Late Bloomer or
Developmental Delay
When my son was eighteen months he
did not speak in real words. We were
living in France at the time and he sounded like the old Frenchmen who we saw sitting
outside the corner Cafe. His pitch went
up and down like their speech and he would add some gestures and a very French
belly laugh. When my father-in-law came to visit he said that he thought Tommy
was speaking a foreign language. Tommy
would call from our garden to the trash men and police men as they walked by,
they would wave to him and speak in French and he would wave back and speak in
his jargon. They thought he was speaking
American English.
Being a certified and licensed
speech language pathologist I was worried.
He had met his motor developmental milestones with no problem. He walked at nine months and was running by
ten months. He was physically fine but
he did have a history of chronic ear infections and there was also a family
history of late talking; both of my brothers were in speech therapy through
third grade. I began discussing my
concerns with my speech therapy colleagues back in the U.S. When I asked if they thought he needed speech
therapy I really didn’t get any definitive answers. That’s when I approached my pediatrician in
the U.S. with my concerns.
My pediatrician sent us to a
pediatric ENT who worked with a pediatric audiologist for a hearing assessment
and a tympanogram to assess the possibility of fluid in his ears. Somehow he passed the hearing assessment, but
the tympanogram show that there was indeed fluid in both ears. The ENT said that when children have fluid in
their ears, it sounds like it does when you are talking under water at the
pool. I knew that a child first needs to
hear speech before they can produce it, so I was no longer surprised that
Tommy’s speech was delayed. He also said
that when children’s ears are full of fluid they do one of two things – they
either act out or they withdraw. This
was another eye opener. Tommy was never
one to withdraw, but his constant activity seemed to have increased and he
didn’t respond to our requests. Now
everything made sense, he wasn’t talking because he was hearing distorted
speech sounds and he wasn’t following our directions because he couldn’t hear
them.
We worked with our ENT to come up
with a treatment plan. We decided on the
placement of tubes in both ears and I began providing Tommy with speech therapy
and I taught my husband and daughter how they could help stimulate his speech
development. I also talked with Tommy’s
preschool teachers and I explained how important it was for Tommy to see their
faces when they were talking to him. I
also asked that he sit close to the teacher when she was reading stories or leading
other group activities.
Waiting for Tommy’s speech to catch
up was hard and I know that waiting is very difficult for all parents,
especially when you are concerned about your child’s development. It’s hard to know the exact age a child will
meet speech and language milestones; but there are milestones that children
consistently pass through. At twelve
months, a child can say one or two words, like dog, hi, dada, mama. By
eighteen months, the child should be able to understand simple questions, like Who’s that? Where are your shoes? By two to three years, the child is able
to put three words together and familiar people understand their speech. By five years old, they can tell a short
story, understand most of what is said at home and school, and say most speech
sounds in words.
If the child is not able to do these
things in the time frame listed above, they may be exhibiting a delay in speech
and language development. If parents are
concerned about their child’s speech and language development, they should
consult with a speech language pathologist.
A speech delay is when a child has difficulty producing sounds in
words. A language delay is when a child
has difficulty with the code that we use to communicate thoughts and to
understand others.
When parents bring their child into
my office, I analyze the child’s utterances for both what they understand and
the speech and language that they are using.
I determine factors that may be slowing down the child’s speech and
language development and I council parents on the next steps to take to help
their child. The treatment services that
I provide as a speech language pathologist varies depending on the child’s
specific areas of difficulty. Some
children may only need help with language.
They may have problems with understanding what others are saying, their
vocabulary may be small, they may have trouble thinking of words, and they may
have problems saying words and sentences; while other children may need help
with the mechanics of producing speech.
They may substitute one sound for another, they may leave out sounds,
and they may change how sounds are made.
As parents, there are things that you can do at home to help
your child understand and talk.
·
Talk,
talk, talk. Talk naturally to your child
and use a lot of different words. Talk
about what your child sees and talk about what he – and you – are doing. Ask questions that require more than a “yes”
or “no” answer.
·
Listen. Take time to listen to your child and respond
to what he says. Don’t interrupt or
correct speech sounds. If your child
makes some mistakes with sounds, it’s okay.
You can say the sounds correctly when you talk so that your child can
hear the correct pronunciation of the error sounds. A child must first be able to hear the sound
before he can be expected to produce the sound.
·
Read. Ask questions and talk about the story. Help your child retell the story using the
pictures in the book.
·
Play. Talk about the toys as you and your child
play with them. Set aside a special time
each day to play with your child. Provide your child with blocks, dishes, dolls,
boxes, cars, trucks, dress-up clothes, paper and crayons. Reward your child’s play with attention and
praise.
·
Have
your child’s hearing tested if you have to repeat a lot or use a loud voice.
·
Set
limits for TV and computer time. Use the
time for talking, reading, and playing together.
·
Good
resource books are “Beyond Baby Talk” by Apel and Masterson and “Talking on the
Go” by Dougherty and Paul. These books
are available at www.asha.org/shop.
While every child grows at their own
pace, it is always better to consult with a specialist when you feel that your
child is lagging behind. Speech language
pathologists are certified by the American Speech-Language-Hearing Association
and they have completed their master’s degree and earned ASHA’s Certificate of
Clinical Competence (CCC). If you are
concerned that your child may have a speech or language delay, please contact
me.
Laura A.
Michie, M.Ed. M.A., CCC-SLP, Speech Language Pathologist
