Category Archives: Speech Therapy

Is My Child’s Speech Normal?

My child’s speech & language skills… are they delayed?
by Michelle Turkoglu, Speech Therapist at ABS

A colleague of mine mentioned that when he meets his friends’ children or sees children out and about, their speech and language skills seem to differ greatly. The children are all around the same age and don’t appear to have any developmental delays such as Autism, syndromes or other disorders, so why is their language so different?

The easy answer is that there is a wide range of what is considered “normal” for speech, language, and communication development. And while that’s true, it doesn’t help parents, caregivers, teachers or anyone who works with children a good idea if the child needs therapy support or not.

Pediatricians, teachers, speech-therapists and the internet can all provide you with charts, graphs and lists of what is considered typical. While some of this information is accurate, you’ll find that the information can vary from one source to another. It also seems like people are hearing blanketed or general statements that don’t really give enough information. For example, some lists would state that the following milestones should occur between 1-2 years of age:

  • Understands “no”
  • Uses 10 to 20 words, including names
  • Combines two words
  • Waves good-bye
  • Makes the “sounds” of familiar animals
  • Gives a toy when asked
  • Brings object from another room when asked
  • Uses words to make wants known
  • Points to body parts such as eyes, nose, mouth

There is nothing wrong with this information. All these milestones should in fact occur around age 1 and before or right around 2 years. But if an 11-month-old child can do all these things proficiently and a 23-month-old child is just learning these skills, should both be considered “typical”? If we simply based our evaluation off of the “list” we could come to a few conclusions:

  • the 11-month old is advanced
  • the 23-month old is delayed
  • both children are “fine” because there is a wide range of typical

As a speech-language pathologist, I think that these lists can be helpful guidelines but really should be interpreted by a professional with advanced training in child development (SLPs, developmental pediatricians, pediatric neuropsychologist, etc.). The professional that you seek help from should spend some time with the child and engage with him or her in a variety of activities in order to get a good sense of how they communicate and interact. Videos of children at home or in various settings can provide really great insight into how a child is communicating in various environments.

Toddler-Brushing

In the case of the 10-month old vs. the 23-month-old, there could be so many other conclusions drawn once he or she is evaluated by a professional. For instance, the 11-month-old uses well over 10-20 words but all those words are related to a single topic. He or she waves goodbye but only when told to do so and does not look at the person when waving. He or she engages in sing-along but only 1-2 songs from their favorite TV show. They can identify and get items for you but maybe they need the direction repeated several times along with gestures and pointing to understand. So while they can perform the skills that are listed, the manner in which they are performed may be considered “atypical”.

The 23-month-old child may in fact be “delayed” if the listed skills are just beginning to emerge. The extent of the delay would need to be examined. The delay may need therapy to help him or her “catch up”. The delay may be pervasive (continue on) and would definitely need intervention to help him or her develop language skills. On the other hand, maybe the 23-month-old was adopted and is just starting to hear and learn English. Maybe the child’s overall communication, social interaction and other developmental skills are on-track. If we just looked at the “list”, we would consider the child to be delayed or disordered, when in fact, they could just be acquiring a new language (which is not a disorder of speech-language skills).

So if you are thinking that your child may have speech-language-communication delays, getting a professional opinion is the best option. A pediatric speech-language pathologist should be able to determine if your child would benefit from starting therapy right away or explain why he/she thinks that your child does not need therapy.

One final note…As a parent or caregiver, you know your child best. Ask lots of questions. Let the professional know that you’ve done your research and explain why you are concerned. An open dialogue will answer the most questions and help understanding for both the professional and parent.

Helping Talk Gooder

Areas of Need Treated by Pediatric Speech-Language Pathologists

(by Michelle Turkoglu)

When people ask what I do for a living and I tell them, “I’m a speech-language pathologist”, I get a lot of follow-up questions as to what that means or questions about what kinds of cases I may treat or the places where I work. I’ve even found that professionals in related fields such as teachers and doctors are unsure of what a speech-therapist might work on. I think the term “speech-therapist” makes people think that we work on helping people make sounds correctly or help people who stutter. And while those are definitely areas that we treat, “speech and language” covers all areas of human communication. Please check out the following list for a summary of areas that are commonly treated by pediatric Speech Language Pathologists (SLPs). However, experience with certain types of diagnoses or disorders can vary greatly between therapists, so when seeking help from a speech-language pathologist, be sure to ask if he or she is comfortable treating the areas that you are concerned about.

SPEECH

  • Articulation (how words are pronounced)
  • Fluency/Stuttering
  • Voice (vocal quality such as hoarseness or nasality)
  • Volume & Rate (talking too quietly or too loudly or speaking very slowly or too quickly)
  • Apraxia: Usually first observed in young children and is characterized by very little or limited speaking, difficulty in saying words even in repetition, articulation errors that don’t follow a set pattern as seen in phonological disorders or developmental articulation disorders, oral-groping (visible difficulty of the mouth getting out words)
  • Phonological Disorders (patterns of speech errors such as dropping off sounds at the beginning or end of words or dropping one of the consonants in a consonant blend).

RECEPTIVE & EXPRESSIVE LANGUAGE

  • Vocabulary (nouns, verbs, adjectives, categorical labels, multiple meaning words, etc.)
  • Following Directions
  • Grammar & Syntax
    1. Word order/Sentence Formulation
    2. Pronouns
    3. Subject-Verb Agreement
    4. Verb Tenses
    5. Plurals vs Singular
  • Describing
  • Understanding and Answering Questions
  • Using language for a wide variety of purposes (greetings/farewells, requesting, commenting, negotiating, etc.)
  • Inference
  • Nonliteral Language/Idioms 

 SOCIAL-PRAGMATIC LANGUAGE

  • Nonverbal Language (eye contact, appropriate body spatial awareness, appropriate body posture when speaking to someone, understanding & “reading” body language and facial expressions)
  • Conversational Skills (take turns talking, stay on topic, answer and ask questions, use appropriate nonverbal language, etc.)
  • Appropriate Play Skills (be a good sport, learning to win and lose graciously, etc.)

AUDITORY ATTENTION, MEMORY, & PROCESSING

  •  Rote memory (remember a series of numbers or words)
  • Working Memory (holding onto information in order to complete a task or use that information in some way)
  • Attention (maintain attention & stay focused, block out distractions, and know how and when to seek help/clarification)
  • Recalling details to answer questions (i.e. listening to a sentence, a few sentences, or even paragraphs and be able to recall details)
  • Processing language of increased length and complexity
  • Speech Language Pathologists teach students strategies for being able to hold onto information and process information better. These strategies include teaching kids to: subvocalize (say the words back to themselves), visualize (make a mental picture of a word, sentence, sentences), chunk (group a list of numbers or words together as in a phone number), clip (understand the key details and “pull out” these words to subvocalize or visualize).

ORAL-MUSCULATURE & FEEDING DISORDERS

  • Excessive drooling or drooling past 2-3 years old
  • Speech difficulties that haven’t improved
  • Difficulty with eating or drinking (picky eaters, coughing/choking during eating/drinking, avoiding foods, etc.)

 READING & WRITING 

Phonological/Phonemic awareness (which is the understanding of a word’s sound structure)- These skills are needed for the efficient decoding of printed words and the ability to form connections between sounds and letters when spelling

HEARING IMPAIRMENT

AUGMENTATIVE AND ALTERNATIVE COMMUNICATION

For children with limited or no verbal speech, a Speech Language Pathologist can help find other ways to communicate such as sign language, picture exchange communication (PECS), computer-based devices, etc.