When toddlers are slow to start talking

By Erin Dym on November 26, 2013
I’ve nodded and “Ah’d” my way through many of my son’s stories that I didn’t quite understand. I was concerned about his speech at first, but as his third birthday approaches, his command of language has improved dramatically and his speech is sounding clearer.

Approximately one in 10 children under age five are estimated to be at risk for delays in language development. So how do parents know if their child is on track or underdeveloped?

“The general rule is that by age two, toddlers should be using at least 50 words and should understand much more than that. They should also begin using two-word sentences,” says Shira Silver, a speech language pathologist in Toronto. “Many children surpass this guideline, so if you are concerned that your child’s speech or language development is behind, it is important to speak to your family doctor or a speech-language pathologist.”

Shira suggests some other things to consider as well:

  • Does your toddler point, gesture or make a sound to communicate?
  • Does your child understand simple questions?
  • Can your child follow simple directions?

“There’s a wide range of what’s normal,” she says.

It’s important to appreciate that your child’s words won’t sound perfect. “Certain sounds develop at different ages,” says Shira. “Some sounds are easier than others, for instance, using an “F” sound instead of a “Th” is normal. Even by age six or eight certain blends of sounds are still hard.”

To encourage language development:

  • Read books to your children.
  • Repeat words and sounds that your child says.
  • Comment on what they say and describe what you’re doing as you’re doing it.
  • Encourage them to communicate to get what they want – wait for them to ask for their milk at snack time, for instance, before giving it to them.

If they aren’t speaking and your efforts aren’t working, Shira suggests getting your child’s hearing tested. You might want to speak to your pediatrician as well or even secure an appointment for a free government funded speech language assessment in your area (waiting lists can be up to six or nine months in some communities). You could also make an appointment with a private speech language pathologist, but costs vary and could start at $120 per hour.

Online assessment

A new online assessment tool called My Child’s Talk can help parents assess their child. Created by Dr. Daniela O’Neill, a professor at the University of Waterloo, and backed by more than 10 years of scientific research, the tool asks parents to fill out a 20-minute questionnaire at a cost of $20.

“You will be asked a series of yes or no questions and at the end, you get a percentile score that tells you where your child’s language stands relative to boys and girls of the same age in months,” says Dr. O’Neill. “This gives parents a bit more data they can use to decide their next steps.”

A percentile score of 10 percent or below could be cause for clinical concern, and the tool would make a recommendation that parents seek further assessment. Available at my-childs-talk.com, the site also provides a list of resources for parents, including where to find a speech language pathologist and where to get more information.

If there is an issue, early intervention is best. “Slow speech or language development can be caused by a variety of factors, and treatments will range accordingly,” says Shira.

“A lot of times, with work, speech and language issues can improve,” says Shira. “But if you’re concerned, it’s good to seek treatment. Recognizing and treating these issues early on is the best way to help your child.”

Milestones for development

If your child does need the services of a speech language pathologist, here’s what you can expect:

  • A thorough assessment will be conducted, including examining whether your child makes eye contact when being spoken to, whether they understand words spoken to them, and whether they make an effort to communicate back (using noises or gestures).
  • The therapist can provide parents with training to develop their child’s language development, including home visits and videotaping.
  • The therapist will also work with the child using various techniques, including play and discussions.
  • 10 session therapy blocks are common.
  • A speech-language pathologist can help with delayed language, lisps and stutters.
  • Cost is often covered if working through a school board.

Originally published in ParentsCanada magazine, December 2013.


By Erin Dym| November 26, 2013

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