Why Can’t My Child Talk? Common Types of Speech and Language Disorders
There are between 3 and 6 million children in the United States with speech or language disorders. As a pediatric speech-language pathologist specializing in early intervention , I work with children between birth and 3 years of age. When I evaluate a child, after confirming parents’ suspicions that there is a definitive problem, the next question is usually some version of, “Why?” Sometimes we don’t know exactly why a child isn’t talking yet at 2 or 3. Many professionals err on the side of caution and label all children they evaluate as “delayed” when in fact they aren’t yet sure what the exact problem is. It is often difficult to pinpoint an exact diagnosis during the first visit or two (or 10!) with a toddler, but there are many common communication difficulties in this age group.
Below is a list of the most common diagnoses associated with pediatric speech-language problems with a basic explanation for each one. Please remember that this is a listing of specific speech-language diagnoses and not necessarily a medical or educational label. For example, a child diagnosed with autism may exhibit characteristics of apraxia, a child with Down Syndrome may have dysarthria, a child with dyslexia may also have an auditory processing disorder, etc…
The speech-language diagnosis may be just a part of a condition that affects a child’s overall developmental picture, or it could be the only issue a child faces. I have often evaluated children whose parents referred them for what they thought was a speech or language delay, when in fact their children were exhibiting delays in other developmental domains as well. This also happens with other disciplines too. My colleagues who are physical and occupational therapists often end up referring children for communication assessments when parents initially sought their help for what they assumed was just “late walking” or “difficulty with feeding” not realizing that their child was behind in other areas too. Many children with developmental difficulties have issues that overlap the motor, social, cognitive, adaptive, and communication domains.
When in doubt, get an evaluation. Be sure to ask the professional if there are other developmental concerns as well. You’d rather know, and the sooner, the better. All of the current research tells us that early intervention gives a child the best chance of minimizing long-term difficulties. Waiting until your child is school age to see if he will “outgrow” a problem puts him at a serious disadvantage, especially when it comes to communication difficulties.
Apraxia
Apraxia is a neurological speech disorder that affects a child’s ability to plan, execute, and sequence the movements of the mouth necessary for intelligible speech. Apraxia can also be referred to as developmental verbal apraxia, childhood apraxia of speech, or verbal dyspraxia. Most SLPs use the terms interchangeably. Characteristics of apraxia include:
- Limited babbling is present in infancy. These are quiet babies.
- Few or no words when other babies are talking by age 2
- Poor ability to imitate sounds and words
- Child substitutes and/or omits vowel and consonant sounds in words. Errors with vowel sounds are not common with other speech disorders.
- His word attempts are “off-target” and may not be understood even by parents.
- He may use a sound such as “da” for everything.
- Often his errors are inconsistent, or he may be able to say a word once and then never again. The child understands much more than he can say.
- There is sometimes (but not always) a family history of communication difficulty. (i.e. “All the boys in our family talk late,” or “My husband’s grandfather still has trouble pronouncing some hard words.”)
There has been controversy in the field of speech-language pathology in giving this diagnosis to children under 3. However, the kinds of therapy useful for children with apraxia are often not introduced if the clinician does not suspect this as the root cause for a child’s communication difficulty. If you suspect this as your child’s problem, initiate a conversation with your child’s pediatrician and begin speech therapy with a clinician who has experience treating children with apraxia. If your therapist says that he/she does not believe that this can be diagnosed before age 3, look for a new therapist!
An excellent resource for parents and professionals working with children with apraxia is www.apraxia-kids.org. Another comprehensive resource for an explanation of apraxia is http://www.kidspeech.com/index.php?page=56.
Many children with apraxia also have difficulty with sensory integration, or how he processes information from all his senses including visual, auditory, tactile, and proprioceptive. (For more information about sensory issues, go to http://www.kid-power.org/sid.html .)
Feeding issues are sometimes present because of the sensory issues a child exhibits such as poor awareness in his mouth so that he overstuffs to “feel” the food, or to the other extreme, he is so sensitive that he gags when new textures are introduced.
For more answers to a parent’s questions about apraxia on this site look under Amy’s question in the comments section under Ask the SLP or go to this link http://teachmetotalk.com/2008/01/31/ask-the-slp/#comment-24.
Phonological Disorders
A phonological disorder is difficulty with the “rules” or “patterns” for combining sounds intelligibly in speech in English. For example, phonological process patterns include prevocalic consonant deletion (leaving off consonant sounds that precede a vowel such as “at” for hat), syllable reduction (producing only one syllable in a multisyllabic word such as “bay” for baby), or reduplication (simplifying a multisyllabic word to a duplicated pattern such as saying “bubu” for bubble or even “dog dog” for doggie).
There are many patterns for analyzing a child’s speech according to a phonological processes model. All of these processes are common in typically developing children as well. It becomes a problem when most children are maturing in their patterns of production, and a child is not. For example, final consonant deletion (leaving off ending consonant sounds in words) typically disappears between 2 1/2 to 3 years of age. If a child is not including final consonants by this age, it would be considered “disordered” or “atypical” since most of his same-age peers are now using a more mature pattern.
A child with only a phonological disorder exhibits typically developing language, meaning that his vocabulary and utterance length are the same as his peers, but he continues to exhibit patterns that are consistent with a younger child’s speech errors. A child with phonological disorder needs speech therapy to learn new patterns. The most popular approach for therapy for this disorder is the Hodson cycles approach. A pattern is targeted in therapy for a certain number of sessions, then a new pattern is initiated. Once all of the patterns are addressed, the cycle starts over. Your child’s speech sounds begin to improve, even if it’s not “perfect” through the first few cycles. This approach has lots of research to support it. It’s generally used for highly unintelligible kids over 3. For more information on this approach, ask your child’s SLP if it’s right for your child because even the veterans know and use this technique.
Articulation Disorders
An articulation disorder is difficulty with the production or pronunciation of speech sounds. This difficulty may be present with an isolated sound such as substituting /w/ for /r/, difficulty with blends such as “st,” or with distortion of sounds such as a lisp. Sometimes clinicians speak of phonological disorders and articulation disorders interchangeably. I use the term phonological disorder when there seems to be difficulty with attaining a “pattern” of sounds and the term articulation disorder when a child has difficulty with only a couple of sounds rather than an identifiable pattern. If a child is still exhibiting errors with even a few sounds after most of his peers can correctly use the sound, he needs therapy to help him. For a list of ages when children acquire certain sounds, try http://www.talkingchild.com/speechchart.aspx.
For a good discussion of articulation and phonological disorders go to http://www.psllcnj.com/articulation_disorders.htm .
Auditory Processing Disorder
An auditory processing disorder is difficulty with listening to, receiving, analyzing, organizing, storing, and retrieving information. It can also be called central auditory processing disorder (CAPD). In young children this often looks like the child cannot understand what’s been said to him, even when his hearing and language comprehension skills are within normal limits. A child may have difficulty paying attention to what someone is saying to him or difficulty following directions in the presence of background noise or when he’s more focused on something else. This might be the kid that won’t look away from his favorite TV program when a bomb goes off, much less when you’re calling his name.
This is commonly included as a receptive language disorder in children under 3, with an official diagnosis of auditory processing disorder coming later in the preschool or early school-age years since there’s no tests for this condition with younger children. Children with sensory integration differences also exhibit auditory processing disorders. It’s very common for children with autism and other learning disabilities such as dyslexia and attention deficit disorder to exhibit these characteristics as well. I could not find a site for information for very young children with auditory processing disorder, but this is receiving lots of attention in the field of early intervention right now, so maybe we should have a good resource soon.
Dysarthria
Dysarthria is a neurological speech disorder that affects a child’s muscle tone. Weakness is noted in the muscles used for speech including his lips, tongue, soft palate, and cheeks so that his speech sounds slurred. Dysarthria is present in kids with Down Syndrome, cerebral palsy, or any other condition that causes “low tone.” Dysarthria may also affect a child’s vocal and respiratory quality so that he sounds hoarse or breathy.
A child may also have feeding problems due to muscle tone issues such as difficulty sucking from a bottle because his tongue isn’t strong enough, keeping foods or liquids in his mouth because his lips aren’t strong, or chewing because of overall weakness in his jaws and cheeks. A child may also drool because she can’t close her mouth consistently.
