Does my child have a communication disorder? Signs of a speech, language and hearing impairment.
May is Better Hearing & Speech Month (BHSM). As a speech and language pathologist, and now a mom, I want to raise awareness about communication disorders and offer some information for all my followers. I always have other moms ask me whether their child’s communication skills are appropriate or if there is a need for concern. I wanted to take some time and go over basic milestones and provide you all with signs of a communication disorder.
As always, every child is different and develops at his or her own pace. However, if certain skills aren’t met by a certain age, it can cause future speech and language problems that can affect their social and academic skills. The signs of speech, language and hearing disorders in children are not always obvious. I will share with you the signs so you can seek help early if you have concerns. Early intervention is key in helping your child master his or her communication skills. According to the American Speech-Language-Hearing Association (ASHA), 1 in 4 of U.S. parents of children ages 0–8 have have concerns about their child’s ability to communicate.
Although most children say their first word around their 1st birthday, speech and language development actually begins right from birth.
According to ASHA, below are the signs you should look out for. I organized it by age so you can easily look for your child’s age group.
First I will talk about the signs of a language, speech, stuttering and voice disorder. Next I will go over developmental milestones by age and offer suggestions on what parents can do to help the speech and language development.
If you have any concerns about your child’s development, I highly recommend asking your pediatrician for a referral to a speech and language pathologist.
1. Signs of a language disorder
• Does not smile or interact with others (birth and older)
• Does not babble (4-7 months)
• Makes only a few sounds or gestures, like pointing (7-12 months)
• Does not understand what others say (7 months-2 years)
• Says only a few words (12-18 months)
• Words are not easily understood (18 months-2 years)
• Does not put words together to make sentences (1.5-3 years)
• Has trouble playing and talking with other children (2-3 years)
• Has trouble with early reading and writing skills* (2.5-3 years)
*Early reading and writing skills include:
8 months–1 year: Likes to hear you talk and read; looks at pictures in books when you read
1–2 years: Makes sounds or words when looking at pictures in books; points or touches pictures in books when you name them; turns pages in books
2–3 years: Knows that books have a front and back; enjoys books that have rhymes; points to and names many pictures in books
As a parent there are many things you can do, including listening and responding to your child, reading and playing with your child. The more you talk about what you’re doing throughout the day, the better! Use a variety of different words and use longer sentences as your child gets older.
If you speak a second language, feel free to speak in that language to your child. There are many long-term benefits of raising a bilingual baby. If you’d like more info, here’s a great article on 8 benefits https://www.brit.co/benefits-baby-bilingual/
Signs of a Speech Sound Disorder (the way children pronounce words)
• Says p, b, m, h, and w incorrectly in words (1-2 years)
• Says k, g, f, t, d, and n incorrectly in words (2-3 years)
• Produces speech that is unclear, even to familiar people (2-3 years)
Always model direct speech – say the sounds correctly. It is totally fine if your child makes some mistakes with sounds. Do not correct speech sounds—it is more important to let your child keep talking.
This is a very common question I get: “My child says “wabbit” and “wed” for “rabbit” and “red”. Is that normal? Depending on your child’s age, yes it’s normal. Every speech sound is acquired at a different age. I always share this chart with my parents. It shows by what age most children learn a certain sound.
Signs of Stuttering
• Repeats first sounds of words—“b-b-b-ball” for “ball”
• Speech breaks while trying to say a word—“—–boy” for “boy”
• Stretches sounds out—“ffffff-farm” for “farm”
• Shows frustration when trying to get words out
Always give your child time to talk and do not interrupt, stop, or tell your child to slow down while they are speaking. See a certified speech-language pathologist if you are concerned.
Signs of a Voice Disorder
• Uses a hoarse or breathy voice
• Uses a nasal-sounding voice
If your child has any of these, see a doctor. Also, tell your child not to shout or scream and keep your child away from cigarette smoke.
Now I’m going to share with you some developmental milestones by age (these are the average ages when children acquire the skill). You can find all these handouts on ASHA’s website.
Birth to 12-Month Milestones:
Babies are showing off budding speech and language skills from the very beginning. Milestones include:
• Making cooing sounds (birth–3 months)
• Making speech-like babbling sounds, such as pa, ba, and mi (4–6 months) • Responding to changes in tone of voice (4–6 months)
• Babbling long strings of sounds, such as mimi upup babababa (7–12 months)
• Imitating different speech sounds (7–12 months)
• Understanding words for common items/people, like truck, juice, and daddy (7–12
months)
• Starting to respond to simple words/phrases, like “No,” “Come here,” and “Want more?” (7–12 months)
• Saying 1 or 2 words, like hi, dog, dada, mama, or uh-oh. This happens around their first birthday, but sounds may not be clear
• Look and smile at people
• Respond to their own name
• Reach to be picked up
• Enjoy being around other people
• Play simple back-and-forth games, like peek-a-boo
Between One and Two Milestones (published by Pro-Ed Inc.)
