Teach Me

Does My Child Need Speech Therapy?

Mom is crossing her fingers for “mama”. Dad is whispering “dada” to baby at every opportunity. Watching a child learn to speak is a fascinating process and no matter what the child’s first intelligible word is, it feels like a miracle.

Every child learns to speak in their own way, often progressing from cooing sounds to babbling, then from single words to simple sentences. If you’ve noticed that your baby is speaking less or not progressing quite as quickly as their pampered peers, it’s perfectly natural to wonder if they are experiencing a language delay. Tamara Zach, MD, is a pediatric neurologist with Banner Children's. We asked her to share her insight and the milestones for language development to help parents know if they should consider speech therapy.

What are the milestones for speech development?

Parents need to understand that the benchmarks for language are not cut and dry. The milestones for your baby’s progress span several months and while, a positive and proactive attitude can aid in development, it’s perfectly natural for a child to learn at their own pace. Look out for language delays by tracking your child’s progress against universal milestones, avoiding comparison with friends and relatives.

Dr. Zach offered some insight on when these important milestones should be occurring.

  • At 4-5 months, the infant should be cooing. These are “ooh” and “aah” sounds.
  • At 6-9 months, your child should be babbling. Common sounds during this stage include “dadada” and “kakaka.”
  • At about one year you want to see several words being used correctly – let’s say “mama” for mom and “baba” for bottle. At this point they should also understand simple requests.
  • When a child is two years old, they should have a healthy vocabulary of about 50 words and speaking in two-word phrases. They should be about 50% understandable to strangers and should be able to follow requests asked of them.
  • At three years old a child should be saying 3-word phrases and be 75% understandable to strangers.

Is my child experiencing a language delay?

If you’ve noticed your child slipping behind any of the milestones listed above, set up a visit with your pediatrician to determine if your child would benefit from speech therapy. Dr. Zach said, “in order to qualify for language delay you have to be two standard deviations away from normal. Generally, your pediatrician will evaluate first and then refer for therapy evaluation.”

What is causing my child’s language delay?

There are a variety of factors that contribute to your child’s language development. “Even genetics can contribute to your child’s development,” said Dr. Zach. “If siblings and parents spoke late then the child may speak later as well and may require therapy. There are other medical reasons for delays, especially if there were birth complications and the child has weakness in the arms or legs. These kids need to be evaluated by a neurologist.”

Do children from multilingual homes have trouble meeting milestones?

Dr. Zach conceded that speaking two languages at home can cause delays in meeting important milestones. However, Dr. Zach added, “this does not mean you should stop speaking the other language. Teaching a child multiple languages does stimulate the brain and develops it. I would suggest watching these kids closer. Don’t delay a speech therapy evaluation if you are concerned.”

What is speech therapy like?

Speech therapy is done by a trained therapist. They first evaluate the child’s ability to communicate receptively and expressively. Depending on the child’s age, the therapists may start with sign language which helps the child communicate and can alleviate the child’s frustrations at not being understood. As the child progresses, therapy will begin to focus on helping the child produce certain sound combinations. Pediatric therapists work hard to make sure that the experience is comfortable for children, even fun. Therapy through play has proven to be an excellent tool in opening a child to improved communication.

Will my child ever catch up?

You and your child have every reason to feel optimistic. Speech therapy is very effective. The opportunity is even greater when therapists can intervene early, as delays are first seen. “However,” Dr. Zach added, “it is never too late to evaluate a child for speech therapy. “

Speak with a Banner Health pediatrician to learn more about your child’s progress and to make a plan if your child is in need of speech therapy. Before too long, they’ll be stringing endless questions together and you’ll wonder why you were ever in such a rush.

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Neurosciences Children's Health