Is your child bellowing out full sentences at the age of two, and using action words, and solving complex arithmetic problems? Yay, that’s great, but this article is for those of us with kids who are moving a little slower than the rest.
We interviewed Pam Wein, Speech Language Pathologist MClSc, Caslpo Reg. and Gordana Vidovic, Early Childhood Consultant, ECE/RC to give us a little insight into what is a delay and what can be done at home.
Purple Fig: A child may have a few words by the age of 2 but does not use them very much at all. Other than seeking professional help, what can a parent do right now at home to motivate a child to speak. If the child doesn’t seem to want to speak, what is the best method of motivation?
Speech Therapist: By the age of two, a child should have a variety of at least 250-300 words, e.g. objects (ball, car etc.), action words (eat, sleep etc.), descriptive words (big, fast, hot) and location words (on, off, under). The child should be talking mostly in 2 and 3 word combinations (e.g. “I want juice”, “play in park” “eat cookie”, “fast car” etc.). If the child is not yet using this amount of words or word combinations, then a parent can help by creating a “language rich” environment. The parents should be talking to the children all the time, labeling items the child is interested in. You should be keeping sentences short and simple, emphasizing the words you are focusing on for vocabulary development (e.g. train, doll, baby etc.). It is important that you say or repeat the words over and over in the activities. If the child is pointing for items without saying the words, the parent should say what the child is pointing to and then give the item to the child.
We suggest that we don’t put too much pressure on the children to talk, so we don’t force them to say the words. If the environment is ‘language rich’ and there are many opportunities to hear language and pair the words with the objects, actions etc. then a child will eventually begin to imitate the words. Other things that parents can investigate is checking to make sure the child is hearing optimally (so getting their hearing assessed). We also suggest that children should attend language rich and socially rich environments every day such as: an early learning program, an Ontario Early Years Centre, library programs, nursery school or daycare. Children need to be around other children and be exposed to many toys, books, songs in order to develop language. Music classes, library programs, reading programs or any programs that involves a routine circle time are great options to help children with their language. It is also important to mention that it is never too young to read books with your child. Parents can start with chunky board books, that have 1 or 2 bright pictures per page, and they can say and point to the pictures. Repetition of the same books is encouraged! Children love the repetition! Television should be limited. Pediatricians suggest no television at all before the age of 2 years old.
PF: There seems to be a major push for early intervention these days. Let’s say a parent isn’t concerned if their child hasn’t spoken by the age of 2.5 because their other two children started talking at 3. What would you say to them? Is there a risk in not developing certain skills in those first three years that could hinder progress later in life and development of the brain. ie: Use it or lose it theories.
ST: Yes, no matter what the family history is, if the child is not talking by 15-18 months, (most first words are between 12-15 months), then there is a language delay. There are many reasons for language delays, so it’s worth having an expert such as a Pediatrician and/or Speech-Language Pathologist assess the child. Some children end up being ‘late to acquire language’ with no real impact on the future as far as learning and reading; however, at least 50 % of children with a language delay end up having difficulties learning to read and have learning difficulties throughout their school years. Early intervention has been proven to help language delays and alleviate some of these further learning difficulties.
PF: Is there a timeline as to when a child ‘should’ be using words, making sentences ect? Or do you believe that there is a huge individual variation in the rate at which vocabulary and speech is learned? When would you be concerned if a child has not spoken at all? And at that point, should you consider an assessment? Where to call, wait lists, private options ect.
ST: There is a difference between Language Development: vocabulary development , sentence formation, and Speech: how speech sound are made, clarity or pronunciation when speaking. There is a wide range of normal for Language and Speech development. Just like with all developmental milestones, however, we suggest the following guidelines:
For Language Milestones:
– Between 4-6 months of age, children should be babbling with a few different sounds: e.g “mamama”, “dadada”, “bababa”, etc. Children should be using eye-contact and respond to adult engagement.
– By 12-15 months of age a child should have at least 10 words, though they do not have to sound completely clear but may be more ‘word approximations’(for example: “ba” for ball). Animal sounds count as words, as long as they are used to identify the correct animal such as “moo” for a cow.
– By 15-18 months of age, children should continue to develop more words and they should have around 50 words by 18 months.
– Between 18-24 months, there should be huge language bursts and children should be adding new words on a daily basis. By 22-24 months children should be using 2-3 words together in combination to form short sentences.
For speech milestones:
– Early consonant development by 2 years of age: p, b, m, t, d, n, h, w.
– Also by age of 2, words should slowly start to sound more clear; pronunciation is not accurate at all times, but children should be at least marking the first and last consonant in single syllable words such as: “hop”, “Milk”, “up”, “down” etc. Again, the clarity may vary, but their parents should begin to understanding over 50% of what they are saying. Others may not understand them as well by this time.
– By 3 years of age: s, f, k, g,
– Sounds such as: r, l, and th are later developing sounds and may not be perfected before 5-6 years of age.
PF: What are some of your favorite toys to use for speech and language development and interactive play?
ST: Books, books and books! Anything repetitive that has bright big pictures. Any toy or game that you can make interactive so that you can play along with your child. Great games to play are peek-a-boo, catch or hide and seek. As the children get older you can try more concrete interactive games, and turn-taking games, like throwing a ball back and forth. Pretend play is very important as well. If children aren’t using it on their own, you can model and help them build their pretend play skills, you can use: animals, dolls, dinosaurs, cars and garages….
PF: When you evaluate a child, do you test their understanding as much as you do the usage of words?
ST: Absolutely, understanding of language is very important. It is also important that they are responding to their name and that they are using eye contact to interact with you and other people. If they are not understanding simple directions by 15-18 months of age (e.g. come here, give me high five etc.), and not identifying body parts by then, you may need to discuss this with your pediatrician. You may want to ask for a hearing test or have their understanding of language evaluated by a Speech-Language Pathologist. You can also discuss any communication delays with an early interventionist or early childhood educator, who are a great wealth of information and situated in early years centers, daycares, nurseries etc.
PF: Let’s say someone said, “Well, our son (18 months old) is talking up a storm but that’s because his mom is a teacher.” Do you think parents assist that much in advancing a child and on the other side of that, stand in the way of development?
ST: As we mentioned before, the main idea is that parents should be interacting with their children. Talking with and to their children on a daily basis is the key to language development. Despite language rich environments, if your child is lagging behind others in their communication development, you should seek a professional opinion, or assessment as there could be many reasons why your child has difficulties with language or speech, or communicating with others.
You can discuss any concerns you are having with your family doctor or pediatrician. In Toronto you can call our services: Toronto Preschool Speech and Language Services, 416-338-8355 or visit the website tpsls.on.ca.
* Please note: Don’t freak if your kid is not meeting these guidelines perfectly. These are just that, guidelines. Your child may have 10 words at 2 years old, but then speaking in full beautiful sentences by the age of 3. This is just to keep you informed of what you can do at home, and if you need to seek professional help or not.