A child with muscle tone issues may also have difficulty with gross and fine motor skills. Physical and occupational therapy may be necessary to help meet milestones. Low muscle tone never truly “goes away,” and there’s a difference between strength and tone. All of us have varying degrees of muscle tone ranging from high to low, and kids with even very low muscle tone can learn to walk and talk.
For more information visit http://www.stronghealth.com/services/childrens/conditions/Dysarthria.cfm.
You might also try http://www.kidspeech.com/index.php?page=75.
Dysfluency
Dysfluency is the more professional term for stuttering. It is the repetition of individual speech sounds usually at the beginning of words or phrases. Many children with typically developing language “stutter” when they move from using single words and short phrases to longer sentences and/or when they are under pressure to speak and can’t encode their words quickly enough. Typical dysfluency can occur anywhere from age 2-4. If it lasts for more than 6 months, seek a professional evaluation.
Many times there’s a family history of stuttering if this is going to be a chronic challenge. Kids who repeat individual sounds at the beginnings of words with facial grimaces or tremors, tense their muscles, blink their eyes repeatedly, or tap their feet are at greater risk for true difficulty with fluency than those who repeat whole words and who don’t seem to be phased physically by this.
The best advice for parents when your child starts to stutter is to ignore it. Do not tell him to slow down, stop and think, or any other comment that you feel might be helpful. Relax his environment and do not put pressure on him to “perform” verbally including asking too many questions in a row, demanding that he answer silly questions such as, “Did you hit your sister?” when you know he did, or insist that he sing his new song from preschool for grandma, grandpa, and all of your long-lost relatives at Thanksgiving. Don’t interrupt him when he’s talking, even when he’s struggling. This is hard!
Our oldest son had a terrible several month bout with stuttering while I was in grad school taking the class on dysfluency. It was horrible for me!! My professor’s advice was simple - ”Ignore it and it will (probably) go away.” Another piece of advice is to make sure his teachers at preschool, sitters, or even family members are on board with the “ignore it” method so that no one calls attention to this issue. The unnecessary pressure will make it worse, not better, so tell all of your well-meaning friends and family that you are doing this one your way.
Expressive Language Disorder
Expressive language disorder is present when a child is not meeting milestones in the area of language usually involving vocabulary, combining words into phrases, and beginning to use the early markings of grammar. A child with only an expressive language disorder doesn’t have difficulty pronouncing the words per se, but he has difficulty learning or retrieving new words and putting sentences together. A child may rely on non-specific words such as “that” and “there” rather than learning specific names for objects. She may have difficulty learning verb tenses (such as the “ing” for walking and “ed” for jumped) or have difficulty learning word classes such as prepositions or pronouns.
An expressive language disorder can and often co-exists with a speech disorder such as apraxia. I have treated kids like this with only expressive language delays/disorders, but more often than not, late talkers exhibit a speech AND a language disorder. Sometimes children exhibit receptive language disorders as well, so it’s not uncommon to have several speech-language diagnoses at the same time.
An expressive language delay would be a child who is acquiring vocabulary, combing words, and learning early grammar with the same sequence as his peers, but at a slower rate. If there are atypical characteristics present such as your child has some skills at a higher age level but is still missing many lower age-range skills, it’s called a disorder. Delays are typically easier to overcome, and most kids with delays eventually catch up. A disorder is generally something a child will struggle with for a while, perhaps his entire life.
Receptive Language Disorder
A receptive language disorder is difficulty understanding language. This is also called an auditory comprehension disorder. Kids who have receptive language disorders don’t follow directions and not because they’re being disobedient, but because they don’t understand what’s being said. They seem to ignore language because words don’t mean anything to them yet. They often hate reading books unless mommy lets them flip through the pictures because it’s all about listening to words which may not make very much sense.
When a kid gets a little better and understands a little more, signs of a receptive language disorder may be that he repeats a question rather than answering it or gives an incorrect response. For example, if you ask a child with a receptive language disorder who has been learning his colors, “What are you drinking,” he’s likely to respond “red” because that’s the color of his cup. Or if you ask a question such as, “Do you want milk,” she might answer ”no,” but then she still gets upset when you don’t give her the cup because she doesn’t understand that answering “no” means she doesn’t want it.
I have seen many kids whose parents or daycare teachers label as “difficult” or a behavior problem when really there’s a major receptive language delay that no one recognizes. Parents often overestimate what their language delayed/disordered child truly understands. This is so sad to me because when everyone decides to work on teaching and helping him understand language BEFORE we expect him to talk and BEFORE we expect him to “obey,” then everyone benefits; especially the kid who doesn’t understand why in the world he’s in trouble in the first place, even when his mother “told him not to do it!”
Make sure your child’s receptive language skills are addressed, or the other speech-language problems are not going to significantly improve. A child who doesn’t understand much really shouldn’t be saying much either. To expect more is simply wrong and well above what he’s able to realistically accomplish. Most SLPs think of working on receptive language hand-in-hand with expressive language, and this is absolutely the right way to go. When parents get on board with this approach, wonderful things happen.
For more information on improving receptive language, see the post titled, “Help Your Toddler Listen and Obey.”
Comment by Sarah on 5 August 2008:
My son is 26 months old. He has a limited word range. In total he will consistently use 10-15 words and sounds “hi, bye, ta, no, baa”. When should I start getting concerned about his lack of vocabulary or could he just be a late bloomer? Most websites say he should have over 50 words acquired and be starting to make two word combinations. What do you suggest?
Comment by Laura on 5 August 2008:
Sarah - NOW is the time to be concerned about your son. The 50 word milestone is a MINIMUM baseline for children to have by 24 months. By 26 months children with typically developing language have well over 100 words and are talking in short two and three-word phrases consistently.
I would have him evaluated by your state’s early intervention program since he very likely would qualify for speech therapy through them. The evaluation is free, and if he is eligible, therapy is free or low cost in most states compared to what you would pay privately. You could also check into insurance coverage, but I’d go through your state program first. You can find out information about your program by searching your state name + early intervention in a search engine like google.
In the meantime, keep working with him at home using the suggestions on this website and check out my new DVD so you can see the strategies in action.
I want to give you a big word of caution here - Please don’t count on him catching up on his own without help from you and/or professional assistance. If language delays are addressed early, they often are nothing but a memory. If not, it could be a potential long struggle for him. Please don’t dismiss your concern and “wait and see.” Even if he is just a “late bloomer” as you say, therapy is not going to hurt him and could give him the jump start he needs. If it did turn out to be a more complicated issue, you would have started getting him help early, and you’ll feel relieved knowing you did the right thing by not waiting. Many parents who wait often feel so guilty later that they didn’t trust their instincts. This can be prevented by going ahead and having him evaluated when you first begin to be concerned.
Good luck! Laura
Comment by Jennifer on 21 August 2008:
I have been working with a speech therapist for my 28 month old son for about a month now. He has articulation issues. We are also trying to get him to use his speech more frequently without prompting. We are currently stumped on o a couple of issues. One he has the “N” sound at the begging of words (no, noise). But when it is the middle or end he either replaces it with a d or t sound or leaves it out completely. (Bunny turns into buddy) He can do a middle N rarely just like nana (banana) or oh no. Any thoughts? The other this is with some words he replaces the first sound completely such a susic for music and shish for fish. Why would he do that. He can use both an m and f in other words.
Comment by Laura on 21 August 2008:
Jennifer - I can take a stab at these issues based on what info you provided, but again, you’re going to want to rely heavily on the SLP you’re seeing since she can actually SEE your son and consider other pieces of information that I couldn’t possibly know about without spending time with him.
The errors you’re describing aren’t really uncommon for 2 year olds with speech issues. Substituting /d/ or /t/ for /n/ isn’t that unusual since ALL of those sounds are alveolar sounds - or made by elevating the tongue to the alveolar ridge (In English - touching the bumps behind your top teeth with your tongue). Actually as far as “severity” with sound substitutions, it’s not that bad since using these sounds are substitutions with a sound made in the same place in your mouth. The /n/ is probably easier for him to do at the beginning than in the middle or end of a word. Lots of children struggle with medial/middle and final/ending consonant sounds until they get closer to age 3. It’s not even a true “error” to omit a final consonant sound until after 36 months - although many typically developing children master consonant sounds in all positions in words well before this age.
