Does your child need therapy?

If you think your child has a speech problem…

Each child is unique, and the determination as to whether a child would benefit from speech and language treatment must be made on a case-by-case basis. In order to determine whether therapy is appropriate, there must be an evaluation from a qualified speech and language pathologist, who will evaluate a number of areas. (See, “Evaluation Areas”) The following is intended to provide some general information regarding typical speech and language development, and can help you assess whether to consult a speech and language pathologist.

Typically, a child's speech sounds will develop as he or she grows. A baby generally makes early vocalizations around two or three months, begins to babble around six months and uses jargon from about eighteen months to thirty months. By age three, the majority of sounds a child makes should be easily understandable. Although a three year old may not use all sounds correctly, he or she should be intelligible to others.

Shelly and Child

Signs that your Pre-School and Elementary School age child may need an evaluation:

  • If your child has no words by 18 months.
  • If your child has no phrases by two years of age.
  • Little to no vocabulary growth between the ages of 18 months and 2 years.
  • Continued use of pointing, grunting and gesturing to communicate at 2 years.
  • The child who can say words clearly, but is unclear in phrases and sentences.
  • The child who deletes sounds from words past 3 years old.
  • The child who says a word several times and is unable to repeat it on command.
  • If no new sounds are developing.
  • If speech is unclear.
  • If parents are the only ones who can understand their child.
  • If your child is frustrated (commonly manifested by aggressive behaviors, such biting or hitting, or by withdrawing) due to inability to communicate his/her wants or needs.
  • If your child has had several ear infections, or seems to have difficulty hearing (see an Audiologist for a hearing test).
  • Inability to express himself/herself.
  • Limited vocabulary or dropping previously learned words from their vocabulary.
  • If your child exhibits inconsistent or reduced understanding of language.
  • If echolalia (repetition of phrases that the child has just heard) is present beyond the age of two.
  • If your child responds inappropriately to questions.
  • Appears to be confused when spoken to.
  • Inability to recognize common objects by 12–15 months.
  • Inability to follow simple directions by 12–15 months.
  • Childs dependence on speaker's gestures in order to follow directions.
  • Child requires frequent repetitions of directions.
  • Inability to answer simple yes/no, who, what, where questions by 2 years.
  • Asking for repetitions of a command or question.
  • Appears as if he/she is not paying attention.
  • Poor social interaction, dynamics with peers and adults.

Summary of Speech sounds development:

  • Age   Consonants
  • 3      m,n,ng,p,f,h,w
  • 3½    y (as in yes)
  • 4      k,b,d,g,r
  • 4½    s, sh (as in shoe), ch (as in chair)
  • 6      t, v, L, th (as in thin)
  • 7      z, zh (measure), th (father), j (jump)

Norms from Mildred Templin, Certain Language Skills in Children, 1957.

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Shelly and Child

Middle School and High School age children are a significant percentage of the clinic population seen at Milstein Pediatric Speech and Language Services. There are many behaviors that parents may notice at home, or which may be observed by teachers in the classroom, that are indicators of a potential need for a Speech and Language evaluation.

While the following is not intended to be a comprehensive list of potential indicators of a speech or language problem, if your child has any of the attributes or behaviors listed below, it may indicate a potential speech or language problem, and the need for a formal evaluation.

Signs that your Middle or High School age child may need an evaluation:

  • Your child has difficulty remembering names, dates and times;
  • Your child has difficulty following simple directions;
  • Your child has difficulty following multi-step directions (such as “open your book, turn to page 10 and ready chapter three);
  • Your child has difficulty comprehending written materials (reading decoding);
  • Your child is slow to respond to questions;
  • Your child has difficulty with higher level information, Your child has difficulty drawing inferences or problem solving (abstract reasoning);
  • Your child frequently asks for repetition of information;
  • Your child does better, in comprehension or attention, in one-on-one settings;
  • Your child has difficulty with note taking, is unsure what should be highlighted, and has difficulty prioritizing important information;
  • Your child has word finding difficulties, Your child has difficulty coming up with the appropriate word(s);
  • Your child has difficulty with spontaneous formulation skills (expressive language).
  • Your child has difficulty articulating information in a smooth and cohesive utterance, and may also manifest difficulty in written expression;
  • Your child may respond with off-target responses to questions;
  • Your child has difficulty understanding speech with background noise, and is easily distracted by auditory stimuli;
  • Your child has difficulty with spelling;
  • Your child has difficulty with articulation.

As is true at any age, each older child is unique. The fact that your child has manifested one of more of the above attributes is not necessarily indicative of a speech or language problem, since these symptoms can also be attributed to other disorders, such as an attention deficit disorder or a learning disability, or to other factors. A determination as to whether your child would benefit from speech and language, or other, therapy must be made on an individualized basis. In order to determine whether therapy is appropriate, there must be an evaluation from a qualified speech and language pathologist, who will evaluate a number of areas. (See, “Evaluation Areas”)

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Evaluation Areas — when a child is seen by a Speech and Language Pathologist, there are three major areas that are evaluated.

What Are Central Auditory Processing Problems in Children?

Developmental Speech & Language Milestones