What To Do If There Are Concerns
Some children struggle with understanding and speaking and they need help. They may not master the language milestones at the same time as other children, and it may be a sign of a language or speech delay or disorder.
Language development has different parts, and children might have problems with one or more of the following:
- Understanding what others say . This could be due to
- Not hearing the words .
- Not understanding the meaning of the words.
Language and speech disorders can exist together or by themselves. Examples of problems with language and speech development include the following:
- Speech disorders
- Difficulty with forming specific words or sounds correctly.
- Difficulty with making words or sentences flow smoothly, like stuttering or stammering.
Speech And Language Disorders
A 3-year-old who can comprehend and nonverbally communicate but cant say many words may have a speech delay. One who can say a few words but cant put them into understandable phrases may have a language delay.
Childhood apraxia of speech is a physical disorder that makes it hard to form sounds in the right sequence to form words. It doesnt affect nonverbal communication or language comprehension.
Early Identification Of Language Delay
Philip S. Dale, PhD, Janet L. Patterson, PhDDepartment of Speech & Hearing Sciences, University of New Mexico, USAFebruary 2017
Because language is central to so many aspects of human life cognition, social interaction, education and vocation valid identification, prevention, and treatment of language disorders is a high priority for the therapeutic professions. Delay and/or difficulty in beginning to use language is one of the most common causes of parental concern for young children brought to pediatricians and other professionals. Delay may indicate specific difficulty with language, or it may be an early indicator of a broader problem such as developmental delay or autism.
In this article, we summarize current knowledge about the assessment of young childrens language below age 3, particularly in the range of 24 to 30 months , in order to identify early language delay and/or risk for persistent language impairment. The goal of this screening process is to guide decisions concerning the need for further evaluation and treatment, in order to prevent the development of more significant problems. Language sampling and analysis have substantial time and expertise requirements.
Key Research Questions
Five questions are central to early identification of language delay:
Recent Research Results
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What Are Language Disorders In Children
Most infants or toddlers can understand what youre saying well before they can clearly talk. As they get older and their communication skills develop, most children learn how to put their feelings into words.
But some children have language disorders. They may have:
Receptive language disorder. A child has trouble understanding words that he or she hears and reads.
Expressive language disorder. A child has trouble speaking with others and expressing thoughts and feelings.
A child will often have both disorders at the same time. Such disorders are often diagnosed in children between the ages of 3 and 5.
What Causes Language Disorders In A Child
Language disorders can have many possible causes. A childs language disorder is often linked to a health problem or disability such as:
A brain disorder such as autism
A brain injury or a brain tumor
Birth defects such as Down syndrome, fragile X syndrome, or cerebral palsy
Problems in pregnancy or birth, such as poor nutrition, fetal alcohol syndrome, early birth, or low birth weight
Sometimes language disorders have a family history. In many cases, the cause is not known.
Its important to know that learning more than one language does not cause language disorders in children. But a child with language disorder will have the same problems in all languages.
How Autistic Speech Delays Differ
As most babies develop, they quickly learn that communication is the key to getting what they want. Long before they learn to use spoken language, little ones make eye contact, pull on sleeves, babble, point, and otherwise work hard to get their point across to adults and older children.
Over time, the majority of children learn to use spoken language because they get positive results from doing so. In addition, most children:
- Are highly motivated by social responses such as smiles and hugs
- Are naturally inclined to imitate the actions of people around them
- Are likely to spend much more time observing people than observing things
- Tend to be social beings who become quickly bored or lonely when left alone
Children with autism, however, have social communication challenges that stand in the way of meaningful social connection. While children with high-functioning autism may be much more socially inclined than those with more severe autism, the same issues hold true across the spectrum.
For example, a child with autism:
- May be more motivated by his or her own interests than by social responses
- May rarely or never imitate others’ actions
- Be more interested in things than in people
- Be content when left alone to pursue their own interests
All of these characteristics lead to different behaviors, desires, and outcomes.
Signs Of A Language Disorder
The American Speech-Language-Hearing Association provides the following developmental signs that could indicate a language disorder:
- Birth3 months:Not smiling or playing with others
- 47 months: Not babbling
- 712 months: Making only a few sounds and/or not using gestures like waving or pointing
- 7 months2 years: Not understanding what others say
- 1218 months: Saying only a few words
- 1½2 years: Not putting two words together
- 2 years: Saying fewer than 50 words
- 23 years: Having trouble playing and talking with other children
- 2½3 years: Having problems with early reading and writing
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Why Is My 25 Year Old Not Talking
Some parents worry that a toddler who is not speaking may have autism. Children with autism and related conditions may have delayed speech or other problems with communication, but poor social interactions and limited or restricted interests or patterns of behavior are also hallmarks of this disorder.
