How to tell if your toddler needs
speech therapy?
Every child develops at their own pace, and that includes learning to speak. Yet, there are guidelines to help determine if there might be a problem, like a speech delay, or something more serious. Referring to these guidelines and milestones, speech language pathologists can determine if further testing, or online speech therapy services, may be recommended.
We’ve created an online quiz to help you determine which language milestones your child has achieved, or if you might want to consider consulting with a speech language pathologist about your child’s speech development. Click the link below to start the quiz:
How old is your child?
What should you, the parent, look for?
Listed here are some milestones which can help you gauge your child’s language progress:
By the end of 6 months, your child should:
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Smile at you
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Make cooing sounds
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Get quiet or smile when spoken to
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Seem as though they recognize a parent's voice
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Make different crying sounds for different needs
By the end of 12 months, your child should:
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Giggles and laughs
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Babble or make other sounds
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Use their voice to show pleasure/displeasure
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Look in the direction of sounds
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Respond to changes in tone of voice from an adult
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Pay attention to sounds made by objects/toys/music
By the end of 18 months, your child should:
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Attempt to imitate speech sounds
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Begin saying everyday words including, but not limited to, “mama,” “dada,” “doggie,” “baby,” and “go”
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Respond to simple directions, such as "Come here"
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Recognize common items, like "doggie"
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Look when you point
By the end of 24 months, your child should:
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Use P, B, M, H, and W in words
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Follow simple directions, like “give me the ball,” or “push the (toy) car”
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Put 2 words together when talking, or when asking questions, like “more apple,” or “where doggy?”
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Respond to simple questions, like “where is your hat?” or “who is that?”
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Name pictures in books, or point to them when you name what is in the picture
By their 3rd birthday, your child should:
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Use K, G, F, T, D, and N in words
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Ask “why?” and put 3 words together to talk
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Follow simple, but compound directions, like “get the spoon, and put it on the table”
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Say about 50 or more words, and be understood by others about 50% or more
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Talk about things that are not in the room
By their 4th birthday, your child should:
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Respond when you call from another room
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Answer simple “WH” questions, like who, what, and where
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Say plural words, and rhyming words, like “hat-cat”
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Understand words for family, like brother, grandmother, and aunt
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Talk about what happened during the day, and use about 4 sentences at a time
By their 5th birthday, your child should:
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Understand words for order, like first, next, and last
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Respond to “What did you say?”
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Follow longer sentences
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Use a variety of sentences when they speak
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Be understood by others almost all the time
Can others understand what your child is saying?
One of the things we hear most often from parents of young children is that someone – a distant cousin, a new neighbor, the pediatrician – doesn’t understand what their child is saying. Without meeting the child, it’s hard for a speech therapist to determine what that means and what recommendations to make to the parent. Should you schedule a speech evaluation? Is it normal for people not to understand your child?
One of the formulas we often recommend to parents who want to quickly determine if their child’s intelligibility (or speech clarity) in conversation with unfamiliar listeners (or “strangers”) is normal, is as follows:
AGE IN YEARS / 4 x 100 = % UNDERSTOOD BY STRANGERS
Child aged 1 = 1/4 or 25% intelligible to strangers
Child aged 2 = 2/4 or 50% intelligible to strangers
Child aged 3 = 3/4 or 75% intelligible to strangers
Child aged 4 = 4/4 or 100% intelligible to strangers
What this means is that, for example, a 2-year-old in conversation with an unfamiliar listener (i.e. a distant relative, or a pediatrician who sees the child only twice a year) would only have 50% of what they say understood.
This formula gives parents a starting point to determine if their child’s speech is progressing typically or if they should consider an evaluation by a speech therapist.
Of course, a speech therapist goes into much more detail to determine if a child’s speech is developing on track or if treatment is warranted. For example, we use normative data that looks at each speech sound they make (“t” sound, “k” sound etc.) to determine if they are producing all of the sounds appropriate for their age.
If you or the people your child lives with still don’t understand what your child is saying, then intervention might be a good idea. Remember, speech therapy does no harm. To your child it’s just another opportunity to play.
Are you wondering what speech sounds your child should be saying at their age? Download our free and simple chart here.
What is the definition of a "late talker"?
We define a late talker as a toddler (between 18-30 months), with a good understanding of language (receptive language) and with typically developed motor/play/cognitive/social skills, but with a limited spoken vocabulary for this age. These toddlers have difficulty with spoken or expressive language.
Since late talker toddlers are oftentimes doing well in other areas, like social skills or receptive language, parents and pediatricians might assume that they will catch up on their own. Actually, many of these kids do outgrow their "late talking" on their own. But unfortunately, some of them do not catch up to other kids their age.
In fact 20-30% of kids do not outgrow "late talking" on their own.
What are the signs that my toddler might have a speech delay?
Below we list some signs that have been identified to help determine if a child is likely to have continuing language problems. These factors help make it easier to assess whether a late talker will be one of the 30% of children who do not outgrow their language struggles on their own.
Signs a child might be experiencing a language delay:
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They are quiet as an infant, with little babbling
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They have a history of ear infections
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They are limited in the number of consonant sounds they can make (e.g. p, b, m, t, d, n, y, k, g, etc.)
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They do not link pretend ideas and actions together while playing
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They do not imitate or copy words
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They use mostly nouns (names of people, places, things) and few verbs (action words)
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They have difficulty playing with peers (underdeveloped social skills)
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They have a family history of communication delay, or learning/academic difficulties
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They have a mild comprehension (understanding) delay for their age
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They use few gestures to communicate
Current research strongly suggests that a "wait-and-see" approach with late talkers is outdated and it can also delay treatment, which can make a big difference for the child.
What to do if your toddler is a late talker
If you've noticed your child has a limited vocabulary as well as any of these risk factors, consulting a speech-language pathologist may be a good idea. Research has shown that kids with the last three risk factors (family history, comprehension problems, or few gestures) have the greatest risk for a persistent language delay. If you are a busy parent, online speech therapy services may be the most convenient option for your child.
What if your child catches up on their own?
At Better Speech, we recommend that even kids who seem to catch up on their own get speech therapy intervention. Why? Because even though many of these toddlers catch up by the time they start school, studies have shown that they continue to have problems with some aspects of language (e.g. grammar).
Do you need some ideas for what to work on with your child? We have a free download with ideas for every day of the month! Get the calendar here.
At Better Speech we know you deserve speech therapy that works.
We have experts in speech delay therapy at home and we work hard to assign the right therapist for you; not just the therapist that happens to be in your area. If you want to find out more about our services, contact us to schedule a free consultation.
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References:
Ellis, E. & Thal, D. (2008). Early Language Delay and Risk for Language Impairment. Perspectives on Language Learning and Education, 15: 93-100.Telethon Institute for Child Health Research (2008, May 16). Mixed Results For Late-talking Toddlers. ScienceDaily. 16 May 2008. Web. 10 Jun. 2011.Rice, M. L., Taylor, C. L., & Zubrick, S.R. (2008). Language outcomes of 7-year-old children with or without a history of late language emergence at 24 months. Journal of Speech, Language, and Hearing Research, 51, 394-407.Olswang, L.B., Rodriguez, B. & Timler, G. (1998). Recommending Intervention for Toddlers With Specific Language Learning Difficulties: We May Not Have All the Answers, But We Know a Lot. American Journal of Speech Language Pathology, 7, 23 - 32.