This can be the hardest question that parent's struggle to answer. When should I be worried? When do I get help? Will they just grow out of it? Below is a list of milestones that as a guide help us to determine if a child will need to be seen by a therapist. Please remember all children are different!! Our golden rule at Chatterbox for all parents - 'if you are concerned, come in, get your child checked out and be reassured.' Regards, Mel
- Speech sound development:
Some children have difficulty acquiring speech sounds that are appropriate for their age. (NB. Children acquire speech sounds in a particular order and at approximately the same age. However, the speech sounds that a 2½ year old will acquire are different to those expected from a 7 ½ - 8 yr old child).
- By 3 years: familiar people will understand the child
The first sounds children learn for 0 – 3 years; m, n, p, b, t, d, w, y, k, g - By 3 ½ – 4 years: people who see the child regularly will understand them
Children learn these sounds in preschool, around 3 ½ - 4 ½ years; f, sh, ch, j, l, s, z - By 4 – 4 ½ years: unfamiliar listeners should be able to understand the child
The following sounds are developed during school-aged years, around 5 – 8 ½ years; r, v, th and sound blends (pl, sl, tr, gr etc).
For children who experience difficulty understanding language (e.g. following instructions) or using language (using the correct word or grammar expected for their age). Children first learn to use sounds, then single words, then two word sentences and so on. Sentence length and complexity continue to develop as the child matures. Consider contacting a Speech Pathologist:
- If a child is not babbling or using a variety of sounds by 9 months of age
- If a child is not using single words by 18 months
- If a child is not using 2 word sentences by 2 ½ years
- If a child is not using correct sentence structure by 4 ½ years
- If a child is having difficulty understanding what has been said to them or trouble following instructions
- If a child has periods when they do not appear to hear well
- If a child does not understand the rules of simple conversations. E.g. if they do not make any eye contact, or if they are unable to take a short turn in a conversation by 3 years.
Children that have trouble speaking fluently. Types of stutters include:
- Repetitions
- Single sound eg. ‘d-d-d-daddy’
- Syllables eg. ‘ba-ba-baby’
- Word eg. ‘I -I -I want a drink’
- Phrase eg. ‘I want- I want -I want a go’
- Prolongations
- A sound is stretched out eg. Where’s the ca-a-a-a-t?
- Blocking
- A silence occurs as the person tries to speak ‘__ I want to.’
- Overuse of filler words
- E.g. “Um”
4. Voice:
Voice difficulties can occur as a result of voice misuse (e.g. yelling, excessive use) or other physical conditions of the vocal area. A voice may sound:
- husky, hoarse or nasal voice
- inappropriately soft or loud voice
- unusually low or high pitch
5. Social Problems:
Children that experience difficulty with the social aspects of language such as; eye contact, taking turns in a conversation and initiating a topic of conversation.
6. Feeding difficulties:
Children need to be able to progress through the stages of feeding development in order to maintain adequate nutrition for their age. Oral movements involved with drinking and eating may be associated with those required for development of speech. You should refer a child to a Speech Pathologist if:
- he/she has ongoing difficulty with breast or bottle-feeding
- If a child is not putting on weight and you have consulted with your early childhood nurse
- If a 9 – 12 month old child is having difficulty progressing from pureed to lumpy foods
- If a 2 year old still has food in their mouth after eating or loses food from their mouth during meal times
- If a 3 year old favours bottle feeding to eating solid foods
Lastly,
When you are unsure of whether to refer, please feel free to call us and ask any questions you may have! Our experience has shown that the earlier a child is referred and treated for a speech or language delay, the quicker the problem is remediate as well as less therapy required in the long term.