What Should You Do
You know your child best. You dont have to wait and see if you think there might be a problem. And you dont have to guess if your child will catch up. You can have your child seen by a speech-language pathologist, or SLP. The SLP will talk to you about your concerns and test how well your child understands, speaks, and uses gestures.
The SLP may give you ideas about how to help your child talk. The SLP may suggest that you come back again if you are still worried in a few months. If your child shows signs of a problem, the SLP may suggest that you talk to an early intervention program. This program can work with you to find ways to help your child communicate better. They can also help if you have any other concerns about your childs development.
Trust your instincts. Find out if your child is a late bloomer or has a language delay. Help is available.
See ASHA information for professionals on the Practice Portals Late Language Emergence page.
To find a speech-language pathologist near you, visit ProFind.
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Speech And Language Delay Treatment
Your child may not need treatment. Some children just take more time to start talking. But if your child needs treatment, the type will depend on the cause of the speech delay. Your doctor will tell you the cause of your childs issue and talk to you about treatment options.
Your doctor may refer you to a speech and language pathologist. This person can show you how to help your child talk more and speak better, and also can teach your child how to listen or how to lip read.
Other specialists your doctor may recommend you see include a psychologist , an occupational therapist , or a social worker . Your doctor may also suggest programs in your area such as Early Intervention.
Tips For Supporting Your Childs Speech And Language Development
- Start talking to your child at birth. Even newborns benefit from hearing speech.
- Respond to your babys coos and babbling.
- Play simple games with your baby like peek-a-boo and patty-cake.
- Talk to your child a lot. Tell them what you are doing as you do it.
- Read books aloud. Ask a librarian for books appropriate to your childs age. If your baby loses interest in the text, just talk about the pictures.
- Sing to your child and provide them with music. Learning new songs helps your child learn new words, and uses memory skills, listening skills, and expression of ideas with words.
- Use gestures along with words.
- Dont try to force your child to speak.
- Expand on what your child says.
- Describe for your child what they are doing, feeling and hearing in the course of the day.
- Listen to your child. Look at them when they talk to you. Give them time to respond. .
- Encourage storytelling and sharing information.
- Play with your child one-on-one, and talk about the toys and games you are playing.
- Plan family trips and outings. Your new experiences give you something interesting to talk about before, during, and after the outing.
- Look at family photos and talk about them.
- Ask your child lots of questions.
- Dont criticize grammar mistakes. Instead, just model good grammar.
- Follow your childs lead, so you are doing activities that hold their interest as you talk.
- Have your child play with kids whose language is a little better than theirs.
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Speech Therapy For Children
For your child, speech therapy may take place in a classroom or small group, or one-on-one, depending on the speech disorder. Speech therapy exercises and activities vary depending on your childs disorder, age, and needs. During speech therapy for children, the SLP may:
- interact through talking and playing, and using books, pictures other objects as part of language intervention to help stimulate language development
- model correct sounds and syllables for a child during age-appropriate play to teach the child how to make certain sounds
- provide strategies and homework for the child and parent or caregiver on how to do speech therapy at home
Cause Of Expressive Language Disorder
For many children, the cause of expressive language disorder is not known. Some children experience difficulties in language development alone, while other areas of their development are progressing as expected. For other children, expressive language disorder is associated with known developmental difficulties or impairments .Many children with expressive language disorder will have an accompanying receptive language disorder, meaning that they have difficulty in understanding language. Expressive language disorder can be a developmental impairment or an acquired impairment . It can be the result of trauma or a medical condition. Research suggests that, in some cases, expressive language disorder occurs in more than one family member, and across generations.
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What Is Expressive Language Disorder
Children with expressive language disorder have difficulty conveying or expressing information in speech, writing, sign language or gesture.
Some children are late in reaching typical language milestones in the first three years, but eventually catch up to their peers. These children are commonly referred to as late-talkers. Children who continue to have difficulty with verbal expression may be diagnosed with expressive language disorder or another language impairment.
Language And Speech Disorders In Children
Children are born ready to learn a language, but they need to learn the language or languages that their family and environment use. Learning a language takes time, and children vary in how quickly they master milestones in language and speech development. Typically developing children may have trouble with some sounds, words, and sentences while they are learning. However, most children can use language easily around 5 years of age.
