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Speech and Language Development and Disorders

Compiled by Dr Helen Grech (Ph. D.)

 

Introduction

Parents are often concerned about their children’s speech and language development when they don’t seem to be talking as well as other children of the same age. Some of these children catch up while others don’t. Some parents postpone seeking professional advice unless they observe other areas of “delay” in the early development of their child. Difficulties with spoken language may lead to frustration and this could consequently reflect on the child’s behaviour and learning. Knowledge of what’s “normal” speech and language development can help parents figure out if they should be concerned and whether they should refer their children to a Speech-Language Pathologist (SLP).

Before 12 months

It is important for children this age to be observed cooing and babbling. As babies get older (often around 9 months), they begin to string sounds together and use the different tones of speech.

From 12 – 15 months

Children of this age should have a wide range of speech sounds in their babbling and at least one or more meaningful words. Nouns usually come first, like “baby” and “ball.” The child should also be able to understand and follow single directions (e.g., “Please give me the toy”).

From 18 to 24 months

Children should have a vocabulary of about 20 words by 18 months and 50 words or more by age 2. At this stage, they will also start to combine two words, such as “mum drink” or “papa car.” A 2-year-old should also be able to follow two-step commands (e.g., “Please give me the toy and bring me your cup”).

From 2 to 3 years

The child’s vocabulary should increase (to an amount where there are too many words to count). S/he should routinely combine three or more words into sentences. The child’s understanding also matures and prepositions, some colours and adjectives embedded in short sentences should be understood. At this stage, children still find certain speech sounds difficult to pronounce. The child’s speech may not sound clear but should be intelligible to familiar people such as parents, siblings and grandparents.

From 3½ to 4 years

Children should express themselves in clear sentences though a few speech sounds such as ‘g’ in‘ginger’‘or long words may not be produced clearly. They should also understand complex commands.

 

Warning Signs of a Possible Problem

 

Between 12 to 24 months of age:

  • Not responding to sound or not vocalizing
  • No use of gestures, such as pointing or waving bye-bye
  • Prefers gestures over vocalizations to communicate by 18 months
  • Finds difficulty with imitating sounds by 18 months

 

Over 2 years of age:

  • Can only imitate speech or actions and does not produce words or phrases spontaneously
  • Says only certain sounds or words repeatedly and cannot use spoken language to communicate more than his or her immediate needs
  • Cannot follow simple directions

 

What causes delayed speech or language?

There are many reasons for delays in speech and language development. Speech delays in an otherwise normally developing child are rarely caused by problems with the tongue or the roof of the mouth. Having a “tongue-tie” is almost never a cause of delayed speech.

A number of children with speech delays have oral-motor problems, meaning that they encounter difficulty using the lips, tongue, and jaw to produce speech sounds. Speech may be the only problem or may be accompanied by other problems such as feeding difficulties. A speech delay may also indicate a more general developmental delay.

Hearing problems are also commonly related to delayed speech, which is why a child’s hearing should be tested by an audiologist whenever there’s a speech concern. If a child has trouble hearing, he or she may have trouble understanding, imitating, and using language.

Speech development is a mixture of nature and nurture. There may be pre-disposing factors that affect the child’s speech and language development. However, a lot of it depends on the child’s environment.

 

What will the Speech-Language Pathologist do?

If you, or your child’s doctor/teacher, suspect a problem, early assessment (by a speech-language pathologist) is crucial. You can seek out the help of a SLP on your own, without the need of prior consultation or referral of a doctor. The SLP will look at your child’s speech and language skills within the context of his or her total development. Along with observations of your child, the SLP will use tests as well as his or her knowledge of milestones in speech and language development.

 

What can parents do?

If the SLP finds that your child needs speech therapy, parental involvement will be very important. Parents can observe therapy sessions and learn to participate in the process. The SLP will also show carers how they can work with their child at home to improve his or her speech and language skills. With appropriate therapy, the child will likely be able to communicate better with family members and the rest of the people around him/her.

 

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