Late-talking children are those at age two with a vocabulary of fewer than 50 words and who use limited or no two- or three-word combinations, such as “more juice.” Most late-talking toddlers gradually catch up with their peers during the first years of school. However, a substantial number will continue to have trouble with acquiring expressive language. For this reason, it’s important to know how to spot atypical communication in your child and to know what to do.

Signs of Speech Delays

Certain risk factors or signs of speech delays at age two suggest a child should receive early language intervention services. These signs include:

• Small vocabulary for age (fewer than 20 words)
• Use of few action words (verbs)
• Trouble understanding simple language
• Limited vocalizations with few consonants
• Reduced or absent imitation
• Few communicative gestures (for example, shaking head for “no”)
• Chronic otitis media (middle ear infections)
• Family history of delayed speech, language, or reading

When parents express concerns about late talkers, some pediatricians adopt a “wait-and-see” attitude. But intervention may be of benefit for all concerned in situations like these: You are feeling concerned, communication seems more of a struggle than a pleasure for your child, or your child is frustrated by attempts at making connections with you and others.

A good place to start is with the Family Resource Centers or your pediatrician. They can help you find a speech-language pathologist (SLP) who has expertise in early intervention. SLPs can determine how much delay exists by doing an assessment of your child’s speech and language skills.

Assessment consists of meeting the child, playing with developmentally appropriate toys, and listening to the child’s sound system. Vowels are usually the first sounds acquired. Consonant sounds may not all be produced until around age eight.

Standardized tests can also be used. There are many standardized tests for children from age birth to three and the ones chosen are at the discretion of the agency that is testing. To assess every aspect of development, tests look at at least five domains:

• Cognitive
• Expressive communication
• Receptive communication
• Gross motor
• Fine motor

Other more specialized testing is available for social-emotional and behavioral aspects of a child’s development. Tests are also available for more in-depth assessment of a child’s communication skills.

Types of Speech Sound Disorders

Is your child starting to speak a few words and attempting to combine words? But, are you (and all other listeners) unable to understand what your child is saying? If so, this might signal early signs of a speech sound disorder. The term “speech sound disorder” might conjure a mispronounced “s” sound or a “lisp,” or problems making a clear “r” sound (the “wed wabbit” syndrome). But other types of speech sound disorders also exist. The underlying cause of the disorder is the first concern of a SLP. Understanding what’s causing the problem can help with planning an effective intervention.

An articulation disorder is one possible cause. This is thought to result from not learning the movements needed to produce the correct consonant sound. The articulators are the structures that move to make speech sounds, like the lips, tongue, and jaw. If no structural or motor problems exist, and the problem is just due to incorrect learning, an articulation disorder is the most easily corrected speech sound disorder. Many children easily learn the new or better way of producing the sound through direct teaching using placement cues, auditory feedback, and clinician guidance. Other speech sound disorders are referred to as phonological processing disorders. These children continue to speak like younger children. They may use mostly vowel sounds with only a few consonants, or they leave off final speech sounds in simple words.

Another speech sound disorder is called childhood apraxia of speech (CAS). Over the years, it has been called a number of other things, such as developmental verbal dyspraxia (DVD). Children with CAS can start out by looking like late talkers. Their speech development can seem quite delayed. Children can become very frustrated by not being understood. They may look as if they are struggling to get their mouth to move in the correct way. If a child is frustrated and CAS is suspected, intensive therapy may be recommended.

If your child is showing any signs of these speech sound disorders, be sure to see a qualified speech-language pathologist. In many cases, early intervention is the best way to turn things around.

References

Rescorla, L. & Ratner, N.B. (1996) “Phonetic profiles of toddlers with specific expressive language impairment (SLI-E)”. Journal of Speech and Hearing Research, 39, 153-165.

Lof, G.L. (2004) “Confusion about speech norms and their use.” Thinking Publications Online Conference.