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Speech Delays

Overview
We eagerly await our children's first words, so it can be disappointing  -- and worrisome  -- if they're slow to come. But the good news is that most kids who seem to talk "late" catch up without any problems by the time they're around 2. About one in four children is a late talker  -- and most don't need special help to get them on track. Here's what to expect with your child's speech development, and how to tell if you need to see a specialist.

What's normal
Though speech develops pretty much the same way for all children, the pace can vary considerably from child to child. As a rule of thumb, children should be able to say one word at about 1, two-word combinations at 18 months to 2 years, and three-word sentences before turning 3. When speech specialists evaluate delayed speech, they care as much about a child's understanding as they do about how much he speaks. For instance, although a typical 18-month-old can say 50 to 100 words, he can understand far more. Making gestures and following directions indicate that your child is understanding and communicating, and there's likely little reason to worry. The American Speech-Language-Hearing Association offers a detailed chart of language development.

Reasons behind speech delays
Heredity and temperament can make for a linguistic late bloomer, as can a parent's anticipating a child's every need ("Do you want your bottle?") rather than letting her speak for herself. Some kids who tend to be late talkers include:

Boys: They often develop speech later than girls, though there's usually only about a one- to two-month lag. At 16 months, boys use an average of 30 words, while girls tend to use around 50.

Preemies: Babies born early often take longer than others to reach milestones, but by age 2 they usually catch up to their peers. Pediatricians say that when gauging a preemie's development, parents should begin counting from the child's due date, not her birth date. A child born three months early can seem like a later talker but might be progressing just fine.

Multiples: Speech pathologists estimate that as many as 50 percent of all multiples have some language delay. Prematurity, low birth weight, and medical intervention at birth  -- all of which occur more often among multiples  -- can contribute to language delays.

Children with chronic ear infections: If fluid in the ear persists for months at a time  -- especially during the first year, when a child is starting to process language  -- it can result in poor hearing, and thus delayed speech.

Kids who are focused on other skills: If a child is late to talk but her overall development is progressing on schedule, she may just be trying to perfect one skill, like walking, at the expense of speaking.

Signs your child might have a delay
Before your child reaches age 2, there's wide variation in what's considered normal. But some signs that may indicate he needs help:

At 1 year: He isn't babbling or speaking in mock sentences at all. He doesn't seem to understand or respond when you talk.

At 18 months: He hasn't said at least one word.

At 2 years: He says only a few words and communicates mostly through grunting and pointing, or he's losing language skills  -- either his vocabulary has shrunk or he no longer talks very much.

At 2 1/2 years: He's still speaking in single syllables, drops final consonants, or doesn't have a vocabulary of 50 words.

At 3 years: Strangers can't understand his pronunciation, or he speaks using only simple two-word phrases.


What to do
The best time to get professional help is when your child is around 2 1/2  -- the age when late bloomers usually catch up. Language problems are addressed with speech therapy or by treating undiagnosed ear infections or hearing problems. Your pediatrician can recommend a speech-language pathologist; the American Speech-Language-Hearing Association, in Rockville, Maryland (800-638-8255), can also provide a referral.

Before age 2 1/2, listening to your voice is a great way for your child to learn to talk, so read aloud, sing songs, and ask open-ended questions to invite conversation. Blowing bubbles can develop oral muscles, and toy phones and pretend play encourage talking.

 

Speech Development 

Newborn to 3 months
Babies begin to coo and gurgle at 1 to 3 months. Instead of simply being startled by sounds, babies start to respond more specifically to sounds — first by turning their heads and changing their facial expressions and then by actually cooing and gurgling. These sounds will probably be music to your ears, as well they should be. You can consider these sounds to be your child's first words to you, as simple cooing and other verbalizations represent the very beginning of language development.

3 to 6 months
Babies at this age enjoy making sounds. Not only do they like to laugh and squeal with pleasure and excitement, but they perfect their ability to gurgle, coo, and blow raspberries. Some begin to make consonant sounds (n, d, p, b), most can link sounds with the objects that made them, and by the time they reach 6 months of age, they often start to actually imitate sounds.

6 to 9 months
Babies will babble at this age. During these months, most babies start to vocalize a lot more in ways other than crying, not the least of which is laughing more frequently. You're also likely to notice a progression in your baby's talking abilities — from making four different consonant sounds or stringing together chains of vowel-consonant sounds to combining syllables into word-like utterances and shouting to attract attention.

9 to 12 months
Babies will say their first words during this time. At 9 months, infants are often fairly talented at multi-syllable babbling and imitating sounds. Over the subsequent months, you may find that your baby starts to imitate the tone and inflection in your voice as well and may even say his first word.

Words such as "mama" and "dada" clearly have meaning to infants at this age, and some will even say them by the time they turn 1. ("Dada" is much more common than "mama," not as a reflection of a baby's preference, but because "da" is a much easier sound to make than "ma.")

Also at this age babies develop improved nonverbal communication skills. This is a fun age, where many babies not only start to communicate verbally, but clearly seem to understand more and interact more. They typically learn to point in response to simple questions such as "Where's the ball?" or "Where's Mommy?" and to wave good-bye.

12 to 18 months
Kids this age will continue to improve their communication skills. By 12 to 15 months, the average child says two or more words besides "dada" and "mama." Some 18-month-olds will even begin to put two words together, although this is considered to be a 2-year-old accomplishment.

In addition to talking, most toddlers at this age can imitate animal sounds, recognize objects by name, and follow commands. You're likely to find that this newly developed ability to follow directions is particularly endearing when your toddler begins to give a hug or kiss when asked.

While your toddler is probably making great strides in communicating at this age, it helps to be aware that toddlers at this age can become very frustrated because they can understand a lot more than they can say.

18 to 24 months
Toddlers at this age will greatly increase their vocabulary and ability to understand. The average toddler toward the end of the second year can say 30 to 50 words and make two-word sentences. Even more impressive is their ability to understand and follow simple commands.

2 years
Two-year-olds talk in sentences. While the typical 2-year-old has a vocabulary of 30-50 words and can put two words together, another year of language development usually brings the ability to make three-word sentences and communicate more effectively.

Not only do children start to use pronouns such as I, me, you, and we, but they also start to use them to express emotions (in ways other than through tantrums!).

Two-year-olds also learn to name and categorize. They commonly learn the names of five or more body parts and are able to recite their own names (first and last) by the time they reach their third birthday. Sorting objects according to category and understanding descriptive categories like "big" and "little" or "soft" and "hard" are also typical accomplishments at this age.

By the time a child is 3 years old, grown-ups should be able to understand at least 75 percent of what he says.

3 years
Three-year-olds have greatly expanded language skills. During this year, you're likely to notice that the length of your child's sentences increases from around three words at her third birthday to five (or more) by her fourth. By this time, most children have also become fully understandable.

As your child masters the use of pronouns (I, me, you, we, etc.) during the upcoming months, be forewarned that you're also likely to find that she has entered a new stage of development that includes asking a whole lot of questions.

4 years
Four-year-olds make good use of their language skills. During this year, you're likely to notice that your child masters language well enough to put sentences together into full stories and just generally talk your ear off.

5 years
Five-year-olds can understand harder concepts and begin to increase their vocabulary. They typically can understand and apply concepts such as "under," "over," "because," "why," "before," and "after." They often have vocabularies of more than 2,000 words.

http://tinyurl.com/68tljx5 The Parent’s Guide to Speech and Language Problems
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