My child is two and only says 10 words. What can I do?

My child was very slow to talk and seems behind other children of his age. Do you have any ideas for how to help him at home?

First, if your child has noticeable delays, please arrange to have a speech and language evaluation done. This can often be done free by your local school system or Child Find system. Private SLP’s are certainly another (possibly faster) option. If there is a local university that has a speech pathology program, they probably have an inexpensive clinic there. My posts on Reading to Your Child , Stimulating Your Baby’s Language Skills,  and Language Stimulation Ideas for Toddlers may give you  some more ideas. Any child, with or without language delays, can benefit from a stimulating environment. It is also important for a child to have language therapy if necessary because language deficits can last for years, affecting future academic performance and social skills.

My child had many ear infections as a toddler. Is this likely to affect his speech development?

Yes, it certainly may. While many children have frequent ear infections with no noticeable affect on their speech and language skills, other children are not so fortunate. When children (or adults) have fluid in the middle ear, it causes a mild hearing loss. Sounds are likely to sound muffled and words can be difficult to understand. If this continues for weeks or months, the child may not hear the differences between some speech sounds, impeding his ability to learn to produce them correctly. Or he or she may show vocabulary or syntax (grammar) deficits because  he wasn’t hearing high-quality speech at crucial learning times. The first three years of life are very important for language learning, so make sure your child is able to hear well. If your child has struggled with frequent ear infections, be alert to the possibility of delayed speech or language. It is important to both correct the hearing problem if possible and to help the child catch up in his language skills as early as possible!

It can be frustrating when your child makes repeated articulation errors. In some cases, you KNOW that the child can produce the sound if you ask him to. But, should you stop your child frequently to make corrections? Will that help to improve his speech, or will it just frustrate him?

Mastery of speech sounds follows an order of progression. First the child learns to imitate the sound by itself. Then he learns to produce it in single words. At this point, it still takes some focus and concentration to produce it correctly. In conversation, however, the child is thinking about his ideas and has little awareness of what his mouth is doing to produce his sounds and words as he speaks. For sounds to be produced correctly in connected speech, the habits of correct tongue placement have to be automatic.

So….stopping your child while he or she is speaking will likely result in little or no improvement in his speech. He is simply unable to monitor every speech sound and effectively communicate his message at the same time. What correction of conversational speech is likely to do is  to make your child self-conscious of his speech and less willing to talk. It may also make him feel that you are uninterested in his ideas and stories. Remember that the transfer of ideas and back and forth interaction is the ultimate goal of communication. Any attempts to improve your child’s articulation should not interfere with that.

If you want to point out some sound errors to your child, or to encourage better speech, try choosing a time when you are not busy or hurried. Model one of his difficult sounds and have him try to imitate you. If he is able to imitate the sound, have him repeat some words beginning with that sound. If he has trouble repeating the sound, have him watch your mouth carefully. Think about what your mouth and tongue are doing, so that you can explain it to him. For many children, this simple activity will encourage him to master the sound and eventually carry it over into conversation, although this is unlikely to happen immediately. The Super Star Speech book includes a separate page of instructions for teaching your child almost every speech sound as well as picture cards and other activities for practicing sounds.

Be patient with your child’s progress, work with his speech sounds in a low-pressure way, and  seek professional help if needed. But above all, make communication a positive experience for your child!

If you’d like a “jumping off place” for more reading about speech therapy, autism, and hearing disorders, take a look at this article referencing the 20 Best Speech Therapy Blogs. I’m familiar with some of these blogs, but not all, and plan to spend some time browsing through them. They contain a wealth of information!

Not too long ago, the use of sign language was reserved for the deaf and hearing-impaired and the people who needed to communicate with them. Today, signing is much more prevalent. A few weeks ago, at our church’s vacation Bible school, nearly all the songs the kids learned were accompanied by some signing. Not only is it fun for the kids, but the motions help them learn the songs more quickly. And I can’t help but think that if, in the future, some of these kids are in a position to communicate with a hearing-impaired person that uses sign language, they will have  a head start.

Another use of sign language that is becoming more prevalent is the practice of teaching signs to babies, beginning when they are just a few months old, well before they are beginning to communicate through spoken language. And why would parents of normally developing children do this? Well, here are some reasons:

1. Simple signs are easier to produce than spoken words.

2. When babies and toddlers have the ability to communicate, their frustration levels go down.

3. Teaching sign language while speaking to your child does not slow down the acquisition of spoken language. In fact, it may actually accelerate language acquisition.

Teaching sign language to babies is turning into a big business. Several companies produce DVDs and books to teach Baby Sign, which tends to be a simplified version of the ASL (American Sign Language) signs. I taught my children some signs when they were babies. We just used a handful of words….eat, thank-you, milk, please, etc. They did pick them up quickly and use them appropriately before they were a year old. I didn’t stick with it, though. They were all early talkers who spoke in complete sentences between 18 and 24 months, so they didn’t need the additional communication tool. I do wish I had followed up with it more, though, so that they would have had some competence in sign language as older children. They learn so fast when they are little!