OR you could account or categorize his errors as a phonological process called “assimilation.” (For more info on this, search “phonological” on this site.) This means that he might produce a sound correctly in some words but not in others because of the other sounds in the words influencing how he pronounces the sound- not because he can’t produce the original sound. His errors with “susic” and “shish” are because in his little system, LATER consonants seem to influence his pronunciation of the first consonant. He is duplicating or repeating the later consonant sound.
I don’t want to be more technical than this, but you can do some more reading by searching Phonological Disorders. Barbara Hodson is the SLP who did the bulk of the original writing about this. Caroline Bowen is the another SLP from Australia who writes about treating children with these kinds of issues too. You can search this info by their names and the term “phonological.”
That being said - I would highly encourage you to prioritize SPONTANEOUS language over using correct sounds in words at this point. Many experts don’t recommend doing lots of work on specific articulation patterns/errors until after a child’s language is normal AND until he is close to/after age 3. Focus on vocabulary, phrase length, and USING his words appropriately in situations before you try lots of articulation therapy. You’ll be more successful with that when he gets closer to 3 AND once he’s a great talker, without over-relying on prompting and cues from you.
Hope this info helps! Laura
Comment by Wendy on 14 October 2008:
My son was born five weeks early under normal circumstances (i.e., my water broke). He will be 2 1/2 on Oct. 25th, and is talking–he has a vocabulary of about 62 words, and 11 two word phrases–but he doesn’t really communicate when asked a question. For instance, every day when I pick him up from day care, I ask him if he had a good day. He will either say “yeah” or “no” but if I ask him what he did, he either doesn’t answer or he babbles. Also, he throws fits when he wants something and can’t get his point across. I know he understands everything we say (and more, sometimes!!), but he cannot really articulate what he wants to say.
What is really strange, though, is there have been two separate occasions where I am certain he spoke in complete, perfectly enunciated sentences. Both times he was stating a desire. The first time (before he turned 2) he said “Mama I want to play” and the other time (just a month or so ago) he said “I want to go outside.” Just like that. He even emphasized the “t.” Both times I said “what did you just say, baby?” and he just looked at me. Also, there have been times when I have been talking to my husband and have been deliberately using words my son wouldn’t understand, and he will react to something I said. It is obvious he understood, but then he acts like he didn’t (he’ll turn away and pretend he is doing something else).
I really do not know what to think. On the one hand, I think I should have him evaluated, and on the other, I feel like I should give him more time–that he is just being stubborn. What do you think?
Any advice would be greatly appreciated.
Thanks!
Comment by Maria on 14 October 2008:
Hi,
My child is 14 months old and he does not say a single word. As much as I try I cannot make him to say a single word. I am focusing on couple of words thinking that this will help him, but he cannot pronounce them. He is looking how my mouth is moving when i say the word and he tries but what comes out is a scream. He is screaming a lot - when happy or upset, and he is talking to us like Curious George - the monkey does. He like to read the books and he shows me objects on the book. If I say to him “bring that ball” he does, he is very good at sorting 3 kinds of shapes (circle, triangle and square) he is very good at imitating everything, if toys are made from different parts he tries to put them together (he cannot usually but he knows that they should be together), etc. he seems very smart and is very curious and energetic. But the biggest problem is that he cannot speak. My doctor suggested to try couple of things like read the same 2 o3 books all over again, repeat simple words and try to put him repeat after me and wait until 15 month check up. But I am so worried already, it seems to me that he is trying to say the word but he cannot. He will repeat tatatata, babababa, mamama or dadada. But that is it. What do you think? What do you suggest? I will appreciate your advise. Thank you, Maria
Comment by Laura on 14 October 2008:
Wendy - Based on what you’ve said, it sounds like your son could possibly have a mild expressive language delay. By 2 1/2 children with typically developing language skills are frequently using 3 and 4 word phrases and sentences to communicate and can answer simple questions. However, let me say that I cannot “see” him, so know that I am speaking in very general terms here based on the information you provided.
He can certainly understand “everything” (his receptive language skills) and still exhibit delays in how he is able to use words to communicate (his expressive langauge skills). Actually that’s very common.
That being said, he may not exhibit “enough” of a delay to qualify for services thru your state’s early intervention program since children have to meet eligibility requirements.
If you continue to be concerned, you could have him evaluated thru your local early intervention program OR have his speech-language skills evaluated by a speech-language pathologist at a clinic (like Easter Seals or someone in private practice) or a children’s hospital. Your pediatrician could probably point you in the right direction.
Now about your closing comment….I personally don’t believe that most children don’t talk because they’re being stubborn. You may want to check out the article called “Can’t vs. Won’t” for more on that. You can search for it from the home page using the search option.
I also want to recommend the articles on answering questions in the expressive and receptive language sections. You may find some ideas in there that you’re not currently doing. Giving choices is a great way to help him begin to answer questions - such as, “What did you do at school today - paint or play in the sand?” There are other hints in the article too that I hope you will find helpful.
Let me know how it goes! Laura
Comment by Laura on 14 October 2008:
Maria - It sounds like you are on the right track in teaching him to imitate you. Doing this during play making yourself as fun as possible is a way to entice him to want to imitate not only your actions, but your vocalizations as well.
Have you tried sign language with him? This opens the door to communicating for so many children. Check out the articles in the sign language section for help in learning how to do this.
Also check out the clips from the DVD since this may give you some additional ideas for how to prompt words and signs. If you find that your approach is much different than the clips, you may want to order the DVD to give you some additional suggestions.
I applaud how proactive you’re being with him! 14 months is very young, and I understand your concern, but you are so far ahead of when many moms first begin to be worried. Pat yourself on the back!
Laura
Comment by Carole on 14 October 2008:
First, I’d like to thank you for this website — it is such a help to those of us who aren’t sure what to think!
My daughter is almost 17 months old, and her only real words are “no” and “hi”. She doesn’t say mama; she does say “dadadadada,” but I’m not convinced she’s referring to daddy.
She also says please, but it sounds like “ssss.” When she first started saying it (it was her first correctly-used word) she would just blow a raspberry. I have this on video; we thought it was cute/funny at first, but now it worries me.
She sort of has three other words: for ice, she says “ssss”; for shoes, she says “ssss” or “shhh”; for bath, she says “da.” Today when I showed her a plant, she said “/t/.” This was her first attempt at a new word in at least two months.
She can make many of the more difficult sounds (t, d, zh, /s/, sh), but rarely tries to imitate words or sounds. When she does, it almost always sounds like “da.” We can’t get her to make a /b/ sound. We’ve thought twice that she did, but she wouldn’t repeat it. Sometimes when we try to get her to say “buh-buh-buh” she will say “duh-duh-duh,” and she has that sweet proud look on her face as if she were saying it right.
She does ‘talk’ a lot; she seems to think she’s really talking to us in long sentences with lots of inflection. Her receptive language is usually quite good, although it does sometimes seem like she doesn’t hear us. We’ve attributed this to not wanting to hear us, because we know she can hear and she does often follow directions. She also gestures quite a bit (pointing, waving hi, bye, and night-night, reaching, etc). I’ve just started using signs with her, but she hasn’t used any yet.
Until reading articles here, I’ve tried to agree with family who said she was just stubborn (which she is) and wouldn’t talk until she wanted to, and resisted talking because we ‘bugged’ her about it.
But my instinct has been to have her evaluated ASAP. Most people I talk to disagree, and our pediatrician suggested we wait until her 18-month checkup. Should I wait, or get it started now?
Comment by Laura on 14 October 2008:
Carole - I so applaud you for being concerned about her now, even if it’s against the tide of public opinion in your circle! The pediatrician may be having you wait until 18 months since this is such a benchmark age, and it may be a little easier for her to qualify for services if she’s not added anything new by then. She does have some red flags for speech-language delay, so I’d definitely have her assessed at 18 months if she’s not using at least 15 consistent words by then.
