“I…milk!” my eldest son would say at about three years old, meaning of course, “I
want milk.” It’s hard to believe now that my articulate 10-year-old son was once
diagnosed with a speech delay. At the time, however, I found it pretty traumatic
when I saw his ability to vocalize lagging far behind his friends. At age two, his
peers were forming two-word sentences while I was desperately writing a list of
four or five words my son seemed to understand and pronounce.
Speech or language delay are not uncommon. These range from sound substitution (making
a t sound instead of a k, for instance) to being unable to use or understand language.
How a given delay is treated depends both on the specific problem and its underlying
cause.
Common causes
If you can’t hear what a word is supposed to sound like, then you can’t make that
sound properly. So it’s not surprising that hearing loss is one reason for communication
trouble. There are two main types of hearing loss:
Conductive loss is the result of any condition that interferes with the transmission
of sound through the outer and middle ear — a bacterial infection, a waxy blockage
in the ear canal or a damaged eardrum. Usually your family doctor, or an ear, nose
and throat specialist, can treat conductive hearing loss problems.
Sensorineural loss occurs when the inner ear or acoustic nerve is damaged. This
type of hearing loss can be diagnosed soon after birth, and screening programs are
in place in Ontario, New Brunswick, PEI, BC and the Yukon. According to The Hearing
Foundation of Canada’s website, when babies are diagnosed and treated for hearing
loss by six months, their language levels are higher — with no evidence of the developmental
delays seen in children diagnosed after six months.
But language delays aren’t always the result of hearing impairment. In some children,
the physiological systems responsible for communication sometimes take longer than
usual to mature. My son was one of these “late bloomers.”
These types of communication problems generally fall into one of two types:
Expressive language delays occur when a child has difficulty sending a verbal message.
A two-year-old whose language is limited to only one or two words or a child who
talks a lot but is difficult to understand are both examples of expressive language
delays.
Gabriel from Ontario Canada., was diagnosed as having an expressive language delay
when he was 18 months old. His mother, Leslie Hodges, noticed that compared with
his peers, Gabriel seemed unable to say any words. With the help of a speech-language
pathologist, Gabriel worked with his family to learn to pronounce consonants and
“to remember where those sounds were in a word,” says Hodges. Now nine, Gabriel
is doing well. “He’s reading now,” says Hodges, “at a lower grade-four level, but
he is reading.”
Receptive language delays affect a child’s ability to make sense of messages that
are sent or to follow instructions. “A child who is two years old and can’t identify
body parts yet” is typical of this kind of language delay, explains Basiliki Passaretti,
a speech-language pathologist in Hamilton.
David MacDonald,* a Hamilton preschooler, couldn’t understand such questions as
“What is he doing in the picture?” or “Where is the ball?” and couldn’t respond
appropriately. After weeks of therapy, involving play-based interactive activities,
such as special board games where players practice asking and answering questions
in a natural way using vocabulary from the game, David learned to reliably answer
“what” and “where” questions, and is now working on “who,” “why” and “how.”
What can be done?
What should you do if you think your child has a speech or language delay? You can
contact your local preschool speech and language service. You can also see your
family physician for assessment and possibly a referral to the nearest service in
your community.
Sandra Seigel, a paediatrician, encourages parents who are concerned about their
children’s communication skills to address the issues early on “because it helps
to tease out if these are just children who are a little bit slow at acquiring speech
and language skills, but will catch up later on — which is the vast majority — or
if there’s something more going on.” Seigel feels that it is encouraging and significant
if the child is a little bit behind in gaining language skills, but is gaining other
milestones. An early screening helps pick up if there are other developmental delays
such as social and motor development skills. “A lot of kids do catch up as they
get older,” says Seigel.
Early intervention certainly helped with my family. It started the ball rolling,
slowly at first, but with increasing momentum and now it never seems to stop moving.
These days, I eagerly look forward to evening chats with my son. Sitting on the
edge of his bed at night, I love listening to him talk about what new skateboarding
tricks he’s learned and what makes him happy. And that’s a development worth talking
about.
Stepping Stones to Speech
Is your child where he ought to be on the road to communication? Early Words, a
Hamilton preschool speech and language service, offers a map of language milestones:
Age 1
- says first word
- follows simple commands
- gestures and/or vocalizes to indicate wants and needs
Age 1½
- uses about 50 words
- uses connected sounds that sound like sentences in a foreign language
- begins to understand categories like food, toys, animals and clothing
Age 2
- 200 to 250 words
- uses two-word sentences
- follows two-step commands
- uses negatives such as “not” and “no” in combination with another word
Age 3
- vocabulary has increased dramatically
- uses plurals
- follows longer two- to three-step commands
Age 3 ½
- uses four to five words in a sentence
- asks questions using “what,” “where,” “who” and “why”
- can count up to three objects and identify primary colours
Age 4
- speaks in complete sentences that can be five words or longer
- uses the past tense ending of “ed”
- is interested in and able to listen to longer stories
Talking Tips
Help take the worry out of words by making language fun. Try these tips from the
University of Michigan Healthy System to encourage your child’s ability to use language:
- Start talking to your child at birth. Respond to your baby’s coos and babbling.
- Play simple games with your baby like peekaboo and patty cake.
- Listen to your child and look at him when he talks to you.
- Describe to your child what he is doing, feeling and hearing through the day.
- Encourage storytelling and sharing information.
- Don’t try to force your child to speak.
- Read books aloud. Ask questions (“What do you think is going to happen next?”).
- Sing to your child and provide him with music.
- Expand on what your child says. For example, if your child says, “Dog!” you can
say, “Yes, the big dog is running.”
- Look at family photos and talk about them.
- Answer your child every time he speaks as this rewards him for talking.
- Don’t criticize grammar mistakes, just model good grammar.
- Play with your child one-on-one, and talk about the toys and games you are playing
with.
By Holly Ginsler. This article is kindly provided by:
