I am worried that my child is delayed in speech and language—what should I do?
I always listen to parents first when they express concerns about their child’s speech and language skills. You know your child the best so follow your hunch. Write down your concerns and observations and share them with y0ur pediatrician. Be specific such as, “He was with four other preschoolers at the beach and they played around him while he seemed to be in his own world,” “My two-year-is only saying 4 or 5 words,” “He tends to repeat what people say rather than make novel comments,” “My relatives can’t understand her,” or “She repeats the first part of words when she gets excited like, m-m-m-my shirt.” Even if your pediatrician is not concerned and you still have questions, you can do the following:
Birth-3 year olds:
Contact the Birth-Three provider in your area. You can get this phone number from your pediatrician or school district. States vary in pricing but many states will do a free evaluation and have a sliding fee scale for therapy. In Connecticut, they send two professionals to your home to evaluate your child across many areas—speech and language, fine and gross motor and social skills. Depending on the results, if your child qualifies for services, a treatment plan will be proposed with your input.
And/or you can contact a private therapist to set up an evaluation to determine if therapy is needed. Certainly, good therapists are found from word of mouth from other parents, but if you call your Director of Special Education at your local school district, they often have a list of local licensed therapists with whom they have worked that they can recommend. Also you can go to the American Speech-Language-Hearing Association (ASHA)’s website at http://www.asha.org/findpro/ to find a licensed therapist near you. Always ask if they specialize in children from birth to three years of age.
Three year-olds and up:
After a child turns three, the local school district is responsible for evaluating and treating speech and language delays and disorders. You can either call the elementary school that your child will eventually attend, or call the Director of Special education for your district to inquire about how to have your child evaluated.
If your child is already enrolled in school, contact the speech pathologist at her school, express your specific concerns and ask for her to be evaluated. They will share the process by which you can get your child evaluated which involves a set of state-mandated meetings of which you are a part of the team.
Again, you can contact a private therapist in your area to evaluate your child. Certainly, good therapists are found from word of mouth from other parents, but if you call your Director of Special Education at your local school district, they often have a list of local licensed therapists with whom they have worked that they can recommend. Also you can go to the American Speech-Language-Hearing Association (ASHA)’s website to find a licensed therapist near you. Always ask if they specialize in children your child’s age and with the difficulties that you feel your child is experiencing—stuttering, articulation (correctly producing sounds), language such as grammar, social language (eye contact, relating verbally in a social situation) or listening and understanding. Many private therapists specialize in age groups as well as types of disorders, so look for a good match with your child.
What is the best way to work with the school if my child is diagnosed with a speech and language problem?
Having spent 25 years in public and private schools before going into private practice, I can say there are ways to approach the school team and be a welcome, contributing partner in the process of assessing your child’s skills and developing an ongoing productive plan for her therapy. In my article, “A Parent’s Guide to Teaming with the Schools to Build Language,” I offer 10 tips for making your experience with the schools a positive one.
How do I know if my child is delayed in speech and language?
To understand typical speech and language development go to the AHSA, American Speech-Language-Hearing Association’s website.
How can I help my child pronounce sounds correctly?
Often I get calls from parents, wondering if they should seek an evaluation for their child since she mispronounces certain sounds. The parent goes on to say that she is correcting her child and trying to get her to imitate the sound accurately. I tell the parent what I always include in my talks to new moms and dads—don’t ever correct your child’s speech or let anyone else do that. Children as young as a year can detect when we are putting them on the spot, asking them to talk. Notice how when a proud parent tries to show off his kid’s first words and directs his son to say, “dog,” “juice,” or “ball,” and the child is mum? Correcting your child’s speech and drawing attention to it can actually hinder speech development because your child will be less free and willing to talk.
Instead, “model” the correct production of the sound she is having trouble with in your own speech. If your child is substituting a “t” for a “k,” saying “tat” for “cat,” then respond to them by saying, “Yes, that’s a Cat.” Continue your conversation, adding a few short sentences using the sound correctly—“The Cat is so furry. Keep the Cat away from the neighbor’s dog. The Cat doesn’t like him!” Emphasize the sound while you are reading a book during your story time, such as The Cat in the Hat Came back! You will start to hear K’s everywhere and emphasize them.
Have fun playing with sounds with your child. While brushing teeth and looking in the mirror, play imitation games moving your tongue, lips and jaw in funny faces, making sounds to match.
I don’t typically recommend watching DVD’s because personal verbal interaction is far more beneficial to speech and language learning, but recently “Sounds Like a Smile” was produced. A nurse-mom who has a child with delayed speech and language, teamed up with speech pathologists to produce this easy going DVD teaching the first consonants a child is expected to master. You and your child are invited into a teacher’s preschool class to interact with Miss Miley, the grandmotherly puppet as well as the kids, singing songs, reciting rhymes, and following directions—all related to the sounds. Your child will likely enjoy practicing these sounds in response to the characters. See my full review at the Parents Choice website.
What is the best way to teach my child a second language?
Almost every time I speak to a new mothers’ group I am asked this question. I encourage parents by saying that teaching your child to speak a second or even third language is a gift you can give them. The earlier you start, the easier and more effective it will be.