However, as her mom, I’d still do everything I could even BEFORE you get her evaluated to help her move along. Signing is a great way for many children to build their vocabularies AND for you to know what she’s trying to say since she’s using so many sound substitutions in word attempts and lots of jargon. Check out the articles in the signing section - especially the tips to get her started. Since she uses gestures already, this should be an easy next step. Watch the DVD clips (it’s the 2nd one I think) for a brief example of teaching signs to toddlers.
I’m glad you’re finding the site helpful, and let me know if there’s anything else you need! Laura
Please keep using the ideas on this site since they really do work!
Comment by Maria on 15 October 2008:
Laura,
thank you so much for your answer and for encouragement. I know it may be early to evaluate him, but I compare him with my first son who, at the same age, said many words. Thank you, Maria
Comment by leah on 1 November 2008:
hi there,
I am Leah from Malaysia, but currently live in Japan. My eldest son is now 34 months but still cannot make sentences and his vocabs are terrible, not fluent. I am so worried. At home we are talking in Malay language, sometimes I teach him some English vocabs. At his nursery , his teacher and the kids there all are speaking in Japanese. I wonder maybe he cannot talk because he confused with the 3 languages mixed up. Or maybe because he is watching TV too much. Can your DVD help me?
I also not sure whether meeting the therapist here is a good idea because they are Japanese,, so maybe they will teach my kids in Japanese. I want my son to especially can talk in English and Malay. Please advice.
Thanks in advance.
Comment by Laura on 1 November 2008:
Leah - The DVD can help any parent learn to teach their child language, any language. The DVD shows you how to use 6 different strategies to teach your child new vocabulary, in whatever language you are using.
Because he is having difficulty learning language, I would try to minimize the complexity and pick one primary language so that he can solidify his ability to assign meaning to words and then use those words functionally to communicate with you. However, he is going to need to learn how to communicate with his teachers and friends in school. If you are going to be in Japan long-term, he does need to speak and understand Japanese. If this is the case, then I’d definitely go ahead and see an SLP in Japan. They likely speak at least a little English too.
One more thing about the DVD - the DVD should work in your Japanese DVD player since Japanese players use the same operating system as USA players. BUT, if your DVD player is from Malaysia, it probably won’t play using it. In that case, you’d have to view it using your computer, provided that your computer has a DVD drive.
If you want to order the DVD, send me your e-mail address at laura@teachmetotalk.com so I can send you an invoice through Google checkout. Google checkout will not process international orders unless I send you the invoice first with the correct shipping amount precalculated.
Hope this info helps you! Laura
Comment by manisha on 16 January 2009:
hi
i dont know whether there is a problem with my daughter or not.she has just completed 3 years old on jan 12,2009. she repeats what i say.if i ask whats ur name she says whats ur name,but after some time she answers it.i always ask him did u eat chicken in school but in our language(oriya),she answers i ate chicken(in oriya)but she says did u ate chicken in school.
sometime she speaks clearly ,express herself very clearly.she can recognis the letters,sings rhymes very well,counts from 1 to 20 n her pick up pawer is very good.she likes to read.her memory is also sharp.
can u help me in this.i want her to make her own sentence to answer,not repeating mine
Comment by Laura on 16 January 2009:
Manisha - She sounds like she’s “stuck” in the developmental phase of being able to imitate questions, but not answer spontaneously on her own.
This usually happens with children younger than your daughter, so based on what you’ve said, it does sound like she may possibly have a mild language delay. Do you have access to a speech-language pathologist in your area? I would have her evaluated if possible. In the meantime, look at the articles about answering questions in the expressive and receptive language categories. Hope these ideas help! Laura
Comment by hannah king on 19 January 2009:
my son is 27 months old i have been concerned about his speech for a long time
he proberly has 3 words he uses regulary
hello (says it correctly) hat (means pat)hes a big postman pat fan! and he says umma for mummy.
we finally have speech therapy appointment after asking for nearly a year, my friends and family all tell me not to worry he will speak when hes ready however i do feel as his mum he does have a problem
3 months ago he would say grandad well i knew he was saying it although it wasnt clear to others, he would call our cat by her name tigger, he would say daddy and dog dog, all of a sudden he says nothing but the above mentioned 3 words. ive been told hes just lazy!
everything is a grunt he no longer says daddy calls him hmmm infact everything is hmmm. its frustrating for myself and partner as we can see hes frustrated trying to talk.
ive heard baby signing is a good way to communicate although im not sure if its too late to start that with him now??
i have speech therapy with him next week fingers crossed he will come on in leaps and bounds. im just concerned as a mother!
any advice would be greatly recieved.
Comment by Laura on 19 January 2009:
I NEVER think a kid doesn’t talk because he’s lazy. Read my article Can’t vs. Won’t and you’ll see why.
To only have 3 words at 27 months indicates an expressive language delay, and losing words is a red flag as well.
Signing is an AWESOME way to help with communication as well as jump start speech, and IT’S NEVER TOO LATE! Read the articles in the sign language section for ways to implement this at home. There’s also a video clip of me using sign language in speech therapy sessions on the Teach Me To Talk DVD post.
He’ll qualify for speech, and I hope you get good specific advice for being able to work with him yourself at home in addition to his sessions with the therapist. Children who make the most progress are the ones with committed parents!
Hope all goes well! Laura
You
Comment by michele on 10 February 2009:
I just wanted to make a comment to parents also that if your child is exhibiting speech problems particularly in pronunciation please also get them tested for their hearing. We were shocked to learn our son has mild to moderate hearing loss due to fluid in his ears (never had an ear ache in his life). Just wanted to alert other parents to this as I’ve noticed some speech issues for several months and had him evaluated but never thought to have his hearing tested and wish I had done it much much sooner.
Comment by Joyce on 19 February 2009:
My son is 23 months old and just started speech therapy. He tested normal in all other areas other than communication (cognition was a little low, but adaptive, motor and social were great). He has lost some words, but still slowly gains new words (he said about 15 words at 12 months, but about 6 words today).
My main concern is that he doesn’t seem to understand speech (doesn’t respond to his name, and doesn’t follow direction). The two items above that possibly described my son were the Rec. Lang. Disorder and the Aud. Proc. Disorder. I was curious what the prognosis is for these two disorders? Can I expect that he will, with therapy, eventually speak and understand at a conversational level? Or is it likely that he will never follow even basic directions or be able to tell me what he wants?
Comment by Laura on 20 February 2009:
Joyce - I’m not surprised that he tested lower in cognition since he’s having difficulty understanding language. Language and cognition go hand-in-hand for children under 3, and many of the milestones and questions on both the cognitive and receptive language sections on developmental tests are the same.
As far as a prognosis goes, it really is individualistic. The more severe the initial problem, the harder it will be to overcome. Generally if you get started in therapy early, as you are, you’ll have a much better outcome than if you did nothing.
As I always tell parents when I’m actually seeing their children or writing to parents here on the website, kids whose parents are very involved and faithfully work with their children, regardless of the “diagnosis,” always do better than kids with parents who leave everything to the therapists, or worse, those parents who wait until their children are school-aged to do anything.
I’d imagine you’re not that kind of mom since you’re seeking additional information here and already have him evaluated before he’s 2, so pat yourself on the back.
