From 18 to 24 months
Children should have a vocabulary of about 20 words by 18 months and 50 or more partial words by the time they turn 2. By age 2, kids should be learning to combine two words, such as "baby crying" or "Daddy big." A 2-year-old should also be able to follow two-step commands (such as "Please pick up the toy and bring me your cup").
From 2 to 3 years
Parents often witness an "explosion" in their child's speech. Your child's vocabulary should increase (to too many words to count) and he or she should routinely combine three or more words into sentences. Your child's comprehension should also increase - by 3 years of age, he or she should begin to understand what it means to "put it on the table" or "put it under the bed." Your child should also begin to identify colors and comprehend descriptive concepts (big versus little, for example).
What's the Difference Between Speech and Language?
Speech and language are often confused, but there is a distinction between the two:
- Speech is the verbal expression of language and includes articulation, which is the way words are formed.
- Language is much broader and refers to the entire system of expressing and receiving information in a way that's meaningful. It's understanding and being understood through communication - verbal, nonverbal, and written.
Although problems in speech and language differ, they frequently overlap. A child with a language problem may be able to pronounce words well but be unable to put more than two words together. Conversely, another child's speech may be difficult to understand, but he or she may use words and phrases to express ideas. Another child may speak well but have difficulty following directions.
What Are Some Warning Signs of a Possible Problem?
If you're concerned about your child's speech and language development, there are some things you can be on the lookout for.
An infant who isn't responding to sound or who isn't vocalizing is of particular concern. Between 12 and 24 months, reasons for concern include a child who:
- isn't using gestures, such as pointing or waving bye-bye by 12 months
- prefers gestures over vocalizations to communicate by 18 months
- has trouble imitating sounds by 18 months
For the child over 2 years, you should seek an evaluation if he or she:
- can only imitate speech or actions and doesn't produce words or phrases spontaneously
- says only certain sounds or words repeatedly and can't use oral language to communicate more than his or her immediate needs
- can't follow simple directions
- has an unusual tone of voice (such as raspy or nasal sounding)
- is more difficult to understand than expected for his or her age. Parents and regular caregivers should understand about half of your child's speech at 2 years and about three quarters of your child's speech at 3 years. By 4 years old, your child should be mostly understood, even by people whom your child doesn't know.
What Causes Delayed Speech or Language?
There are many reasons for delays in speech and language development. Speech delays in an otherwise normally developing child are rarely caused by oral impairments, such as problems with the tongue or palate (the roof of the mouth). Being "tongue-tied" (when the frenulum - the fold beneath the tongue - is too tight) is almost never a cause of delayed speech.
A number of children with speech delays have oral-motor problems, meaning there's inefficient communication in the areas of the brain responsible for speech production. The child encounters difficulty using the lips, tongue, and jaw to produce speech sounds. Speech may be the only problem or may be accompanied by other oral-motor problems such as feeding difficulties. A speech delay may also indicate a more "global" (or general) developmental delay.
Hearing problems are also commonly related to delayed speech, which is why a child's hearing should be tested by an audiologist whenever there's a speech concern. If a child has trouble hearing, he or she may have trouble understanding, imitating, and using language.
speech-language pathologist) is crucial. Of course, if there turns out to be no problem after all, an evaluation can ease your fears.
Although you can seek out a speech-language pathologist on your own, primary care doctors will frequently refer you to them.
In conducting an evaluation, a speech-language pathologist will look at your child's speech and language skills within the context of his or her total development. Along with observations of your child, the speech-language pathologist will use standardized tests and scales, as well as his or her knowledge of milestones in speech and language development. The speech-language pathologist will also assess:
- what your child understands (called receptive language)
- what your child can say (called expressive language)
- if your child is attempting to communicate in other ways, such as pointing, head shaking, gesturing, etc.
- your child's oral-motor status (how a child's mouth, tongue, palate, etc. all work together for speech as well as eating and swallowing)
If the speech-language pathologist finds that your child needs speech therapy, your involvement will be very important. You can observe therapy sessions and learn to participate in the process. The speech therapist will also show you how you can work with your child at home to improve his or her speech and language skills.
Of course, the result of an evaluation by a speech-language pathologist may indicate that your expectations are simply too high. Educational materials that outline developmental stages and milestones may help you look at your child more realistically.
What Can Parents Do?
Like so many other things, speech development is a mixture of nature and nurture. A child's genetic makeup will, in part, determine intelligence and speech and language development. However, a lot of it depends on the child's environment. Is the child adequately stimulated at home or at child care? Are there opportunities for communication exchange and participation? What kind of feedback does the child get?
When speech, language, hearing, or developmental problems do exist, early intervention can provide the help your child needs. And when you have a better understanding of why your child isn't talking, you can learn many ways to encourage your child's development of speech.
Here are a few general tips you can employ at home:
- Spend a lot of time communicating with your child, even during infancy - talk, sing, and encourage imitation of sounds and gestures.
- Read to your child - starting as early as 6 months. You don't have to finish a whole book, but look for age-appropriate soft or board books or picture books that encourage your child to look while you name the pictures. Try starting with a classic book such as Pat the Bunny, in which the child imitates the patting motion, or books with textures that your child can touch. As your child gets older, let him or her point to recognizable pictures and try to name them. Then move on to nursery rhymes, which have rhythmic appeal. Progress to predictable books, such as Eric Carle's Brown Bear, Brown Bear, in which your child can anticipate what happens. Your little one may even start to memorize his or her favorite stories.
- Use everyday situations to reinforce your child's speech and language. In other words, talk your way through the day. For example, name foods at the grocery store, explain what you're doing as you cook a meal or clean a room, point out objects around the house, and as you drive, point out sounds you hear. Ask questions and acknowledge your child's responses (even when they're hard to understand). Keep things simple, but never use "baby talk."
Whatever your child's age, recognizing and treating problems early on is the best approach to help with speech and language delays. With proper therapy and time, your child will likely be better able to communicate with you and the rest of the world.
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