Signing can be a very useful tool for children who are language delayed or who have physical disabilities that affect their speech. Giving a child another means to communicate can greatly reduce the frustration and accompanying tantrums that result from the inability to speak. Simultaneously teaching sign and stimulating spoken language can actually positively affect the speech of spoken language as well.

Here is an interesting article from the Seattle Times about teaching sign language to babies: http://seattletimes.nwsource.com/html/homegarden/2012434730_babysignlanguage26.html

I am sometimes asked about tongue thrust–what it is,  how it impacts speech, and what to do about it.

All babies have a tongue thrust or reverse swallow. When the baby swallows, his tongue pushes forward toward his gums or front teeth, if he has them. Think about feeding a baby pureed food. The baby’s tongue pushes forward, pushing some of the food back out of his mouth. The adult scoops the food off his lips and face with the spoon and puts it back in his mouth and the cycle continues.  As babies mature, they learn, not only to keep their lips closed when they swallow, but to effectively move the food back toward the throat with a more mature swallow.

In the mature swallow, the tongue tip is held on the alveolar (gum) ridge behind the top front teeth and the tongue efficiently moves the food backward with a rolling motion. Children should have a normal, adult swallow by the time they are 7.

Sometimes, however, a child continues to tongue thrust or reverse swallow. When this occurs, generally his teeth are slightly separated, the tongue presses forward against or between the front teeth, and the lips are tightly closed to prevent the tongue from protruding. Many children who have a tongue thrust are mouth breathers, often due to either allergies or enlarged tonsils/ adenoids, causing the tongue to sit between or against the front teeth at rest. Then, when they swallow, the tongue pushes forward against the teeth.

How can I know if my child has a tongue thrust?

-The most obvious answer is to have him evaluated by a speech pathologist. But you may be able to diagnose this yourself.

-Is he a mouth breather? Does he keep his tongue between his front teeth when at rest? These are signs that he likely has a tongue thrust.

-Have him take a sip of water and observe his swallow. Try to pry his lips apart during the swallow. There should not be any forward movement of the tongue. Generally, children with a tongue thrust are unable to swallow with their lips parted.

What are the results of a tongue thrust?

-The tongue is a very strong muscle. If it is pressing against the front teeth during thousands of  swallows a day, it will most likely cause the teeth to protrude. If this happens, the tongue thrust must be corrected before orthodontic work is done or the the teeth will quickly move out of place again.

-The strong habit of tongue protrusion often affects the speech patterns. The most typical speech errors seen with a tongue thrust  are a “th” for “s” or “z” substitution. In more severe cases, all of the tongue tip sounds (t, d, n, ch, sh, j) can be affected. It can be difficult to correct these speech errors when there is an uncorrected tongue thrust.

What should be done?

-If your child is under seven, give the issue more time.  If your child is seven or older, find a speech pathologist who is experienced in tongue thrust therapy. Be prepared to supervise your child with tongue exercises one or more times a day. It will take a lot of practice to change this ingrained habit.

-If your child is a mouth breather, try to find the cause. If he cannot comfortably breathe through his nose due to allergies or enlarged tonsils and adenoids, this problem needs to be corrected first.

-Encourage your child to keep his lips and back teeth together and his tongue at rest on the upper gum ridge. Having him hold a Tic-Tac or orthodontic rubber band in place with his tongue for 10-20 minutes a day can encourage this habit.

As with all speech and language issues, I encourage you to be alert to your child’s development and to seek professional advice and take action when necessary.

One of the best activities you can do with your children to encourage  language acquisition is reading together. I started reading to my children when they were two or three months old. The first books we read were bright and colorful board books with a single word or short sentence per page. We soon progressed to books of nursery rhymes and books that were illustrated songs. Although my babies didn’t understand the words at first, they enjoyed the bright pictures, the rhythm of the words, rhymes, and songs, and the cuddling with Mommy. Story time became a treasured part of the day for both of us.

Most parents know that reading to their children is very important. But did you know that reading straight through the book from beginning to end is not always the very best way to stimulate your child’s language skills? Studies have shown that when children are engaged more actively in reading, their vocabulary, comprehension, and language expression are greatly improved.  Here are some ideas for new ways to read a book:

1. Point to pictures and name them. Ask your child to name the pictures. Action words and adjectives can be labeled as well. You could ask, “Can you find an animal that is tall?” or “What is that girl doing?”

2. After you read a page, ask questions about the story. The simplest questions are factual ones…”Who said…?” “What happened…?”  More difficult are “why” questions.

3. Ask, “What do you think will happen next?”

4. Have your child retell the story after you finish reading it (narration).

5. Have your child tell you the story by looking at the pictures. Or the two of you alternate pages, making up a story to go with the pictures.

