Communication Skills: Slow to Develop or Delayed?

By Jordan Sadler, SLP

New parents look forward to their child’s first words with great anticipation.  We want to hear that cute little voice, and start to understand better what our child is thinking about.  We dream about how easy parenting will be when our child is able to tell us what he wants with words rather than cries.

But what does it mean when the child in your life is the last one in the playgroup to utter those first words?  What if you are the only one who understands those first words?  What if he starts to stutter all of a sudden at age 3?  And what about that 1st grader who is still lisping? When is it normal and when does it require remediation?  How do we know when we should become more concerned?

“Einstein didn’t talk until he was four,” well-meaning people are fond of saying.  Then there’s the other playground stand-by, “He’s a boy--boys are slower than girls to talk.”  And finally we have the pediatrician’s response, “Let’s just wait and see,” which does many children a huge disservice because it delays critical early intervention so often.

So how do we know? 

First of all, we need to realize that “normal” is a range when it comes to development.  In other words, although there is a distinct sequence of developmental milestones, there is a somewhat broad time line in which they should emerge.  Some children are going to be verbally precocious, while others take their time; both profiles are perfectly fine, most of the time.

It can be difficult, even for professionals, to tell the difference between a child who is simply a “late bloomer” and one who is presenting with a true speech and language delay or disorder.  Researchers have not learned to discriminate clearly between the two at an early age.  Often, a professional will recommend speech-language therapy just in case there is a true delay in development, and knowing that even the “late bloomer” would benefit from a little boost.

There are excellent free online resources available today for parents who are concerned about a child who seems to be having difficulty understanding and/or using language.  Here are a few of the most trusted sources:

American Speech-Language-Hearing Association
ASHA is the professional, scientific, and credentialing association for speech-language pathologists and audiologists in the U.S.  Their website (http://www.asha.org) has many useful tools, including information on typical development, bilingual development, stuttering, age-appropriate activities to enhance development, how to find a professional in your area, and more.

Zero to Three
This national non-profit organization is dedicated to promoting education regarding healthy development for infants and toddlers.  Zero to Three also has a fantastic website at www.zerotothree.org which has many reliable offerings for parents.

First Signs
Found at www.firstsigns.org, the First Signs website provides parents with information related to early identification of developmental delays and disorders.  For families concerned about the presence of a possible autistic spectrum disorder, First Signs has an exciting new offering – there are video clips available online which show specific comparisons between children developing typically and those with an autistic spectrum disorder.

If you are seeking a speech and language screening or evaluation for a child in your care, there are a few options.  All families are eligible to request assistance from trained professionals through Early Intervention (ages 0-3) or your local public school district (ages 3 and up).  Also, some insurance carriers provide coverage for therapists in private practice.  Your pediatrician may be able to make a referral for you.

When it comes to concerns about your child’s development, please don’t take a “wait and see” attitude. If your child would benefit from intervention, pursue it sooner rather than later.

Comments

[Kathryn Johansen]

Our situation is proof positive that you should not wait. When my son was 20 months of age he received a diagnosis of ASD. To me and my husband, there was nothing THAT glaring. Now at age 5 1/2, he still has not begun speaking but he is picking up signs and trying hard to talk. He says a few words. But, when he was 20 months, or 3 years old, etc., it was still hard to tell what was going on. Now, of course, the delay is glaring. Who knows where we would be without the therapy we began at 2 years of age? By the way, both OT and ST basically were doing the same things...both were just trying to get him motivated enough to respond to something. Even in speech, our therapist first used a swing or a trampoline and worked closely with the OT. Getting the child's attention and retaining it for as long as possible is the key. My OT would hold my son upside down and then tickle him. She then got great eye contact and would sit down and do a puzzle with him. Words popped out when she did that. I say be on the safe side and do therapy!

[Niksmom]

I couldn't agree more! All the doctors and nurses who told us "Oh, Nik will catch up, don't worry!" did do Nik (and us) a great disservice.

[drama mama]

Why would anyone want to take a risk with something as important as their child's development?

Denial?

Do everything possible. Whatever means necessary.

Period.

[Susan E]

Oh, we struggled with this. And we chose therapy pretty much immediately, but it was so hard--we didn't want to "overreact," "pathologize," etc. So it meant doing one thing, while we reserved judgment on the other. I wouldn't do anything differently if I had to do it again, except, perhaps, to obsess less. :-)

[Ellen Gerstein]

Is there a chance that therapy services could be deterimental to a child? I can't think of many sitations, other than with a poor provider, where this is the case. Why wouldn't you want to get your child evalauted? Why not have more people in your court, advocating for your child.

Great post, BTW.

[Emily]

I'm relieved the read the responses to this post. After our oldest was dx'd with Asperger's, I started to think when our youngest was born and as I watched our middle son mature that I was becoming paranoid, looking for problems in every little thing. I was in denial because I was worried about being too aware.

Now that our baby is 16 months old and has yet to utter anything except "da," which he says for everything, and has yet to indicate any kind of special idiom for the people in his life, I feel that concern. And I have asked myself, am I just overreacting? But taking this sign along with several others (he walks like John Wayne, he has delayed motor development and retained primitive reflexes, he swings one arm when he walks but tucks the other, etc.), I have to feel like these are objective signs of issues that could be ameliorated with therapy.

And if that's not enough, just reading the comments here is enough. "Do everything possible." Yes, we are and we will. But it's nice to know that others heartily concur.