April 20, 2015

Speech language milestones

Watching your child learn to communicate is one of the most exciting things about being a parent. You see your baby go from cooing to babbling to saying those first words. You watch your toddler sing songs and put words together. You read books, and then suddenly your child is reading to you. It's an exciting progression, and much of the time it seems to happen naturally. But what if your child isn't developing speech or language like other children?

Maybe she has a chronically hoarse voice.  Or maybe he coughs and chokes on food.  In all of these situations, a speech-language pathologist may be able to help.

Children all have individual variations in how they develop communication skills, but if they are lagging behind, or not meeting milestones, they may need some help getting there. If you have any concerns with your child's communication development, talk to your pediatrician. He or she can refer you to the right place for an evaluation. Sometimes the first step is getting a hearing test, because if children cannot hear speech and language, it is much more difficult to learn to talk.

If your child is not meeting the milestones listed below or has any of the other symptoms listed, he or she may need to see a speech pathologist.

0-3 months: Your baby should coo, make noises, smile, interact with people, and react to voices.

4-7 months: Your baby should babble (babbling is "baby talk" combining consonant and vowel sounds, like "bababa," "yayayaya," "googaba.") He or she should show interest in the world around him or her, respond to her name, and interact with you.

7-12 months: Your baby should be making a variety of consonant and vowel sounds, gesturing, and combining consonant and vowel sounds into "nonsense language."

12-15 months: Your baby should be saying a few words, using gestures, sounds and words to tell you what he or she wants, and understanding simple sentences.

2 years: Your toddler should have at least 50 different words and be starting to combine 2 words together ("mommy up," "daddy go," "my ball.")

2-3 years: Your child's speech should be mostly understandable to close family, though not at an adult level. He or she should be speaking in multiple word sentences, though grammar may not be correct.

2 years and up: Your child should show interest in other children and want to play with them.

4-5 years: Your child's speech should be mostly understandable to most people, although some sounds may not be produced like adults.

School-aged: Your child should be able to say most consonant sounds. A few sounds develop later than others and there is some normal variation in typically developing children, but by about 7 years old, kids should have most adult speech sounds. Communication problems in school-aged kids can also manifest as behavior problems, difficulty paying attention in class, difficulty getting along with other kids, and trouble with reading and writing.

Any age:

Stuttering: Stuttering is characterized by repetition of sounds and parts of words, unusually long hesitations during speech, and difficulty getting words or parts of words out. Though normal dis-fluency (repeating sounds once or twice, inserting "u,") some children have more pronounced difficulties that negatively impact their communication.  Many toddlers and preschoolers have temporary dis-fluency or stuttering-like behavior which usually resolves within a few months. Consult a professional if it lasts more than 3 months, your child seems upset or distressed about it, starts avoiding certain words or sounds, or they begin to show physical signs of stress or tension with speaking.

Hoarseness: Hoarse, rough or scratchy voice is not normal in children outside of an illness.  Consult your doctor if your child is hoarse for more than 2 weeks following an illness, is hoarse without being sick, repeatedly loses his or her voice, seems to strain to talk, or has trouble controlling the loudness of his or her voice.

Hypernasality:  Consult your doctor if your child seems to have an unusually "nasal" voice.

Swallowing: If your child is regularly coughing or choking on food or liquids he or she may have difficulty with swallowing and you should consult your doctor.

For more resources on normal communication development, and ways to help your child if they are having trouble, check out the American Speech Language and Hearing Association's website, http://www.asha.org and their partner site http://identifythesigns.org.