News from the website of DrConcannon.com and DrVitale.com.
Disclaimer:  This medical information is designed as an aid only for the patients of Drs. Concannon & Vitale.
It is not a substitute for a medical exam and direct advice from your physician.
Speech Delays, or What to do if your child should be talking—but isn't yet

As with other areas of development, there are milestones in the development of language. Most babies, for example, are babbling by 6 or 7 months of age. Most 1-year-olds have said their first words, and, by age 2, most toddlers are using two- or three-word phrases and pronouns. By age 3, most children can say their name, age, and gender.

If your child is 18 to 20 months old and uses fewer than 10 words, or is 21 to 30 months old and uses fewer than 50 words and no two-word combinations (such as "mommy car"), she (or he) is considered a "late talker." A delay in language may simply be a developmental lag (these children are often called "late bloomers"). Most late talkers catch up to their peers with some simple "language enrichment." In other cases, a language delay indicates a problem that will require more direct intervention by health or education professionals (or both).

You can stimulate speech development.  How you talk to and play with your young child can make a big difference in her language ability, even if she has already been referred for evaluation or therapy because of the pediatrician's concerns about late talking. Here are some recommendations for promoting development of speech.

Take advantage of the ordinary. Don't limit playtime to structured sessions with toys. Opportunities present themselves all day long, whether you are shopping, working in the garden, folding clothes, or driving. Verbalize repetitive activities. For example, when setting the table, say, "Plate, plate, plate, plate; fork, fork, fork, fork." Use "self talk" and "parallel talk"—providing a running commentary on all of the events of the day.

Funny sounds. Employ a funny or odd tone to your voice and encourage your child to copy you. Have her imitate the sounds of mechanical objects such as the doorbell, or the ringing of the phone, or the "vroom" of a car engine. Talk like a cartoon character, such as Donald Duck or a monster.

Amplify and play back. Letting a child hear the sound of her own voice encourages more sounds. Good toys for this exercise range from inexpensive plastic echo sound microphones to tape recorders, and even higher priced karaoke machines that can be hooked up to your television.

Vocalize. Sometimes late talkers are not even able to make basic sounds that reveal pleasure or excitement. Use any opportunity you can to try and initiate a copycat response. Point to rides at the amusement park and say, "Oooooh," or point at food, rub your stomach, and say, "Mmmmm."

March to the beat. While singing simple songs, use instruments or kitchen items to add a beat. Depending upon her ability, encourage your child to fill in words or sing aloud. Music, singing, and dancing help a child "express" herself. Start with songs like "Old Mac Donald" and see if she'll do the "e-i-e-i-o" part.

Puppet play. Puppets are perfect for stimulating imaginative play and speech sounds. You don't have to invest in expensive puppets. Simply place a gaggle of your child's favorite stuffed animals behind the couch and have her sit on the other side. Put on a show for her and see if she will play too.

Animal play. Your child may love to pretend she's a puppy or a kitten, or even an elephant, a cow, or a bear. The ways that the animal moves, sounds, and eats are amusing activities to imitate. Animal sounds such as "baa," "moo," "meow," "woof," and "neigh" have an ideal variety of vowels. As an example, using monkey sounds "eee eee," "ah ah," and "ooh ooh, ah ah" (with corresponding arm action) can be a lot of fun. To create the "eee" sound, make sure the teeth are together; open lips for a big smile and then make the sound. To make the "ah" sound just open your mouth all the way. You can use a tongue depressor and pretend you're at the doctor's office. For the "ooh" sound, why not try "fish face"? Use your fingers to round your lips for an "ooh." Once your child stops laughing you can let her try fish face with the "ooh" sound too.

Nursery rhymes. Children develop the ability to detect rhyme before they can produce it. Rhyming is an important pre-literacy skill. Reading rhyming books like Dr. Seuss's Sam I Am helps develop an ear for rhyme.

Echo and correct. Your daughter says, "Her frew dat ball." Don't say, "That's not how you say it." Simply repeat it correctly: "You saw Anne. She threw the ball."

Praise. Children love to be told "well done," reinforced with a big hug.

Accept assistance and keep asking questions!  Early identification and treatment of speech and language problems can prevent later reading and academic problems, protect self-esteem, and reduce the need for special education services later on. Don't hesitate to bring to the attention of the pediatrician continuing concerns about your child's delay in speech or other areas. Early Intervention is a program available in each school district to evaluate speech problems in preschoolers.  If you have been given a referral to Early Intervention, or to a developmental specialist—because of your parental instincts that your child may have a problem or because of the doctor's concerns—always follow up with the appointment!

What services exist? There are several possible answers to that question. If your child is younger than 3 years, one referral that may already have been made by the pediatrician is to the local Early Intervention (Birth to Three) program through your local department of health. There, the staff will perform a developmental evaluation to determine your child's eligibility for services— at no cost to you or on a sliding-fee scale based on income. Again, don't delay following up appointments and referrals that have been given to you: A six-month wait in the life of a toddler is a long time in her development. If your child is 3 or older, the pediatrician my have referred you to special education services in your school district, for which your child may be eligible.

Resources on language delay

Books

Web sites
And finally....
If you have a significant problem with your speech, please call us for an appointment at 943-7337.  Good luck!

Adapted from Contemporary Pediatrics, November 2004, p33-34
Rev. 10/2005 SPEECHDELAY.htm
  • Back to Top
  • Back to Library Contents
  • Other sources:
  • Search KidsHealth.org
  • Search Children's Hospital Boston
    •