As parents, it is so exciting looking forward to the milestones your little ones will meet, such as hearing their first words, eating their first foods, or hearing them say “Mama” or “Dada”. But what if they aren’t talking? What if they are difficult to understand? What if they are having trouble with transitioning to solid foods? What if they don’t appear to be understanding what you say to them?
If you have concerns about your child’s development, you are likely to get all kinds of advice or comments from your friends, family, or even your doctor. All too often we hear parents report that others told them their kid will “grow out of it”, that “some kids just need more time” , or anecdotal stories like, “My nephew didn’t talk until he was four and he is just fine!”. While this advice might be well-meaning, as speech-language pathologists (SLPs), we cannot advise that parents follow the “wait and see” approach. Evidence shows that early intervention is the most effective way to support children who may be falling behind on meeting developmental milestones. The best time to seek out an evaluation with an SLP is when you notice that your little one is falling behind on meeting their speech, language, or feeding milestones. It is never too early (or too late!) to start therapy.
When Should I Be Concerned?
Signs that your child may need speech therapy may be subtle at first, but without intervention, the gaps may become wider as your child has difficulty keeping up their communication or feeding skills at the same rate as other children their age. We recommend speaking with your pediatrician if you have any concerns or scheduling a free consultation with one of our SLPs. Here are some signs by age that you your child may benefit from speech therapy:
18 Months
Not able to make a variety of sounds
Relies on grunting to communicate
Has less than 20 words (at minimum)
Does not point or use gestures
2 Years
Not able to identify body parts
Not able to point to a variety of common objects
Has less than 50 words (at minimum)
Not combining two words together, such as “want milk”, “car go” or “blue ball”
3 Years
Not combining words to form sentences at least 3 words in length
Is not able to name most items or actions that occur as part of their everyday routines
Difficulty following 2-3 step directions, such as “Go get your shoes and put them in the basket”
Difficulty talking or playing with other children
Being hard to understand, even to people who know the child well
Repeating the first sounds of words (“b-b-b-ball” for ball), pausing a lot while talking, or stretching out sounds in words (“ffffffarm” for farm).
Feeding Milestones: Just like speech and language, there are feeding milestones too! Concerned about feeding? Read more on the critical milestones of feeding here. Here are some red flags your little one may benefit from speech therapy to improve their feeding abilities:
Cries or fusses while eating
Has difficulties breastfeeding
Has trouble breathing while eating or drinking
Refuses to eat or drink
Aversion or avoidance of all foods in specific texture or nutrition group
Difficulty chewing
Coughing or gagging while eating
Has liquid come out of their mouth or nose
Is not gaining weight or growing
Inability to accept any table food solids by 12 months of age
Inability to transition from breast/bottle to a cup by 16 months of age
Parent repeatedly reports that the child is difficult for everyone to feed
Parent reports the child is a picky eater for 2 or more well visits
What Can Speech Therapy Help With?
Speech therapy can help treat children with communication problems, including improving understanding and using language, producing speech sounds, and stuttering. Speech therapy can also help with oral motor problems, including difficulties with chewing and swallowing.
The first step is scheduling an evaluation to determine what problems your child may be facing. From there, you and your child’s therapist work together to create an individualized treatment plan.
How Can I Support My Child’s Communication and Feeding Development At Home?
Use short words and sentences. Speak clearly.
Repeat what your child says, and add to it. If she says, “Pretty flower,” you can say, “Yes, that is a pretty flower. The flower is bright red. It smells good too. Do you want to smell the flower?”
Let your child know that what he says is important to you. Ask him to repeat things that you do not understand. For example, say, “I know you want a block. Tell me which block you want.”
Teach your child new words. Reading is a great way to do this. Read books with short sentences on each page.
Name objects, and talk about the picture on each page of a book. Use words that are similar, like mommy, woman, lady, grown-up, adult. Use new words in sentences to help your child learn the meaning.
Ask your child to make a choice instead of giving a “yes” or “no” answer. For example, rather than asking, “Do you want milk?” ask, “Would you like milk or water?”
Sing songs, play finger games, and tell nursery rhymes. These songs and games teach your child about the rhythm and sounds of language.
Talk to your child in the language you are most comfortable using.
As your child’s parent or caregiver, you know your child best! Trust your instincts. If you have concerns about your child’s communication or feeding milestones, feel free to contact us and we will be happy to help answer any questions.
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