Certainly there are many areas of the world where this is done seamlessly without instructions. But the best way is to separate the languages your child is hearing by person or place. In other words, Mom speaks only Spanish to Katerina, Dad speaks English, Grandma speaks Spanish, and preschool might be only in Spanish and so on. When you make the boundaries clear it is easier for your child to learn the two languages. Avoid mixing the languages, using words from each language in one sentence.
Recently, a mom asked me evaluate her child for a possible language delay. According to my evaluation he was behind but I learned that both parents’ first language was German. The grandparents lived with them and spoke only German, Dad was speaking English and Mom was speaking both German and English to her little Hans, sometimes mixed in the same sentence. He was two years old and had a few words that were in English. I would never suggest that mom stop speaking German to her son since there is more than a language connection there but emotional bonds too. I did suggest that while we were building up his English that she segment her day and speak English to him for the main portion of the day and maybe reserve German for her evening routine with him. I believe part of his language delay was that he was confused by hearing a mix of languages without the boundaries of people and place.
I will admit it takes some courage to choose to speak a language other than English exclusively to your baby. Parents have shared with me that they are afraid their child won’t understand them or they feel awkward doing it. Or what if it doesn’t work? Go ahead. You have an amazing opportunity if you or your spouse, relative or nanny is fluent in a second language. Your child will pick up English from the community. Our neighbor has raised her children hearing exclusively Lithuanian. When her son was three years old, his English tutors were his neighborhood buddy and his peers in preschool!
A helpful resource for families considering raising a bilingual child is the newly released 7 Steps to Raising a Bilingual Child by Naomi Steiner, M.D. A developmental-behavioral pediatrician at Tufts, Dr. Steiner grew up speaking four languages and her Swiss husband five languages. Her personal experience raising her two children to be bilingual as well as dealing with bilingual families in her practice make this guide especially helpful. She deals with the benefits of raising a bilingual child, how to do it, common myths, dealing with predictable obstacles, and how to teach your child to read and write in another language. Resources at the end include websites that offer educational activities, podcasts, encyclopedias, and books in a second language.
What about “educational” baby DVD’s?
The American Academy of Pediatrics recommends no videos under the age of 2. As far as I know, there is no research that shows children under two years, gain information from a DVD versus the well-founded resource of a human being speaking to them. Don’t let the marketplace influence you with false advertising that says watching these will boost brainpower.
What toys are most stimulating to encourage speech and language growth?
Check out my article on “What Makes a Good Language Toy.” Most parents are surprised to hear the importance of faces so you can have little conversations with your toy.
Also, I have posted video reviews of some of my favorite toys, by age for stimulating speech and language:
Is it okay to talk “baby talk” to my baby?
I want to make a clear distinction between “baby talk” which is using babyish words for things such as “ba ba” for bottle or “blankie” for blanket. No, you shouldn’t talk baby talk and use incorrect words for objects. Use the adult words, “bottle” and “blanket,” or else your child will learn to speak using the incorrect names.
Baby talk does NOT refer to the wonderful little sounds that your baby is making. Those “coo” and “goo” sounds are his attempt to communicate with you and you DO want to answer him. When he says, “la,” then you repeat “la.” Pause a second before repeating what he says. Research actually shows that by pausing, it helps your baby increase his attention span and take in new vocabulary. Repeating your baby’s sounds develops his language as well as builds a social bond between you two, saying you’re important, I’m listening and responding to you!
How can you tell if my child is truly saying a word?
A true word:
· Must have meaning each time it is used. So each time your toddler points to the TV and says, “do” for his Elmo DVD, it has the same meaning, which can be “I want my Elmo DVD,” or “I want to watch my Elmo DVD.”
· Shows your child’s intention to communicate. “do” is being used to communicate with you that he wants to see his Elmo DVD.
· Is used flexibly in different contexts—home, school, or a playmate’s house. So if you are at home or at grandma’s house, your toddler would use “do” to communicate the Elmo DVD because “do” is a true word representing that object no matter where your child is.
· Is a simple one or two syllable utterance that stands alone, with a pause after it.
· Is used in conversation with people.
· Is determined by its usefulness in your child’s environment. First words are often objects, people or pets that are integral to your child’s daily activities such as dog, ball, juice, or cracker.
Listen closely and you will start to hear the differences in the utterances your child makes. Usually, kids have more words that Mom or Dad realize. Often, the longer I play with a toddler, the more little words I hear. It’s like discovering little treasures
Will teaching my baby sign language prevent him from talking on time?
No, currently, the research shows that teaching your baby sign language can actually enhance your child’s language development. In Baby Signs, How to Talk to Your Baby Before Your Baby Can Talk, by Linda Acredolo, PhD and Susan Goodwyn, PhD, the authors cited research studies funded by the National Institute of Health, finding the following benefits to using baby signs:
· Makes life easier on the family because it reduces frustration, tears and tantrums since your baby can express himself through signs when he is not yet able to verbally communicate his needs.
· Allows your baby to share her needs and thoughts and let you into “her world”
· Enriches interactions with your baby and strengthens baby-parent bond
· Helps your child develop language skills, learn to speak sooner, and have a richer vocabulary
· Benefits emotional and intellectual growth. Baby signers scored more impressively on tests of mental development (performed higher on IQ tests in elementary school) pretend play, and ability to remember where things are, than their non-signing peers. A love of books may develop since they can label earlier.
· Also has a positive affect on self-confidence since they can communicate