When to Worry About Speech Development
We recently received a question in regards to concern about a child’s speech development and wanted to reassure you that not all children start talking at the same time, just as not all children begin to walk at the same time. Here is the question we received from a concerned parent, “My child, who is 21 months old, doesn’t talk. Is it okay that his speech is not developing at the same rate as other children his age?”
8 Ranges of Speech Development and Guidelines
You’ll worry less if I take you through the normal wide range of speech development yet leave you with some practical tips on when to seek speech therapy. Keep in mind that when children say words and how many they say varies widely. Just as there are normal late walkers, there are normal late talkers.
1. Receptive Language
Let’s first talk about receptive language, meaning how much your child understands. If your child understands simple requests like: “Bring mommy your toy,” then there is unlikely to be an underlying hearing problem. Also, observe if your child gives you facial contact, as if understanding what your facial language is trying to convey. If your child seems to have normal receptive language, that’s a good sign and you don’t need to worry.
2. Expressive Language
Next, is expressive language, meaning how much your toddler says. When I was working in our pediatric office, it was quite usual for moms to say during their toddler’s check-up, “She seems to understand everything but says very little.” Keep in mind, boys tend to start talking a lot later than do girls, and this quirk is called the “Einstein syndrome” because this genius was a late talker. Here are some steps to enrich your child’s speech development, as well as signs for when to seek help:
3. Speaking Comfortably
The cardinal rule of speech development is a child must learn to speak comfortably rather than correctly. So, when your child uses body language, sign language, or points to communicate what he wants or needs, listen to him and respond with the words you would like him to say, but in a fun and comfortable way, not in a corrective tone. For example, “Okay, do you want another egg?”
4. Keep a Speech Diary
Another rule of speech development is progression is more important than timing. As a general guide, as long as your toddler is adding about a word a week and uses two-word phrases by age two that gradually expand into intelligible sentences by age three, you don’ t need to worry. Keep in mind the red-flag word “plateau.” If you look at your child’s speech diary and your toddler is not adding a lot of new words over a three-to-six-month period, it would be wise to consult your healthcare provider to identify underlying reasons why your child may be slow to speak. A commonly missed cause of delayed articulation is posterior tongue tie.
5. Read with your Beginning Talker
Play “point and ask.” Point to a picture, say of a child playing ball, and ask, “Where is the ball?”
6. Look and Listen for Teachable Moments
Learning speech is caught, not taught. Suppose you’re walking through a park and your child points up in the sky and utters “buh” for bird. Add the correct: “Yes, that’s a bird” and then expand with: “Look how the bird flies and lands in the tree. Point out more birds to me.”
7. Play the Body-Parts Game
During bath time play “Where’s your nose?” and “Where’s your belly button?” As you’re dressing your toddler, narrate your activity, such as: “Now we put on your shoes. Next, we put on your shirt.”
8. Sing a Lot
Because singing stimulates more language centers in the brain than do words alone, sing to your child and move your body in rhythm to the words.
Be sure to take your speech diary with you for your child’s two-year check-up and use the guidance I’ve given you to convey to your doctor your degree of worry.
Enjoy watching your child’s unique way of talking on his or her own personal timetable.
Written By: Martha Sears, RN
Martha is the mother of Dr. Bill’s eight children, a registered nurse, a former childbirth educator, a La Leche League leader, and a lactation consultant. Martha is the co-author of 25 parenting books and is a popular lecturer and media guest drawing on her 18 years of breastfeeding experience with her eight children (including Stephen with Down Syndrome and Lauren, her adopted daughter). Martha speaks frequently at national parenting conferences and is noted for her advice on how to handle the most common problems facing today’s mothers with their changing lifestyles. Martha is able to connect with both full-time, stay-at-home mothers and working mothers because she herself has experienced both styles of parenting. Martha takes great pride in referring to herself as a “professional mother” and one of her favorite quips when someone voices their concern about her having eight children in an already populated world is: “The world needs my children.”