As for additional ideas, read all of the articles in the receptive language section. You may want to check out the DVDs Teach Me To Listen and Obey for other strategies and so you can SEE the techniques in action. Let me know if there’s anything else I can do to help you. Laura
Comment by meena on 23 February 2009:
dear laura
my daughter is 3 and 1/2 and is not yet talking. her hearing has been tested(normal) and she has been observed by SLT and has had SLT involved 4 the last yr and still no improvment. otherwise she is a well behaved very intelligent girl. she follows instuctions and is otherwise perfect. she tries at times to make sounds but finds it hard like she is using her tummy to talk. plez if u have any suggestions i need them
thanx meena
Comment by Laura on 23 February 2009:
Meena - What does your SLT think? I’d talk about this with her first. If that answer doesn’t make sense to you, or even if it does and you’re still concerned (as I would be), I’d take her to a speech-language expert for another opinion since she’s not made progress after a year of therapy. It’s time for some new ideas and treatment strategies or at least an explanation for why she’s still having difficulties. Usually there’s something else going on when speech and language skills aren’t moving along by this age, especially after a year of therapy. Hope you can find some answers soon for her and for you! Laura
Comment by meena on 26 February 2009:
hey laura the slt thinks her interaction with people needs 2 be better! but i think the problem is she doesnt know how to talk or finds it hard to talk. a lot of people that see her and interact with her say she is just taking her time but i feel its time now and i can see she wants to express herself also i just need the intial key steps to get her to open up. i spent time with her the other day tring to get her to say mummy and she did but it took ages of repeating and encouragement to get her there!!! plez if u have any ideas let me know,as ive kind of given up on the slt we currently have.
thanx meena
Comment by Leslie on 13 April 2009:
Dear Laura,
I’ve been slightly concerned that my 17 month old son is not speaking yet. He will say “up” but that’s about it. He does the pterodactyl scream when he wants something and babbles up a storm when mimicking conversation but no real words. He’ll say mama but I’m pretty sure he doesn’t know what it means. And yes, he will follow an instruction when he’s in the mood. Should I be concerned? We just changed pediatricians and his new doc doesn’t seem worried but his old one was starting to. Any advise would be wonderful. Thank you.
Comment by Laura on 13 April 2009:
Leslie - As I’m sure you know, by 18 months toddlers should be using about 15 words consistently and spontaneously, so it would be a concern for me. But he certainly understands that he should talk since he’s babbling and screaming when he wants something, and it’s great that he’s following some instructions, but at his age and since there is a concern with language development, I’d want to see it a lot more often than “when he’s in the mood.” Is he looking at familiar people when named? Does he follow routines such as running to the bathroom when you announce it’s time for bath? Will he retrieve his favorite toy on request? Is he waving bye-bye? If these things aren’t consistent yet, then I would go ahead and pursue an evaluation with your state early intervention program, with or without a referral from your pediatrician.
In the meantime, at home I would place a huge emphasis on facilitating words and even signs with him right now during play and during daily routines using the strategies you can read about in articles in the expressive language section. If he doesn’t come along with you reading and implementing the ideas, then you may want to check out ordering the DVDs to help give you new ideas for working with him at home. Good luck and I hope you see big improvements right away! Laura
Comment by jennifer on 8 June 2009:
Hello! My daughter will be 2 at the end of this month. She has a large number of single-syllable words, and groups words telegraphically, e.g. she’ll say “Mama book read” or “shoe off” but won’t use any real sentence structure. My real question is about her articulation — she fits to a tee the criteria for a Phonological Disorder as you described above. All of her one syllable words drop the last consonant sound (ree instead of read), and about 90% of her two syllable words simply repeat the same first syllable twice (”pi-pi” for pillow, etc.). She also has a number of substitutions (p’s replace f’s, y’s replace l’s). You said in your information about phonological disorders that they’re not typically diagnosed until a child is 3 — is it possible to break this pattern with a child of my daughter’s age? Usually, I just repeat the word in my response so that it doesn’t seem as if I’m correcting her; however, when I have asked her to sound out the word along with me she can repeat each syllable but reverts to her original pronunciation (pi-pi) when I use the full word.
Comment by Diane B. on 2 July 2009:
Hello, I have a 3 1/2 year old boy that does not say a single word at all. He can hear and understand things. He will come when you call him. He don’t understand when you ask him to get a sippy cup for example. Iam at a big lose on what to do. Can you help
Comment by Laura on 4 July 2009:
Diane - Thanks for your question. As I’m sure you’re aware, from what you’ve described at his age at 3 1/2 your son is exhibiting a pretty significant speech-language delay, not only in what he says (expressive language), but more importantly, in what he understands (receptive language). I would have him evaluated by a pediatric speech-language pathologist as quickly as possible. In the USA for children over 3, the least expensive way to have this done is to consult your local public school or Head Start program. If you have insurance coverage or can afford to pay privately, I would recommend having him evaluated at a private clinic like Easter Seals or a children’s hospital. Again, I’d urge you to do this right away since it’s unlikely time or maturity is going to help him catch up on his own.
In the meantime, keep reading ideas here on the website. Check out the older articles where most of the real “information” is. You can do that by clicking on a category across the top menu, scroll down to the bottom of the page, then click older entries until you get back to the oldest post in each category. Begin here and then you can read forward.
I’d also recommend that you check out the DVDs. Teach Me To Talk is to help get his expressive language going, but likely the most important information for you will be in Teach Me To Listen and Obey 1. This addresses receptive language development from the beginning and will help YOU learn how to teach him to understand words and follow directions.
You’ve got your work cut out for you! It’s sometimes scary to have your child evaluated, but I’d so encourage you to do that for him so that you can have a professional help you learn how to help him. Laura
Comment by Jennifer on 6 July 2009:
Hi Laura,
Does speech problems run in families or can they be hereditary?
My mom said she was a “late talker” could, but refused to talk until she was 3 yr old. I was in speech for a while when I was in grade school and my older son was in speach from 3ys old till I can’t even remember. I don’t know what his dx was ( I was a younge mother) but I know it was mild, but I guess his progress was slow since he was in speech for so long - I had never throught too much about his speach back then, he was in “real school” b/c of the speech delays and it just became apart of schooling for him. The ST did not tell me too much and I did not ask too much, it was just away of life.
Fast forward to now and our pedi said that if my son (15mns)has not increased his vocab by the time of his 15 month well visit, he wants a hearing test. I know Max hears well, he follows commands, but he does have a hx of ear infections. Max was slow at adapting to new textures and eating, was about 12mns before he no longer gaged on food and even now at 15 month he is just now not spitting all his food out. But again hx of ear infections and frequent colds, so I don’t know if it was just all the illness that slowed him down or if there is/could be oral motor skill problem.
If the pedi wants the hearing test, I want to ask about speech and oral motor skill eval (although in the past 2 wks his eating has improved greatly)
just wondering if speach issues were known to be hereditary.
also, is there any questions I should ask the pedi, or buzz words I should throw out to him when we have our well check up.
Thank you for your time.
Comment by Laura on 7 July 2009:
Jennifer - Thanks for your questions. Communication problems can definitely “run in families.” I think it’s great that your pediatrician wants to be so proactive with your baby and would want to refer him for a hearing eval and for a speech-language assessment. Tell him the same things you’ve told me - you have a family history of speech-language problems, and you’d like to have him evaluated early so that you can give him the best start possible. I applaud your commitment to find out more information for yourself so that you can be prepared for the visit. However, I don’t want you to waste time waiting on a professional assessment. Read through the website for ideas on how YOU can help him at home. Good luck!! Laura
Comment by Aimee Thompson on 3 September 2009:
Hi Laura
My son was 2 last week and he doesn’t understand anything I say. He says mum and dad and that is all. He doesn’t wave, clap or point and I have no communication with him whatsoever. He gets really frustrated and I fear there is something very wrong with his brain. I have seen numerous health visitors and speech people but all they do is monitor him, I am really concerned and its very upsetting as I’m not getting any answers!
He doesn’t interact with other children and he gets upset when babies cry. He is quite a sensitive little sole. He won’t feed himself and sometimes just spits food out.
Any suggestions?
Comment by Laura on 3 September 2009:
Aimee - At the very least he has a severe receptive language delay as well as an expressive language delay and likely a social communication disorder. If you were in the States, he’d likely be getting speech therapy weekly. I’d still push for that now and have them teach you how to work with him at home.
In the meantime, please read the articles on this website, especially those in the receptie language section. He has to understand language BEFORE he can talk.
I’d also recommend my DVD series Teach Me To Listen and Obey so that you can SEE exactly how to play with him so that he interacts with you and then learns to understand words. You can watch the DVD clips here or on youtube or Facebook.
Parents play a KEY role in helping children with special needs. In addition to working with him yourself,
please continue to fight for the services your child needs. You’re his best advocate!! Good luck!!
