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Sharp Health News

How to know when a child needs speech therapy

July 26, 2017

How to know when a child needs speech therapy

Every child learns and develops at his or her own rate. While some children begin to develop earlier than others do, many parents become concerned when their child is not speaking when their peers are.

“It’s important to keep in mind that not all children progress at the same pace,” says Jordan Weber, a speech language pathologist at Sharp Rees-Stealy Medical Centers. “However, there are key milestones that children should reach.”

“It’s important to watch for specific behaviors that should prompt a referral for a speech and language evaluation,” adds Weber.

The following milestones are considered normal when it comes to language and speech development:

By 18 months:

  • Imitate words and short phrases
  • First words continue to emerge — i.e., vocabulary of 20 or so words
  • Understand more words and phrases than produced

By age 2:

  • Vocabulary expands to about 50 words — rapid language and vocabulary expansion is typically seen at this age
  • Start to combine words together, such as “mommy up” or “more milk”
  • Masters pretend play, such as feeding a baby doll
  • 50 to 75 percent of speech is understood by family and friends

By age 3:

  • 90 to 100 percent of speech is understood by familiar listeners
  • 75 to 100 percent of speech is understood by an unknown listener (people who they do not see often)
  • Correctly produces vowels and early developing consonants — such as b, p, m, w, h — in words
  • Repeats phrases when not understood
  • Able to identify self by name and state age

By age 4:

  • 90 to 100 percent of speech is understood by unfamiliar listeners
  • Consistently produces speech sounds — i.e., t, d, k, g, f, j

By age 5:

  • Understood by all listeners in most situations
  • Correctly produces most speech sounds — with the exception of r and th

By age 6 to 7:

  • Can tell stories with a clear beginning, middle and end
  • Asks and answers questions and comments during conversation
  • Consistently produces letter sounds and combinations, such as l, r, sh, ch, zh, ing, v, th, s and z

What to do when a child isn’t meeting these normal milestones
According to the American Speech-Language-Hearing Association, studies show that positive outcomes increase when early intervention is provided for children with language delays and other developmental conditions.

“Speech language assessments are critical for early intervention for patients diagnosed with a variety of medical conditions, such as Down syndrome, autism spectrum disorder or hearing loss,” explains Weber. “It is important to provide early intervention to allow a child with a developmental delay to have the opportunity to master fundamental language skills and prevent the child from falling further behind.”

Weber suggests these five ways to encourage language growth:

  • Talk to your child daily
  • Read books and ask questions throughout
  • Give the child time to respond
  • Tell stories
  • Engage in interactive play

“Ultimately, it’s important to never criticize the way your child is speaking; rather, recast what they are producing correctly and expand on what they are saying,” says Weber.

For more information about additional speech and language disorders or language delays, talk to your pediatrician. Information is also available from the American Speech-Language-Hearing Association.

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