

From 2 to 3 Years

  • Parents often witness an “explosion” in their child’s speech
  • Your toddler’s vocabulary should increase (to too many words to count) and he or she should routinely combine three or more words into sentences
  • Comprehension also should increase — by 3 years of age, a child should begin to understand what it means to “put it on the table” or “put it under the bed”
  • Your child also should begin to identify colours and comprehend descriptive concepts (big versus little, for example)

The difference between speech and language

Speech and language are often confused, but there is a distinction between the two:

Speech is the verbal expression of language and includes articulation, which is the way sounds and words are formed

Language is much broader and refers to the entire system of expressing and receiving information in a way that’s meaningful

  • It’s understanding and being understood through communication — verbal, nonverbal, and written
  • Although problems in speech and language differ, they often overlap
  • A child with a language problem may be able to pronounce words well but be unable to put more than two words together
  • Another child’s speech may be difficult to understand, but he or she may use words and phrases to express ideas
  • And another child may speak well but have difficulty following directions

Warning signs of a possible problem

If you’re concerned about your child’s speech and language development, there are some things to watch for:

An infant who isn’t responding to sound or who isn’t vocalizing is of particular concern. Between 12 and 24 months, reasons for concern include a child who:

  • Isn’t using gestures, such as pointing or waving bye-bye by 12 months
  • Prefers gestures over vocalizations to communicate by 18 months
  • Has trouble imitating sounds by 18 months
  • Has difficulty understanding simple verbal requests

Seek an evaluation if a child over 2 years old:

  • Can only imitate speech or actions and doesn’t produce words or phrases spontaneously
  • Says only certain sounds or words repeatedly and can’t use oral language to communicate more than his or her immediate needs
  • Can’t follow simple directions
  • Has an unusual tone of voice (such as raspy or nasal sounding)
  • Is more difficult to understand than expected for his or her age
  • Parents and regular caregivers should understand about half of a child’s speech at 2 years and about three quarters at 3 years
  • By 4 years old, a child should be mostly understood, even by people who don’t know the child

Causes of delayed speech or language

  • Many factors can cause delays in speech and language development including:
  • Hearing problems are also commonly related to delayed speech, which is why a child’s hearing should be tested whenever there’s a speech concern – a child who has trouble hearing may have trouble articulating as well as understanding, imitating, and using language
  • Ear infections, especially chronic infections, can affect hearing ability and should be managed appropriately by an ENT Specialist
  • Simple ear infections that have been adequately treated, though, should have no effect on speech
  • Speech delays in an otherwise normally developing child can sometimes be caused by oral impairments, like problems with the tongue or palate (the roof of the mouth)
  • Kids with speech delays may also have oral-motor problems, meaning there’s inefficient communication in the areas of the brain responsible for speech production

Management for speech and language delay

If you or your doctor suspect that your child has a problem, early evaluation is recommended to assess:

  • What your child understands (called receptive language)
  • What your child can say (called expressive language)
  • If your child is attempting to communicate in other ways, such as pointing, head shaking, gesturing, etc.
  • Sound development and clarity of speech
  • Your child’s oral-motor status (how a child’s mouth, tongue, palate, etc., work together for speech as well as eating and swallowing)

If your child needs speech therapy, your involvement will be very important – you can observe therapy sessions and learn to participate in the process. The speech therapist will show you how you can work with your child at home to improve speech and language skills.

What parents can do

Here are a few general tips to use at home:

  • Spend a lot of time communicating with your child, even during infancy — talk, sing, and encourage imitation of sounds and gestures
  • Read to your child, starting as early as 6 months

Use everyday situations to reinforce your child’s speech and language

  • In other words, talk your way through the day
  • For example, name foods at the grocery store, explain what you’re doing as you cook a meal or clean a room, point out objects around the house, and as you drive, point out sounds you hear
  • Ask questions and acknowledge your child’s responses (even when they’re hard to understand)
  • Keep things simple, but never use “baby talk”

Children’s speech development – key points

Whatever your child’s age, recognizing and treating problems early on is the best approach to help with speech and language delays

With proper therapy and time, your child will likely be better able to communicate with you and the rest of the world

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