We love to hear the first sweet sounds from newborn babies when we feed them and cuddle with them. Then they quickly progress to happy babbling and, at last, WORDS! All within a fast moving, short 12 months. Somewhere between the ages of 3 and 4 years old, a parent may say, “My child has so many words; I couldn’t possibly count them!” Then, babies progress to speaking sentences, having conversations, and using their words for imaginative play. Of course, there are also the fun word skills they learn when they enter the amazing world of reading.

This describes typical, fantastical language development ... BUT what if things are not typical? What if there are concerns? What can the parent expect? When should a parent seek help and from whom?

Some concerns may include:

1. Little or no babbling. Well-formed babbling should be in place by 10 months of age at the latest. Vowel sounds, e.g., ah, oo, ee, etc., are used first, and then they will start pairing consonants with vowels to make syllables like, “ba-ba-ba-go-da-tee” and more.

2. Slow in saying first words (after 12 months)

3. Vocabulary count is low. (See my previous blog on Is my child's speech 'normal?' )

4. Significant drooling beyond 18 months of age.

5. Difficulty understanding what your child says or you are one of the few people that can understand what he or she says.

6. Not speaking in 2 -3 word combinations by 24 months of age, e.g, “I fishing;” “My toys;” etc.

7. Child acts frustrated by difficulties with his or her own communication skills.

8. Child overuses gestures to communicate his or her wants and needs.

9. Poor eye gaze to the speaker’s face.

10. Lack of variety of play skills.

11. Lack of interest in engaging others in play.

Who can help a parent sort out these concerns?

Talk with your pediatrician and ask for referral to a speech/language pathologist for an evaluation if you have concerns. A speech-language pathologist (SLP) is educated and trained to evaluate and treat communication problems from birth through to adulthood. A speech/language evaluation will identify your child’s communication strengths and challenges, and a plan of care will be recommended, if necessary. You, as the parent, will want to see a SLP who is experienced with children.

Speech/language therapy can be provided in a number of different settings - therapy provided in a clinic setting is primarily on an individual basis: one child – one therapist. Therapy provided in the public schools is typically in a group setting. Different settings and models of care can be selected based on your child’s and family’s needs. Participating with your child in therapy is an important part of care and will help maximize your child’s progress.

We all want our children to develop skills with ease. Remember, when that development is on a continuum and there is a range of typical development. However, if there is a concern, ask your doctor for a referral to see an SLP. By identifying potential challenges early and obtaining intervention such as speech/language therapy, the outlook is definitely brighter. Early identification and intervention are key.

For more information:

• Cook Children's speech therapy
• Is my child's speech 'normal?'
•  http://www.cdc.gov/ncbddd/childdevelopment/screening.html
• http://www.cdc.gov/ncbddd/actearly/pdf/parents_pdfs/developmentalscreening.pdf
• http://www.cdc.gov/ncbddd/childdevelopment/freematerials.html - Positive Parenting tips based on child’s age.
• http://www.asha.org

That question makes me cringe. Not because of the question itself. I understand it. As parents, we all want what’s best for our children. I’m not afraid of the question or looking to evade it. It’s just who is making the choice on what’s “normal.” I use the opportunity to talk to parents. To reframe what may be thought of as normal, go over their concerns and provide perspective.

Here are some basic guidelines that I give to parents on how a child should be developmentally from 1 to 6 years old. Every child is different and this is only a starting point. If you have you concerns, please talk with your pediatrician for a referral to a speech/language pathologist.

