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Frequently Asked Questions

Q. My child is not yet talking. How do I know if he needs help of if he is just a late talker?

A. A general rule of thumb about children’s speech and language development is that most children use single words at age 1, two-word combinations at age 2, and three-word phrases at age 3. There can be a number of reasons why children don’t talk. Some of these reasons might be related to problems with hearing, muscle coordination, learning or experience. The best way to find out if there is a problem that your child needs help with is to get professional information through an assessment conducted by a speech-language pathologist.

Q. My child is 2 and I can’t understand everything he says. Should we be getting speech therapy?

A. Speech sound acquisition is developmental. That means that some sounds emerge early and other sounds are not fully developed until age 5 or 6. At age 2, we should be able to understand about 50 percent of what a child says. By age 3, we should be able to understand between 70 and 90 percent of what he says. Some of the last sounds to emerge are the “r,””th” and the “s” sounds. For more information, see Signs of Speech Problems and Speech Milestones.

Q. My child is 3 and still uses a pacifier and sucks his thumb. Will this affect his speech development?

A. Yes, it can. Using a pacifier and thumb-sucking can prevent the tongue from moving into a more natural position for both eating and speaking purposes. The muscles of the tongue may not get enough exercise and could be weaker than they should. The tongue may move independently from the jaw, making sound production difficult. Also, children who have their pacifier or thumb in their mouth don’t spend as much time talking and don’t get the practice they need to learn.

Q. My child can watch videos or TV shows for a long time but he seems to have trouble paying attention to other things, like reading stories, playing with toys and talking with me. Should I be concerned?

A. A short attention span can be a symptom of other learning problems and can interfere with a child’s ability to learn new words, ideas and concepts. Ask yourself these other questions: Can he listen to and follow simple verbal instructions? Will he sit down and share a book with you? Can he choose a toy to play with and play with it for an age-appropriate time before moving on to the next activity? Can he sit down with the family and finish a meal? Can he play successfully with other children? If you answer “no” to several of these questions, you may want to request a speech-language evaluation or a developmental evaluation. See Developmental Evaluation Clinic.

Q. If there is more than one language spoken in my home, will my child’s speech and language development be affected?

A. Many researchers agree that a child who is exposed to multiple languages at an early age simultaneously will naturally learn to use all languages. Children can be expected to go through some periods of mixing two languages and borrowing vocabulary to express ideas, sometimes within the same sentence. Children may not be equally skilled in all languages. It is common for there to be greater understanding than actual use of one language. In general, speech-language problems are less likely to occur when languages are introduced early and simultaneously. There is a greater possibility of problems if children are introduced to a second language during the preschool years after another was used exclusively.

A speech-language evaluation of skills will include evaluation of all languages and will be completed by a bilingual speech-language pathologist, one who has knowledge of the rules and structure of the languages, or the assistance of a translator or interpreter. The discovery that a child has some delays in both languages does not necessarily indicate a need for professional services. These delays may be characteristic of a two-language-learner.

Q. How do I know if my child has a speech/language delay?

A. See Signs of Speech Problems and Speech Milestones.

Q. How can I prevent a speech or language disorder in children?

A. You can help prevent a speech or language disorder by doing the following:

  • Learn about typical speech and language development.
  • Know developmental milestones and ask your physician for an evaluation if your child is not meeting them.
  • Talk and read with your child regularly.
  • Have your child’s hearing checked.
  • Participate in early identification or screening programs.
  • Avoid drinking and substance abuse during pregnancy.
  • Use helmets, car seats and safety belts to prevent brain injury.
  • Spend regular time alone with your child and talk about the things he/she is interested in.

Q. At what age can treatment be done?

A. Our department treats people of all ages, frominfancy through adulthood.

Q. When should I seek help?

A. Deciding when to seek help is entirely up to you. If you have any doubts or questions that aren’t being answered to your satisfaction, then you should seek help until you have your answer.

Q. What can I do at home?

A. When a child is beginning to develop a speaking vocabulary, he uses one word to represent an entire thought. It is entirely normal for the 12 to 18 month old child to say “hot,” meaning “The stove is hot” or “Mommy’s coffee is hot” or to say “daddy,” meaning “Where is daddy?” or “Daddy just came into the driveway.” A somewhat older child whose language is delayed will also use one word to express an idea. While this is a necessary stage in the development of expressive language, there is an excellent technique that parents can use to help their child move naturally and easily into the next stage of language expression: the combining of two words to express thoughts. If your child is already using two-word responses, the same technique will help him to move to three-, four-, five- (and more) word responses.

The technique deals with expansion of your child’s responses and is a simple one to learn and use. When your child makes an incomplete response (be it one word or three words), you interpret the total meaning he intends and then put this into simple, adult language. For example, if he says “cookie,” you would say “Bobbie wants a cookie,” or “Yes, you have a cookie in your hand,” depending upon the situation and the child’s intended meaning. If he says, “Daddy bye-bye,” you might expand this to “Yes, daddy went bye-bye in the car.” In this way, you are giving him a chance to hear (and learn) the correct total response although you do not expect him to use it for some time to come. If your child does not have frequent exposure to complete responses involving those things in which he is interested, he is likely to take much longer in developing his own more complete sentences.

For some parents, response expansion comes naturally and they are unaware that they are using a highly effective technique in helping their child develop skills. Listen to yourself. If you find that you are simply nodding or saying “Yes” when your child says “kitty,” stop yourself and expand his response by saying “Yes, there’s a kitty…the kitty is drinking his milk.” If you find you are simply getting a cookie because your child has said “cookie,” then you know that you will have to make a conscious effort to make response expansion a regular technique. Once you have developed a habit of expanding your child’s responses, you will find that it takes very little extra time and that the rewards in terms of your child’s language development will be substantial.

For more information, visit the American Speech-Language-Hearing Association website.