Laura
Comment by Leshia on 14 October 2009:
My son is 40 months old and is talking but not like I think he should be. He can put together 6+ word sentences and he is using he and she but sometimes he babbles. He can’t seem to answer any questions that I ask him. If I ask him “Why” he did or wants something, he simply replies because. He cann’t tell me what he did in a day or what he ate for lunch. He can tell me what he wants but does not tell me how he feels a lot.
When he went home for summer vacation he spent a lot of time with his 4 yr. old cousin and his vocab doubled in like six weeks. Do you think his problems will be solved by being around other children?
He also uses words at random and says huh after everything I say. He plays well with others but does not like to play by himself AT ALL! He is set up to get an evaluation in a few weeks. He was evaluated when he was two but they decided to monitor him instead of help.
You are so right about feeling guilty. I feel like an absolute failure and I want to help him. I give him lessons daily and he enjoys them. He has no problem paying attention but gets discouraged quickly. He knows is ABC’s, colors, can count well, and can draw a line, his shapes and a few letters.
Perfect Example: He just finished eating some chips and he comes up to me and wiggles his fingers and says “It tickles”
Me: What tickles?
Him: The chips
Me: Chips don’t tickle.
Him: See mommy, I can’t do it.
?????????
What on earth is the problem? Any advice on literature or anything would be greatly appreciated.
Comment by Laura on 14 October 2009:
Leshia - I’m so glad you’re having him evaluated. Since I can’t see him, of course I don’t know what’s going on for sure, but let me give you a couple of ideas based on what you’ve said.
I hope your SLP takes a very close look at his ability to understand and process language since he’s having difficulty answering questions when he’s obviously a smart kid based on the pre-academic skills you report he can do.
Receptive language problems/processing differences can certainly cause a child’s expressive language to lag as well and often presents as you’re describing your son. He can use sentences and even tell you what he wants, but he can’t answer simple questions. He’s also using words that don’t quite fit the situation indicating that he doesn’t understand what he’s saying.
Again, since I can’t see him, I don’t know this for sure, but it is something to ask the SLP about during the assessment.
Secondly, I never recommend that a child attend daycare in order to help him learn how to talk since I think ADULTS help kids learn to understand and use language, but it could be that a great part-time preschool program would be very beneficial to him. The time with his cousin may have been so valuable because everything was on his level and he had lots of 1:1 time doing things that made sense to him. Preschool would serve the same purpose. In the meantime I would take lots of time at home to play, play, play WITH him making sure that you’re helping fill in the gaps with things he doesn’t seem to understand or be able to express.
Keep us updated with what the SLP says at his eval. When I know what the problem is, I’ll likely be able to give you more specific advice. You made a great decision by choosing to have him evaluated again. Good luck!! Laura
Comment by isaiahsmom on 14 October 2009:
Hello I have a son who just turned 3 on Saturday. He knows the alphabet, can count to 20 to 10 in spanish and can count backwards. He will follow direction, somethimes he will just sit in his room and talk sometimes I can understand sometimes not. He will see someone and say hi over and over again. If he likes something he will reapeat it over and over. He plays with me and his dad. He is also a only child with not other cousins or friends to play with, except at school. He is always happy and well disciplined, not perfect, but he knows what time out is. He is very well behaved. I am going to have hime evaluated next week, but my husband thinks that in 6 months he will get better. He loves us to read to him and has a few book memorized. He says thank you and oops sorry.
It is hard for me to tell if he is just immature for his age and he is 39 1/2 inches tall. I wonder if that also throws people off. Like I said he just turned 3 on the 10 of Oct. I have been so depressed about this and constantly beating myself up. Because I am a stay at home mom, I should have done better.
Do you have any advice or can you recommend any dvd’s or books so I can work more with him at home.
Thanks for your time
Comment by Laura on 15 October 2009:
Isaiah’s Mom - Thanks for your question. Let me ask you a few before I give you any recommendations. Is he not talking directly to you during the day to tell you what he wants or ask and answer questions? How many other words does he say other than counting/letters or hi? Does he come up with words on his own, or is he just repeating books or what he’s heard?
Even before you answer these questions I will say that I’m so glad you’re having him evaluated. Hopefully you’ll get some answers! More importantly the therapist should be able to teach you how to work with him at home.
I also hope that you’ve continued to read the website for ideas. I started the site to help give parents specific recommendations for improving a child’s ability to understand and use language. If you need more direction, I’ve also have filmed a set of DVDs for parents which will SHOW you exactly how to help him learn to communicate. Be sure to check those out for new ideas too!
Try not to be consumed with guilt over what’s happened with him. Being paralyzed by your emotions does NOTHING to help his situation, but taking action so that you do learn HOW to help now will make a huge difference. I hope the site and my DVDs will be able to help you do that! He needs you!!!! Laura
Comment by Leshia on 15 October 2009:
Thank you so much for your response. I will provide an update once I finish the evaluation.
Comment by angie on 16 October 2009:
I have a question:
Should i be concerned that my two year old daughter says the same word twice in her speaking. For example: if she wants to jump in the bounce house she will say: jump, jump. If she wants milk she will say: milk, milk, etc.
Comment by Laura on 17 October 2009:
Angie - Many young children repeat a word twice because many early first words follow this pattern - Mama, Bye bye, Dada, etc… SLPs call this reduplication. It should go away on its own as she matures.
One piece of advice- make sure you’re not repeating her to reinforce this. You could also start saying Mommy and Daddy and just “bye” if you don’t do this already. Does she have other words when she doesn’t use this repetitive pattern? Keep encouraging those! Laura
Comment by Cara on 24 October 2009:
My son is a twin. He is 22 months old now but when he was 3 months old he was put on an NG tube because he refused to nurse or drink from a bottle. The doctors said it was reflux but at 6 months old (after being on the NG tube for 3.5 months) we had his tongue tie clipped and he immediately took the bottle again. By then he has a severe bottle aversion but we managed to get him to overcome it. He eats a variety of table food now but refuses any fruit or veggies unless they are pureed. He has been diagnosed with low tone in his mouth and trunk. However, he has met all gross motor milestones on or ahead of time. He understands most everything I say and can follow directions. At 22 months he only has about 5 words he uses spontaneously (dada, down, uh oh, up, car which sounds like gar) and animal sounds for lion, snake, sheep and elephant). It seems like its hard for him to immitate the words I say to him. He uses the letter D in most of his imitations. I have him in ST and OT 1x a week for two hours and EI 2x a month. We are working on bilabials right now. He was not a quiet child, always babbling but with limited consonants (d,k,g). The SLP does not think she can diagnose him with something like apraxia right now but I am wondering if the NG tube and lack of oral muscle use over those 3.5 months could have caused his weak oral motor strength and contribute to his picky eating and delayed speech? Or does he have to have a diagnosis such as apraxia? I feel like he has some of the apraxic symptoms but not all. I am scared that my little boy will have a lifetime of difficulties ahead of him and never be like his peers. Will he ever talk? Will he need to be in special schools?
Comment by Laura on 25 October 2009:
Cara - Thanks so much for your great questions. First of all, it is waaaay too early for you to be worried about special schools and if he’ll have friends. He is only 22 months old, and from what I read, you are doing everything you can to help him get better. He’s in therapy and you are tackling the language and feeding issues head on. One thing I’d recommend is that you stop focusing on specific sounds, and just focus on adding more words to his vocabulary, regardless of what sound substitutions he uses. This takes the pressure (and in my opinion, incorrect focus) off speech and puts it on communication and language. To target specific sounds when a child is under 2 often defeats your purpose. When you become more playful and focus on WORDS, then you typically see faster results. The truth is, the more practice he gets with speech/talking, the faster those speech sound errors will clear up. If you need more help to know what specific strategies I recommend for toddlers, check out my DVDs Teach Me To Talk (for general language strategies) and Teach Me To Talk with Apraxia and Phonological Disorders (for more specific speech strategies if the language strategies aren’t as successful).
