Talking About Speech Problems

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When my daughter was three, I noticed she was protruding her tongue slightly when pronouncing a soft ‘g’.

At first it seemed sweet, but months went by and I began to worry. It wasn’t affecting the sound she made, but the maneuver looked unnecessarily difficult. What if it became permanent? Shortly afterward, I happened to be in the company of a speech pathologist. I know you’re not supposed to bother professionals in social situations, but I hesitantly asked for advice. Was I silly to be worrying about my child’s speech when she was so young? She recommended that my daughter be assessed.

It was great advice: In short order, a speech pathologist targeted her speech difficulty and demonstrated specific daily
exercises. After just six or seven weeks of doing the simple drills together, and only two more sessions with the therapist, my daughter had mastered the ‘correct’ way to make the soft ‘g’ sound. Problem solved!

Holly Ross, of Windsor, N.S., remembers the communication difficulties her twin sons had when they were even younger – not yet two years old. “The boys often had their own ‘twin talk’. Although they could understand each other very well, to others, it sounded like gibberish. They were leaving off sounds, substituting some sounds and not articulating well. They had difficulties with pronouns, such as saying ‘me brother’ instead of ‘my brother’. I thought that they would need speech therapy, but I wasn’t aware of how soon it should start.”

Her boys had had several surgeries due to chronic ear infections, but Holly recalls that the ‘very traditional’ specialist who was caring for them reassured her that, in time, their speech would be fine. In the end, it was a friend studying speech-language pathology who advised Holly to get help for her children. By then, they were three years old. Holly now feels that time was wasted. “Listen to your gut instinct,” she advices parents. “I’m certain that my sons would have benefited from an earlier start with therapy.”

Margo Hand, of St. John’s, Nfld., says, “By age two, my son Graham was only saying about 10 words and these were not clearly spoken. Only members of the family really understood him.” By the time he was three and in preschool, she requested a referral to speech therapy at her local children’s hospital. She says, “Don’t delay. If your child doesn’t sound similar to his or her peers, investigate.”

Suzanne Martin, a speech-language pathologist in Toronto, says that communication skills begin early – well before a child goes to school or even nursery school. She says that they begin to develop long before we hear a child’s first words. She emphasizes the importance of early intervention.

Corinne Burgess, a speech-language pathologist in St. John’s, agrees.

“Addressing speech problems early is important because speech and language are the foundation for learning,” she
says. “Speech difficulties can have a negative impact on literacy development, especially if a child is unable to produce speech sufficiently to say the letter sounds, sound out words, and blend sounds to form words.”

After all, we know that children progress at different rates and will reach different stages at different times. Suzanne Martin suggests parents refer to the following chart from the website of the Canadian Association of Speech-Language Pathologists and Audiologists for a rough guide to some developmental communication milestones. It’s a good guide. And it’s a start.


When is it too early to seek help from a speech pathologist for your child?

“Almost never,” says Suzanne Martin, a speech-language pathologist in Toronto. “If you have any concerns at all, have an assessment done. Even if the evaluation indicates your child is where he should be, a speech-language pathologist can give you pointers on how to continue to encourage further development, and what to look for to make sure things stay on track. “Sometimes parents don’t try to address their children’s speech difficulties until they are much older. But speech patterns become habitual, and changing an error that has been made for several years can be challenging.

“If therapy is recommended be prepared for homework. A weekly session is usually not enough to result in change. Regular practice will be required.

“On the other hand, it’s never too late to begin speech therapy if the older child or young adult is motivated. Sometimes the difficulties encountered from waiting are offset by high levels of motivation.”

So, along with the tips suggested by Holly Ross and Margo Hand, how else can parents know whether or not their child might benefit from an assessment?

BIRTH TO 3 MONTHS: Does the child…

  • make cooing sounds?
  • have different cries for different needs?
  • smile at you?
  • startle to loud sounds?
  • soothe/calm to a familiar voice?

4 TO 6 MONTHS: Does the child…

  • babble and make different sounds?
  • make sounds back when you talk?
  • enjoy games like peekaboo?
  • turn his/her eyes toward a sound source?
  • respond to music or toys that make noise?

7 to 12 MONTHS: Does the child…

  • wave hi/bye?
  • respond to his/her name?
  • let you know what he/she wants, using sounds and actions like pointing?
  • begin to follow simple directions (e.g., Where is your nose?)?
  • localize correctly to sound by turning his/ her head toward the sound?
  • pay attention when spoken to?

BY 12 TO 18 MONTHS: Does the child…

  • use common words and start to put words together?
  • enjoy listening to storybooks?
  • point to body parts or pictures in a book when asked?
  • look at your face when talking to you?

BY 18 TO 24 MONTHS: Does the child…

  • understand more words than he/she can say?
  • say two words together (e.g., More juice)?
  • ask simple questions (e.g., What’s that?)?
  • take turns in a conversation?

2 TO 3 YEARS: Does the child…

  • use sentences of three or more words most of the time?
  • understand different concepts (e.g., in versus on; up versus down)?
  • follow two-part directions (e.g., Take the book and put it on the table)?
  • answer simple questions (e.g., Where is the car?)?
  • participate in short conversations?

3 TO 4 YEARS: Does the child…

  • tell a short story or talk about daily activities?
  • talk in sentences with adult-like grammar?
  • generally speak clearly so people understand him/her?
  • hear you when you call from another room?
  • listen to TV at the same volume as others?
  • answer a variety of questions?

4 TO 5 YEARS: Does the child…

  • pronounce most speech sounds correctly?
  • participate in and understand conversations even in the presence of background noise?
  • recognize familiar signs (e.g., stop sign)?
  • make up rhymes?
  • hear and understand most of what is said at home and school?
  • listen to and retell a story and ask and answer questions about a story?

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