Speech & Language: What parents need to know

There’s so much information available to parents and caregivers that it can sometimes be overwhelming, especially when you have concerns about your child. Sometimes other parents reassure you “children develop on their own time” or share stories about their child “catching up” without therapy, but what does the research say?

We’re answering some of the most common questions we get asked regarding speech and language in young children.

What is the difference between speech and language development?

Both speech and language are important to communication. Speech development refers to the sounds used to make words. Speech is how we use our lips, teeth, jaw, tongue, and voice to produce sounds, like “g” in “dog.” A speech sound disorder, also called an articulation disorder or phonological disorder is someone that has difficulty producing certain sounds correctly. An example would be saying “dok” instead of “dog.” Young children may say some sounds incorrectly as they learn, but as they get older they are able to start being better understood and say sounds more correctly.

  • Children may also stutter (Fluency Disorder) or have difficulty speaking clearly due to an inability to put sounds and syllables together correctly (Childhood Apraxia of Speech), which influences speech production.

Language is how we use words to express ourselves. This includes written and spoken language and involves using grammar, vocabulary, and appropriate word order. There are three types of language disorders:

  • Receptive language disorder indicates a person has difficulty understanding parts of language, such as not being able to answer questions correctly, follow directions, or comprehend stories.
  • Expressive language disorder refers to a person’s difficulty sharing their thoughts with others, such as not able to request their needs, use vocabulary appropriately, or participate in conversation with their peers.
  • A person can have either one of these disorders or a mixture of both in which they are unable to use or understand language effectively. Also, a person can have only a speech disorder or a language disorder, or can have both at the same time.

What are important milestones for speech and language development?

Milestones and developmental norms are guides for development. While there can be a range of “normal,” we expect all children to follow a typical pattern of development. If you have concerns, please contact a certified speech-language pathologist. An expert will be able to use more specific developmental norms to help determine if there is a delay or disorder.

The biggest indicators for positive speech and language development are consistent growth in:

  • vocabulary,
  • comprehension,
  • sentence length,
  • and intelligibility (how much others understand you)

If you see those skills plateau over a 4-6 month period in a child younger than four years old, talk with a speech-language pathologist. CLICK HERE for a list of general speech, language, and feeding milestones for all ages.

Intelligibility Norms

Intelligibility is how much you say is understood by others. This is important as not all young children use speech sounds correctly until they get older; however, we still expect them to be understood by family members most of the time.

Age Percentage of Speech Understood by Others
2 years 50% is understood by others
3 years 75% is understood by others
4 years 100% is understood by others

(Sander, 1972)

Vocabulary Norms

Age Number of Typical Words Said Red Flag
12 months 2-6 words No babbling, not trying to say adult-like words
15 months 10-25 words Fewer than 10 words
18 months 50 words Fewer than 20 words
24 months 200-300 words + combining two words together “mama go” Fewer than 50 words and not putting two words together

(www.childdevelopmentinfo.com)

Articulation

This is a great chart showing the typical range of mastery for each speech sound created by Katie Yeh, a speech-language pathologist. You can find more information about articulation development and disorders by visiting her website HERE.


What are general red flags I should watch for?

If you see the following, talk with your child’s pediatrician or contact a speech-language pathologist.

  • Very little or no eye contact with others
  • Unable to request their needs in a way others understand
  • Limited words or no words at all by 18-24 months of age
  • Little or no interest in communicating with others or using gestures
  • Not responding to their name by turning and looking
  • Frustration when they are unable to communicate with others or parental concern

If you see some red flags, but you’re still not sure–CLICK HERE to read 4 questions to ask yourself.

Is it true that boys develop speech/language later than girls?

Yes-but just by a few months.

Boys and girls develop language differently, and girls typically develop speech and language faster than boys. However, boys develop speech and language still within the “normal” range of developmental milestones, just a few months later than girls. Boys should still be meeting the general milestones for speech and language. If they are significantly behind their peers, it could be a sign of a language delay or disorder.

It is also true more boys than girls have language difficulties or disorders, a ratio of 2:1 or 3:1. The incidence of Autism is also higher in boys, 4x more common in boys than in girls.

Is it true younger siblings talk later than first-born children?

Not usually.