The NG tube, feeding difficulties, and muscle tone issues could certainly all be related to the late talking, but again, it sounds like you’re doing all of the right things. Keep at it, and keep us posted on how he does. Good luck!! Laura
Comment by Cara on 25 October 2009:
Thanks Laura, I just purchased your teach me to talk for Apraxic children (even though we don’t have a diagnosis). I figured it can’t hurt to use these techniques, especially since I know he is having issues with oral motor skills. WE are using a powered toothbrush and NUK brush to strengthen the muscles in his mouth and I work with him on a ball and trampoline to help strengthen his trunk. His low tone is on the mild side from what the OT has told me. So I am seeing some early results in that area. I guess I just wish I knew if it was apraxia or just an expressive speech delay. For some reason the apraxia diagnosis scares me more and I can’ get in to see a developmental pediatrician for about 4-5 months from now. I hope the amount if speech and OT I am getting for him is enough right now. I know that some kids go 5 days a week. Do you think I should be advocating for more?
Comment by Laura on 25 October 2009:
Cara - If you are committed to working with him at home, I don’t think you necessarily need to advocate for more speech or OT sessions right now. As you know he is very, very young - not even 2 yet. I VERY RARELY increase a child’s frequency to more than once a week when they are under 3, and even when I do, honestly, I’m not sure that they do drmatically better than the kids I continue to see weekly who have very committed moms and dads who work with them everyday on their own. Now that opinion may ruffle the feathers of other SLPs who strongly feel that “more is better”, but for most 2 year olds I’ve seen, this has been the case in my practice over the last 10 years or so. I do currently have a couple of 2 year olds that I’m seeing more than once a week and they are doing great, but I’m not so sure they wouldn’t have done equally as well with once weekly. When it clicks for toddlers, it clicks, and more often than not, kids look dramatically better when turning 3 than at their 2nd birthday. Maturation, coupled with the right kinds of therapy in sessions and MORE IMPORTANTLY at home, does marvelous things!! Let us know how he continues to do, and I’d love to hear how you do with the strategies on the Apraxia DVD. Laura
Comment by samantha on 27 October 2009:
hi my son is 6 and a half and he still can talk proper we have great difficulty in understanding him he has speech therpy every week but shows no signs of getting better with his speech
Comment by kara on 2 December 2009:
Hi– My daughter is 18mo and doesn’t talk much. She says dada and various “forms” of words but not actual words. I’ve tried to work with her, by constantly talking to her….but it is very hard to get her to pay attention. She is very busy and always on the move. At dinner she will eat and look at you, but she’s not one to try and repeat what you say. Typically when I say “mama” she smiles and says “dada”. I try to read books, but she won’t sit still for the whole book. She tries to flip that pages and if I hold he book she just gets up and gets another book she can hold. I just don’t know what to do anymore!
Comment by Laura on 3 December 2009:
Kara - I’m going to answer your question on the December 3 edition of my podcast Teach Me To Talk with Laura and Kate so we can give you lots of good ideas for ways to work with her at home. Listen in by clicking on the blogtalkradio icon on the right column of this page. Laura
Comment by Sarah on 7 December 2009:
Hi Laura,
I love your website. It has lots of great information. My question is about my 27 month old son. He tries to talk, and tries to say lots of different words, but they don’t resemble the word at all. He says them the same way each time, but I seem to be the only one who can understand him. For example, he will say “aba” for fast food places (whenever he sees one). He says “aga” for water. Some words are very clear, such as “no”, “more”, and “mom”. Do you think it is too early to start working on sounds with him? I’m not sure what my next steps should be.
Comment by Laura on 7 December 2009:
Sarah - Usually we want a child’s language skills to be at or near an age-appropriate level before we focus on sounds in speech therapy sessions. For a child your son’s age, that would mean that he’s frequently speaking in 2-3 word phrases.
Many SLPs target speech sounds as a real goal before ages 2 1/2 to 3, but I really don’t UNLESS a child is soooo unintelligible that he’s frustrated that no one can understand him.
As a rule I “work on” sounds with children this young by modeling the correct word and giving a few cues such as, “Put your lips together” for /m/ and giving sounds “names.” You can read more about these techniques here on the site in the articles in the apraxia and intelligibility categories. I also discussed speech sound issues on my podcast Teach Me To Talk with Laura and Kate in September, so look in the archives on the right-hand column for this show. If you’d like to SEE examples of cueing sounds with toddlers, check out my DVD Teach Me To Talk with Apraxia and Phonological Disorders.
Thanks for the great question! Laura
Comment by Tiffany on 8 December 2009:
Hi-
My son is 23 months and does not talk at all. He attemots to have conversations with me but everyhting that comes out of his mouth sounds like ah ah ah. He is in speech 2 times a week and he see’s a developmental ped in January. I am worried he has Apraxia and I need to know that some day he will talk. I upset myself thinking that he may never talk??
Comment by Laura on 12 December 2009:
Tiffany - There are some children with severe apraxia who don’t learn to speak, but most children, even those with speech-language delays, do eventually learn to communicate. You’re doing what you can to help him by having hin enrolled in speech therapy at such an early age, and you sound like you’re doing your part at home to help him as well. Keep reading ideas here on the site, listening to the podcast, and if you’re not sure how to work with him at home, check out my DVDs. Good luck! Laura
Comment by dk on 14 December 2009:
just discovered your site…
however, the home page comes up blank (when I click on home or the header)
I also tried to subscribe and received the following message:
The feed does not have subscriptions by email enabled
help
Comment by Nancy on 21 December 2009:
My daughter is 13 months old and does not talk at all. She has no words, or even word approximations. All she says is “ah, ah” or she’ll point and grunt if she wants something. She also doesn’t really babble and never even babbled as a baby. She very rarely will babble in the car when we are driving, she’ll say “babababa” but this is rare. I am having her hearing tested in two weeks, but I think she can hear because she seems to understand everything we say ie. “where’s the baby?” and she will go get her baby doll for me. She claps and waves bye bye.
She seems fine socially and has met all other milestones. She walks well, feeds herself and is affectionate. Her receptive language is excellent also. I am having her seen here in Canada for her speech, but at this point all they are offering me is parent training because of her young age. I am trying some of your tips on your website, but it has been so discouraging because she doesn’t have any sounds apart from “ah, ah”.
I guess I am wondering if it is possible that she is a only late talker despite the fact that she never babbled. Have you ever seen or worked with a child who was only speech delayed (as opposed to apraxic)and never babbled as an infant? I am so worried about her. What are your thoughts?
Comment by Laura on 22 December 2009:
DK - We’re experiencing website problems. The home page seems to go down about every 48 hours, and we’re working to find a permanent fix. Thanks for the notification!
Comment by Laura on 22 December 2009:
Nancy - I have worked with children who seemed to skip babbling and go straight to words, but as you noted yourself, children with apraxia do this more often. Try looking at the article “Help! My Child Won’t Imitate Words” for other ideas of sounds she may be more likely to try to imitate. Some children try animal sounds more often than any other sound, and these are made up of the very same consonant and vowel sounds that words are, so try these. Also try these during fun and playful exchanges when you are just modeling the sounds yourself without lots of obvious cues for her to imitate you if she seems to “shut down” with pressure to perform. For more ideas, check out my DVD Teach Me To Talk with Apraxia and Phonological Disorder since you can SEE the techniques in action with real toddlers. Thanks for your question. Laura
Comment by Chris on 5 January 2010:
My grandson just turned 4 and barely speaks. Occasionally he will blurt out a word but not often. He had seizures starting at 2 months old and were finally under control at 13 months. He has been on medication and seizure free for 3 years. He is going to an early intervention pre-school where he gets speech, occupational and physical therapy once a week. He is doing remarkably well in most areas but is not talking. He knows some sign language and uses it. He understands if you tell him to get something or when I’m reading a book that he has heard repeatedly and he knows when his favorite part is coming up. He points to everyone when asked and watches wonder pets, etc. and laughs at the right places. I am concerned that he won’t talk. What is your advice.