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How Are Language Disorders Treated In A Child
To treat your child, the speech-language pathologist will help him or her to learn to relax and enjoy communicating through play. The SLP will use different age-appropriate methods to help your child with language and communication. The SLP will talk with your child and may:
Use toys, books, objects, or pictures to help with language development
Have your child do activities, such as craft projects
Have your child practice asking and answering questions
The SLP will explain more about the methods that are best for your childs condition.
How Can I Tell If My Child Has A Language Problem Or Is Just Late
It can be difficult for a parent to tell whether a child is a late bloomer or has hearing loss, an expressive language disorder or other underlying cause of speech delay. A trained specialist will be able to help you determine if your child is experiencing speech or language delays. The earlier your child gets help, the greater their progress will be. And if they turn out to be a late bloomer, the extra attention to their speech will not have hurt in any way.
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Is Sli A Lifelong Condition
SLI is a developmental disorder, which means that its symptoms first appear in childhood. This does not mean that, as children develop, they grow out of the problem. Instead, the problem is apparent in early childhood and will likely continue, but change, with development.
For instance, a young child with SLI might use ungrammatical sentences in conversation, while a young adult with SLI might avoid complex sentences in conversations and struggle to produce clear, concise, well-organized, and grammatically accurate writing.
Early treatment during the preschool years can improve the skills of many children with language delays, including those with SLI. Children who enter kindergarten with significant language delays are likely to continue having problems, but they and even older children can still benefit from treatment. Many adults develop strategies for managing SLI symptoms. This can improve their daily social, family, and work lives.
Is It Language Disorder Or Learning Disability A Tutorial For Parents And Professionals
Recently I read a terrific article written in 2014 by Sun and Wallach entitled: Language Disorders Are Learning Disabilities: Challenges on the Divergent and Diverse Paths to Language Learning Disability. I found it to be so valuable that I wanted to summarize some of its key points to my readers because it bears tremendous impact on our understanding of what happens to children with language disorders when they reach school years.
The authors begin the article by introducing a scenario familiar to numerous SLPs. A young child is diagnosed with receptive, expressive and social pragmatic language deficits as a toddler begins to receive speech language services, which continue through preschool and elementary school until 2nd grade. The child is receiving therapy under the diagnosis of specific language impairment , which is characterized by difficulties with acquiring language in the absence of any other known disorders. By 2nd grade the child has seemingly caught up in the areas of listening comprehension and complex sentence production but is now struggling academically in the areas of reading and writing. Now his teachers are concerned that he has a learning disability, and his bewildered parent asks Is it true that my child now has another problem on top of his language problem?
Heres the approximate hierarchy of language development in young children:
- Exploration of the environment
- Comprehension of words, phrases, sentences, stories
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Physical Examination And Screening Tests
A precise measurement of the child’s height, weight and head circumference is necessary. A review of the appropriate parameter on the growth chart also can help in early identification of some types of speech delay. Any dysmorphic features or abnormal physical findings should be noted. A complete neurologic examination should be performed and should include vision and hearing evaluations.
The Early Language Milestone Scale is a simple tool that can be used to assess language development in children who are younger than three years of age.19 The test focuses on expressive, receptive and visual language. It relies primarily on the parents’ report, with occasional testing of the child. The test can be done in the physician’s office and takes only a few minutes to administer.7 For children two and one-half to 18 years of age, the Peabody Picture Vocabulary TestRevised20 is a useful screening instrument for word comprehension. If the child is bilingual, it is important to compare the child’s language performance with that of other bilingual children of similar cultural and linguistic backgrounds.
Early Language Milestone Scale.
Reprinted with permission from Coplan J. ELM scale: the early language milestone scale. Austin, Tex.: Pro-Ed, 1987.
Early Language Milestone Scale.
Reprinted with permission from Coplan J. ELM scale: the early language milestone scale. Austin, Tex.: Pro-Ed, 1987.
Living With A Speech And Language Delay
If your childs speech is delayed due to a hearing loss, hearing aids or cochlear implants may help your child hear speech. Once your child has access to sound , he or she may be able to develop language and even catch up to his or her hearing peers.
If your child hears and understands language, you can encourage him or her to speak by talking as much as you can around them. Describe what youre doing as you do everyday activities. Keep talking. If your child speaks, confirm what he or she is saying. Always provide positive feedback.
Speech and language delays can be frustrating for parents and children. Children who cant express their thoughts and emotions are more likely to act out. They anger easily. They may use unexpected behavior to get your attention. Try to remember your child does want to communicate with you. Read to your child and talk as much as you can. Encourage your child to speak. When he or she tries to speak, praise their efforts.
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