Research shows language development of first-born and second- or third-born children follow a similar path. One study showed first-born children reach the 50-word milestone earlier, but after that there were no differences between language development in siblings. Although older siblings may interrupt or talk for their younger siblings, it does not appear to have a negative effect on development.

What causes speech/language delays or disorders?

Most of the time, we aren’t sure.

Sometimes a child may have other disorders that contribute to slower development in speech/language, like hearing loss, cleft palate, or a genetic disorder or medical diagnosis such as Autism Spectrum Disorder, Down Syndrome, or other intellectual disabilities. Suspected causes may include genes and heredity (20-40% have family history of speech/language issues), prenatal nutrition, or prematurity.

Approximately 2-8% of school-age children may have a language disorder. Nearly 1 in 12 U.S. children ages 3-17 has had a disorder related to speech, language, voice, or swallowing in the past 12 months (CDC, 2018).

What if my pediatrician said to wait, but I’m still concerned?

Don’t wait!

Pediatricians are often responsible for screening children for speech and language delays at the child’s well check. However, pediatricians have only a general knowledge about speech and language development. Speech-language pathologists are the experts and have more specific education and training to help identify children who need help. Research shows the earlier a child with a delay receives help, the better the outcome will be (Rosetti, 1996).

If you have a concern, contact a certified speech-language pathologist.

My friend said late talkers always catch up and don’t need therapy. Is this true?

Not true.

Research supports that 70-80% of “late-talkers” will outgrow a language delay if it is an expressive delay only, which only involves spoken language, not understanding or social use of language (Ellis & Thal, 2008). This means 20-30% of young children will NOT catch up to their peers without intervention. When children don’t catch up, they usually have persistent language difficulties that can affect reading and writing as well (Sharma, Purdy & Kelly, 2009). We cannot yet predict which children will catch up on their own, and if we wait it results in later intervention for those that really need help.

Do bilingual children talk later?

No.

Children learning two languages at the same time will follow the same developmental pattern in both of their languages. Sometimes vocabulary may look smaller, but when all words are included from both languages, it should be comparable to their monolingual peers. Bilingual language learners may also mix up words or use different grammar, called “code switching” which is normal and does not indicate the child is delayed. A language difference is NOT a language disorder. A bilingual child with a true language disorder will have deficits present in both languages.

If you have concerns, please contact a bilingual speech-language pathologist.

How can I help my child develop speech and language skills?

  • Talk about things you see, hear, smell, and touch. “I see a squirrel in the tree! I hear an airplane; look in the sky!”
  • Expand on your child’s words. For example, if your child says “dog!” you could respond with “Yes, that is a big brown dog!”
  • Make time to read together. Point out pictures and talk about what you see on each page.
  • Play social games, like peek-a-boo with babies, Ring Around the Rosie with toddlers, or I Spy for older children.
  • Use gestures to help you child understand what you mean.

Where can I find a speech-language pathologist?

ASHA ProFind lets you search certified speech-language pathologists listed by city, state, area of expertise, and bilingual providers. You can also contact your local Early Childhood Intervention (ECI) or school district for more information. Also, we offer free consultation to answer all your questions at Heart & Soul Speech – Contact us today!

Here’s what parents should know about hearing loss!

References:

https://www.nidcd.nih.gov/health/statistics/quick-statistics-voice-speech-language

https://www.nidcd.nih.gov/health/speech-and-language

https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935321&section=Incidence_and_Prevalence

http://www.hanen.org/helpful-info/articles/fact-or-fiction–the-top-10-assumptions-about-earl.aspx

https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/communication-disorders/difference-between-speech-impairment-and-language-disorder

http://www.hanen.org/helpful-info/articles/a-closer-look-at-the-late-talker-study–why-parent.aspx

Berglund, Eriksson M., and Westerlund M. (2005). Communicative skills in relation to gender, birth order, childcare and socioeconomic status in 18-month-old children. Scandinavian Journal of Psychology46, 485-491.

Ellis EM, Thal DJ. (2008) Early language delay and risk for language impairment. Perspect Lang Learn Ed., 15(3): 93-100.

Sharma M., Purdy, S.C. & Kelly, A.S. (2009). Comorbidity of auditory processing, language, and reading disorders. Journal of Speech, Language and Hearing Research, 52(3),706-22.

Rosetti, L.M. (1996). Communication intervention: Birth to three. San Diego: Singular Publishing.

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