Ask The Expert: Red Flags in Speech and Language Development

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Today’s Lauren’s Hope blog comes to us from Sharon Ascher, M.A., CCC-SLP, a highly sought-after Gainesville, Florida-area pediatric speech-language pathologist who specializes in speech and language evaluations and therapy for young children. Last June, we interviewed Mrs. Ascher about aphasia and the many reasons why adults and children with speech and language disorders need to wear medical alert jewelry. Today, she gives us the low-down on recognizing the signs that your child may need speech and language therapy.

Red Flags in Speech and Language Development

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It can be difficult to know whether or not your child’s speech and language development is on track, whether it’s your first child, and you’re just not sure what “normal” is, or it’s your second or third child and he just doesn’t seem to talk as much as your first child did at a particular age. It’s important to note that there’s a great deal of variation in what is considered normal or typical when it comes to speech and language development. Here are some answers to common questions about communication development.

Is there a difference between speech and language?

Yes. Language is the understanding and expression of ideas. It involves vocabulary, grammar, and pragmatics (the function of language, like requesting or answering questions). Children can have deficits in any combination of these areas. Speech is the act of talking and involves articulation (speech sound production), fluency (how smooth the speech is), resonance (how much sound comes through the nose versus the mouth), and voice.

Are there any red flags that indicate that there may be a problem?

Yes. There are red flags even before we would expect a child to be talking. That’s because before children talk, they go through a period of prelinguistic development. If the prelinguistic development doesn’t occur, then language is unlikely to develop without intervention. Here are some red flags for infant and toddler communication development:

  • At 6 months, the child does not laugh and squeal or does not look toward new sounds.
  • At 9 months, the child has little to no babbling or does not show emotions.
  • At 12 months, the child does not point to objects or does not use gestures like waving or shaking his head.
  • At 15 months, the child has not used his first words or does not respond to “no” and “bye-bye.”
  • At 18 months, the child does not use at least 6 to 10 words consistently or does not hear well.
  • At 20 months, the child does not use at least 6 consonant sounds or does not follow simple directions.
  • At 24 months, the child does not have at least 50 words in his vocabulary or has little interest in social interactions.
  • At 36 months, unfamiliar people have difficulty understanding what the child is saying or he does not use simple sentences.
  • At any age, the child stutters consistently for longer than 6 months.

Should we just wait and see if it gets better?

No. Speech sounds are more easily corrected the earlier they are treated. The longer a child mispronounces a sound, and therefore words, the more ingrained it becomes, and the harder it is to fix.

From a language standpoint, children must be competent in each of the areas of language in order to be successful in school and in life. The brain is the most malleable during the first few years of life, so intervention is most successful during these early years.

My child is exhibiting one or more of the red flags. What should I do?

Contact a speech-language pathologist (SLP) in your area for an evaluation.  The American Speech-Language-Hearing Association maintains a database of certified SLPs, which you can search by location, the age population served, and language spoken.

If your child is under the age of 3, you can contact the early intervention program in your area for a free developmental evaluation.

Special thanks to pediatric speech-language pathologist, Sharon Ascher, M.A., CCC-SLP for sharing her expertise! You can read Sharon’s blog here, and check her out on Facebook too!

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