Between one and two Milestones (published by Pro-Ed Inc. full article here)
- Understands “no”
- Uses 10 to 20 words, including names
- Combines two words such as “daddy bye-bye”
- Waves good-bye and plays pat-a-cake
- Makes the “sounds” of familiar animals
- Gives a toy when asked
- Uses words such as “more” to make wants known
- Points to his or her toes, eyes, and nose
- Brings object from another room when asked
Activities to encourage your child’s language
- Reward and encourage early efforts at saying new words
- Talk to your baby about everything you’re doing while you’re with him
- Talk simply, clearly, and slowly to your child
- Talk about new situations before you go, while you’re there, and again when you are home
- Look at your child when he or she talks to you
- Describe what your child is doing, feeling, hearing
- Let your child listen to children’s records and tapes
- Praise your child’s efforts to communicate
Between two and three Milestones
- Identifies body parts
- Carries on ‘conversation’ with self and dolls
- Asks “what’s that?” And “where’s my?”
- Uses 2-word negative phrases such as “no want”.
- Forms some plurals by adding “s”; book, books
- Has a 450 word vocabulary
- Gives first name, holds up fingers to tell age
- Combines nouns and verbs “mommy go”
- Understands simple time concepts: “last night”, “tomorrow”
- Refers to self as “me” rather than by name
- Tries to get adult attention: “watch me”
- Likes to hear same story repeated
- May say “no” when means “yes”
- Talks to other children as well as adults
- Solves problems by talking instead of hitting or crying
- Answers “where” questions
- Names common pictures and things
- Uses short sentences like “me want more” or “me want cookie”
- Matches 3-4 colors, knows big and little
Activities to encourage your child’s language
- Repeat new words over and over
- Help your child listen and follow instructions by playing games: “pick up the ball,” “Touch Daddy’s nose”
- Take your child on trips and talk about what you see before, during and after the trip
- Let your child tell you answers to simple questions
- Read books every day, perhaps as part of the bedtime routine
- Listen attentively as your child talks to you
- Describe what you are doing, planning, thinking
- Have the child deliver simple messages for you (Mommy needs you, Daddy )
- Carry on conversations with the child, preferably when the two of you have some quiet time together
- Ask questions to get your child to think and talk
- Show the child you understand what he or she says by answering, smiling, and nodding your head
- Expand what the; child says. If he or she says, “more juice,” you say, “Adam wants more juice”
Between three and four Milestones
- Can tell a story
- Has a sentence length of 4-5 words
- Has a vocabulary of nearly 1000 words
- Names at least one color
- Understands “yesterday,” “summer”, “lunchtime”, “tonight”, “little-big”
- Begins to obey requests like “put the block under the chair”
- Knows his or her last name, name of street on which he/she lives and several nursery rhymes
Activities to encourage your child’s language
- Talk about how objects are the same or different
- Help your child to tell stories using books and pictures
- Let your child play with other children
- Read longer stories to your child
- Pay attention to your child when he’s talking
- Talk about places you’ve been or will be going
Between four and five Milestones
- Has sentence length of 4-5 words
- Uses past tense correctly
- Has a vocabulary of nearly 1500 words
- Points to colors red, blue, yellow and green
- Identifies triangles, circles and squares
- Understands “In the morning” , “next”, “noontime”
- Can speak of imaginary conditions such as “I hope”
- Asks many questions, asks “who?” And “why?”
Activities to encourage your child’s language
- Help your child sort objects and things (ex. things you eat, animals)
- Teach your child how to use the telephone
- Let your child help you plan activities such as what you will make for Thanksgiving dinner
- Continue talking with him about his interests
- Read longer stories to him
- Let her tell and make up stories for you
- Show your pleasure when she comes to talk with you
Between five and six Milestones
- Has a sentence length of 5-6 words
- Has a vocabulary of around 2000 words
- Defines objects by their use (you eat with a fork) and can tell what objects are made of
- Knows spatial relations like “on top”, “behind”, “far” and “near”
- Knows her address
- Identifies a penny, nickel and dime
- Knows common opposites like “big/little”
- Understands “same” and “different”
- Counts ten objects
- Asks questions for information
- Distinguished left and right hand in herself
- Uses all types of sentences, for example “let’s go to the store after we eat”
Activities to encourage your child’s language
- Praise your child when she talks about her feelings, thoughts, hopes and fears
- Comment on what you did or how you think your child feels
- Sing songs, rhymes with your child
- Continue to read longer stories
- Talk with him as you would an adult
- Look at family photos and talk to him about your family history
- Listen to her when she talks to you
I hope you found this information helpful. Remember that every child is unique and develops on his own timeline. However, if you notice any of these signs, it never hurts getting a second opinion from a speech and language pathologist. Speech therapy can tremendously help avoid later academic problems.