6. Interrupt your reading occasionally to comment on the story or setting or to explain a concept or define a word.

7. Read expressively!

8. Rhymes and songs are wonderful for language development–even if you can’t carry a tune!

Most importantly, keep reading fun! Use these suggestions to enhance your storytime, not to turn it into a lesson. Enjoy the time spent with your child. Snuggling up on the couch and reading together has always been one of my favorite ways to spend time with my children.

Babies don’t talk. You don’t have to worry about speech for the first year or two, right? WRONG!

No, babies aren’t born with any language skills and it will be about a year before the baby actually says his first word, but the language learning process begins at birth. The foundations in speech and language you give your child from his or her first weeks will affect his development for years to come. Babies are constantly listening, watching and learning to interact with others. At three to six months, they begin to experiment with sounds and back-and-forth interaction with their caretakers in preparation for the real language that will be emerging at around a year.

Here are a few things a parent can do to encourage speech and language development:

-Interact with your baby a lot. Talk, coo, and babble at him. Make happy or silly faces at him and watch how he reacts.

-When your baby starts to coo or babble, imitate him. See if you can get a “conversation” going by taking turns making sounds.

-Any talking to your baby or toddler is great, but the best way to encourage language growth is to make your sentences just a little more complicated than his are. If baby points and says, “ball,” you might say, “Yes, big ball,”  That will give him a speech model to grow towards. When you speak in very long, adult sentences, it is just too much for him to take in.

When your child wants something, model the appropriate words to him. “Juice, please.” “Want up?”  If he is able, require him to say the words. Don’t respond to grunts and pointing if your child is capable of more.

Read,  read, read to him! Reading the book as it is written is great, but some of the time, you might just talk about the pictures, or name the pictures and see if he can imitate you.  As he grows older, talk about the story and pictures with him.

Recite nursery rhymes and sing with your child.  You can even make up little rhymes and songs about your daily activities—buckling up in the car, changing a diaper, and so on. The rhyming and repetition is great language stimulation and fun for the child as well.

Play pat-a-cake and peek-a-boo games with your child. Again—rhymes, language, and playing all in one!

My children always enjoyed listening to music during naptime or in the car–lullabies, nursery rhymes, and other child-appropriate listening fare.

Most of all, enjoy your child! Spend time with him or her, using language whenever appropriate and your child is likely to reach his full potential!

Do you ever wonder if your child’s language abilities are at age level? Do you compare your child’s speech with that of other children?

Here are a few things to ask yourself:

Is my baby vocalizing and babbling? Babies should be playing with their voices and sounds. Babies from three to six months should be “cooing,” which is vocalizing mostly vowel sounds. Babies begin “babbling” at around six months. Typical babbling sounds are, “mamama,” “baba,” “dada,” “gagaga,” etc. It is said that babies under a year old play with all the possible sounds of every language and that after a year of age, the ability to produce and even to hear sounds that are not used in the native language is gradually lost. (Isn’t that cool?)  Around a year of age, most babies are using “jargon,” sentence-like intonations. It may sound as if your child is jabbering away in another language! If a baby doesn’t babble and vocalize, or if he stops vocalizing, this could be a sign of hearing loss.

Does my baby make eye contact? Does he try to imitate sounds or facial expressions? Is he learning turn taking? (He babbles, mom babbles back or says something, he babbles again.) Even passing a toy back and forth is a precursor of conversational skills. Children actually begin to learn these early conversational skills well before they are using actual language.

Does my baby or toddler communicate his needs? Even before babies are using actual language, they should communicate by vocalizing and pointing.

Does my toddler follow simple commands? By one year of age, babies should respond to “no”  and their own names, and should give an object on request. By eighteen months, children should be able to point to one to three body parts and follow simple one-step commands.

Does my child have an age-appropriate vocabulary? Babies usually produce their first few words around one year of age. The average vocabulary of an eighteen-month-old is 50 words.  By twenty-four months, a child’s expressive vocabulary averages about 200 words. Children vary in their development, but if your child is more than six months behind these norms, there may be cause for concern.

Is my toddler putting words together into sentences? Toddlers typically begin using two-word phrases at about eighteen months. If a child is not doing this by age two, he may be considered delayed in language skills. The typical child  is producing three to four-word sentences at  twenty-four months.

If you have any concerns about your child’s language development, please consult a speech pathologist. Children develop at different rates, and your child may be completely normal, but it is very important to catch potential problems early, since language disorders can impact socialization and future educational performance. Often, public schools will even provide free services for preschoolers.

Although, as I have said before, children do develop at different rates and sequences, some sounds are easier to produce and are usually mastered at earlier ages. The sounds labial (lip) sounds, p, b, and m, are probably the easiest. N, t, and d are also easy sounds that most children master very early. Think of a child’s first words….mama, dada, ball (without the “l”). Other early words often have these sounds substituted for more difficult sounds: “tat” for “cat,” or “du” for “juice.”

By age 3, most children have mastered m, p, b, and n.  By 3 1/2, they are also correctly producing t, d, k, g, w, y, and ng in their speech. To see more detailed information on speech and language development at various ages, visit these links:

Articulation Sounds Chart

Speech and Language Development Chart