Chris
Comment by Laura on 6 January 2010:
Chris - This website is FULL of advice for ways you can play with him at home and facilitate those first words. I’d highly recommend that you take a look at articles in both the receptive language section to be sure he’s UNDERSTANDING language too since you have to understand words before you talk. You should also read the articles in the expressive language section as well to give you more ideas for eliciting those first words. I’d also recommend that you check out my DVD Teach Me To Talk for 6 strategies you can implement at home to get those early words going. It’s filled with examples of real children during therapy sessions and the kinds of things SLPs do to encourage young children to learn and use words and simple phrases. Sometimes it’s not what you’re doing, but how you’re doing it, and the DVD can help you SEE that first hand. Hope this helps!! Laura
Comment by vita on 12 January 2010:
My son is 3years and almost 4 months. He would say one or two words every now and then but he wont speak 3 more words. He’s not speaking in sentences. His father and older brother had ADHD. Had being that they grew out of the symptoms. They also had to see speech, behavior, and occupational therapists. My son is hyper and mostly inattention and doesn’t look me in the face when I’m talking to him. He looks me in the face when I’m singing. He learned his ABCs by the time he was 1 1/2 years old. His motor skills are fine. He’s just mumbles sometimes.
Comment by Laura on 14 January 2010:
Vita - Based on what you’ve said, your son does likely have an expressive language delay. By 3 children should be talking in 4 and 5 word sentences consistently. Since he’s not doing this, I’d go ahead and encourage you to have him evaluated. You want him as ready as he can be for kindergarten in a couple of years. Check with your local public school district for an evaluation. Laura
Comment by Jana Green on 5 February 2010:
Hi Laura, it’s me again (heh!).
As I go through the symptoms you list of apraxia, Jakob did/does ALL of them. And as far as I know my husband didn’t talk until he was almost three, and I required Speech therapy to work on my r’s until the 3rd grade.
I have decided to get Jakob referred to a private SLP and have him re-evaluated, and I want to talk to the Therapist and see if she will treat him like he DOES have apraxia, even though he has not been diagnosed.
Does that sound like something that I should do, or should I give the ‘traditional’ speech therapy techniques done by our ECI SLP a chance?
I just don’t see them working. They don’t work for me, do you think they might work for her? I know (because I used to teach) that kids do different things for different people, especially when that different person is NOT his mom. Could this be the case with this SLP and Jakob?
If so, how long do we keep doing the traditional methods before I press her to try something else, more focused?
There’s a chance I might decide to do BOTH…private and state-funded ST. Could this be harmful to Jakob?
Also I am working with him on my own at home, but I don’t want to stress him out, and I don’t want him to feel like he doesn’t do ANYTHING right. He is in fact very adept at many other aspects of development. So what would you say is the best way to go around our day-to-day routine and work on speech, but not OVER-DO it?
Thanks,
Don’t worry, I’ll mellow out after I hear this answer….
Comment by Thomas on 7 February 2010:
Hi all,
I am a 21 year old male. I have difficulty producing any words in a logical sentence and even writing logically. No words really come to my head. I was an only child and had everything done for me (spoilt in a sense) so now I walk around everyday staring at what is around me and not knowing where to go or what to do. I have resorted to finding at least one job so my girlfriend doesn’t think I am a complete bum. I don’t even know what to have for breakfeast, lunch or dinner. I am extremely absent minded and have a hard time observing what is around me. I have $8,000 in debt.
If your child is experiencing any speech problems I would get onto it straight away or else you will risk having him end up like me. Please do it for the benefit of your children.
Comment by Laura on 7 February 2010:
Jana - Since you’ve graciously decided to be on the podcast, we’ll talk about all of this at length on the show! Laura
Comment by Laura on 7 February 2010:
Thomas - Thanks for your comment, and I hope things improve for you. There are many SLPs who work with adults, so I’d encourage you to continue with treatment, even as an adult. There are many, many techniques you can use to help you recall words and target improved written language. Ask your physician or search for community-based programs like Vocational Rehab who can refer you for continued treatment. If you need more specific ideas, email me back at Laura@teachmetotalk.com so I can help you find resources in your city. Good luck to you! Laura
Comment by Jonathan on 11 February 2010:
My Son is 3 1/2.. He has lots of problems pronoucing words. Most of the time we can figure out what he is saying and sometimes we cant. He even gets frustrated when we cant understand. He is extremly smart and understands anything you ask of him. We did take him to a speech therapist about 15 times but all he got out of it was to clearly say “mine” which discouraged my wife and I from continuing. Older brother and sister did most of the talking for him when he was younger which might be most of the problem. He started daycare at age 3 to be around kids his age and has had lots of improvement. Should we be concerned?? Thanks for any thoughts
Comment by Laura on 12 February 2010:
Jonathan - Let me wholeheartedly recommend speech therapy for you again. If he has intelligibility problems, if he’s becoming even more frustrated, and if maturity is not making it better, then I’d give speech therapy another whirl.
Now, at the risk of really offending you, I’m going to tackle something you’d probably not rather I bring up. I too have worked with parents who didn’t like it when a child learned to say words they didn’t want to encourage like “mine” or “no” or even something like “candy.” However, as I’m doing now, I try to gently point out that I’d much rather have a child use an appropriate word to express a very real-life emotion, rather than the alternative, which might be screaming or even physical aggression like hitting and biting. I would choose to teach a 2 year old to say “mine” every time (being careful to model it in way that’s not “bratty”) instead of leaving him to whack his sibling when he wants a toy, or even worse, stand there helplessly when another child tries to take something from him without an appropriate way to defend himself.
However, YOU are his parents, not me, and I certainly respect your right to parent him as you wish. I just wanted to offer this little word of advice, which is likely much easier for you to read from me than it would be for your next SLP to tell you in person.
If you’re really unsure of trying speech again, let me at least direct you to my DVD to teach you how to work with speech intelligibility problems - Teach Me To Talk with Apraxia and Phonological Disorders. On the DVD you’ll SEE how to implement speech therapy techniques at home that will help him speak more clearly and it’ll point you and your wife in the right direction with ideas for how to work with him yourselves. It may not help you fix everything, but it would likely be better than nothing.
Thanks for your question, and again, I hope I didn’t hurt your feelings
Laura
Comment by Justin on 28 February 2010:
We have a 19 month old son (born 5 weeks early), he does not consistently say or repeat any words. From time to time he spits out a word once however you don’t hear it again (maybe max of 10 different words we have heard once or twice). We live in the States, I speak my native Australian English to him and my wife speaks her native Finnish to him. I see him in the evening and weekends, my wife is at home with him full time. He is not in any daycare and has limited interaction with other children or adults.
He understand questions in both languages, if we ask him (in either language) if he wants milk he runs to the fridge waiting for milk, if we ask for the ball or favorite toy he will get the ball or toy. When he wants something like water her will just reach out and whine to get our attention, before giving it to him we try to encourage him to say water but he just get frustrated. Also when we try and get up close and personal to get him to repeat a word he gets very frustrated. On his own accord he mimics actions like hugging, kissing or being on the phone, however he does not respond to mimic actions under encouragement like waving hi or goodbye.
He has no patience for learning and especially books, he can’t sit still for longer than 1-2 minutes, he just runs and runs all day long. He is not good with identifying putting shapes in the correct location in simple puzzles, he is unable to identify the difference between colors or shapes when asked which is blue or which is square.
He has been developmentally slower across most things like walking and has reached most things with a little extra time. He seems to have very little patience and it doesn’t seem like he is catching up with the speech or identifying the commonalities in colors and shapes.
Comment by Laura on 28 February 2010:
Justin - Thanks for your comment. I don’t think you should worry about him not knowing colors or shapes yet since it’s still too early for that, but he should be imitating familiar words easily and often and should have an expressive vocabulary of 10-15 words by now. I also wouldn’t worry about books or a short attention span just yet either since LOTS of children (especially boys) his age, both with and without language delays, are the same way.
But that being said, his receptive language is moving along, and research tells us that children who live in bilingual homes do speak later than those growing up hearing only one language.
Since you are in the USA you can have him evaluated by your state’s early intervention program. Google your state’s name plus the phrase “early intervention” for contact information. If he doesn’t begin to say some words on his own consitently and certainly if he doesn’t start to imitate in the next couple of months, I’d encourage you to go ahead and pursue this assessment.
In the meantime, read the articles here on the website for ideas. You can also check out my DVD Teach Me To Talk with easy to implement strategies that you and your wife can use to work with him at home. Sometimes SEEING someone else implement the recommendations makes it easier for you to do those things with your own child. Hope these ideas help! Laura