• 12 months old - Children usually can say 1-21 words on their own, actively listen, wave bye-bye, look around when asked, "Where is __?" and use real and toy objects to act out common actions, e.g., feeding, cleaning, etc.
• 24 months old - Speak 145-150 words, combine 2-3 words, produce plural - s and - ing words, enjoy nursery rhymes, finger play and songs and put 2-3 actions in symbolic play.
• 30 months old - Say 360-600 words, speak in simple sentences, have his or her speech understood by family members, listen to real stories and start role playing in life experiences, such as going to the doctor.
• 36 months old - Say so many words you can't count them, have his or her speech understood by more than half the people your child meets, use "I, me, my and you" correctly. Answer what, where, when and who questions and retell familiar stories. At this age, children should be asking questions, not learning to read yet, but enjoying books and making friends. 
• 4 years old - Your child should start playing with words and making up stories. Most children at this age will be playing with friends and pretending to be a superhero, a cowboy, a parent or an animal. Children may begin using voices as characters and creating their own costumes and props.
• 5 years old - Most children at this age have started school. They can sit and listen for a whole story. They will start using words such as "know, understand and think." They will talk to ask questions, to explain things and to imagine.
• 6 years old - At this age, most children begin to speak more like grownups, especially at school. They can be polite when talking and know when adults don't understand what they have said. Often times, children will be able to change what they originally said to be better understood. Children at this age should be able to use all of their speech sounds and begin reading.

You know your child better than anyone and of course there will be times when your child just won't pay attention or doesn't feel like reading. But these general guidelines should be taken into account as an overall view of your child's development. I hope this helps give a better understanding of what we observe as speech patholigsts at Cook Children's.

*The vocabulary ranges used in this blog are based on MacArthur-Bates CDI.

About the author

Carol Edley, M.S., CCC-SLP, is a speech/language pathologist at Cook Children's. Speech/language pathologists focus on oral motor, speech, language and communication skills to enhance development, restore function and to prevent disability from pediatric conditions, illness or injury.

That question makes me cringe. Not because of the question itself. I understand it. As parents, we all want what’s best for our children. I’m not afraid of the question or looking to evade it. It’s just who is making the choice on what’s “normal.” I use the opportunity to talk to parents. To reframe what may be thought of as normal, go over their concerns and provide perspective.

Here are some basic guidelines that I give to parents on how a child should be developmentally from 1 to 6 years old. Every child is different and this is only a starting point. If you have you concerns, please talk with your pediatrician  for a referral to a speech/language pathologist.

• 12 months old - Children usually can say 1-21 words on their own, actively listen, wave bye-bye, look around when asked, "Where is __?" and use real and toy objects to act out common actions, e.g., feeding, cleaning, etc.
• 24 months old - Speak 145-150 words, combine 2-3 words, produce plural - s and - ing words, enjoy nursery rhymes, finger play and songs and put 2-3 actions in symbolic play.
• 30 months old - Say 360-600 words, speak in simple sentences, have his or her speech understood by family members, listen to real stories and start role playing in life experiences, such as going to the doctor.
• 36 months old - Say so many words you can't count them, have his or her speech understood by more than half the people your child meets, use "I, me, my and you" correctly. Answer what, where, when and who questions and retell familiar stories. At this age, children should be asking questions, not learning to read yet, but enjoying books and making friends.
• 4 years old - Your child should start playing with words and making up stories. Most children at this age will be playing with friends and pretending to be a superhero, a cowboy, a parent or an animal. Children may begin using voices as characters and creating their own costumes and props.
• 5 years old - Most children at this age have started school. They can sit and listen for a whole story. They will start using words such as "know, understand and think." They will talk to ask questions, to explain things and to imagine.
• 6 years old - At this age, most children begin to speak more like grownups, especially at school. They can be polite when talking and know when adults don't understand what they have said. Often times, children will be able to change what they originally said to be better understood. Children at this age should be able to use all of their speech sounds and begin reading.

You know your child better than anyone and of course there will be times when your child just won't pay attention or doesn't feel like reading. But these general guidelines should be taken into account as an overall view of your child's development. I hope this helps give a better understanding of what we observe as speech patholigsts at Cook Children's.

*The vocabulary ranges used in this blog are based on MacArthur-Bates CDI.

About the author

Carol Edley, M.S., CCC-SLP, is a speech/language pathologist at Cook Children's. Speech/language pathologists focus on oral motor, speech, language and communication skills to enhance development, restore function and to prevent disability from pediatric conditions, illness or injury.