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March 23, 2008 | Laura | Comments 91

Working Toward Intelligible Speech in Toddlers

“Now that my baby is finally talking, I can’t understand a word he’s saying!”  First we want them to talk, then once that happens, we complain that we can’t understand them.  This is a big concern among parents of toddlers, especially when you’ve waited longer than you expected for those first words.    

“Isn’t it normal not to understand what my two year old is saying?”  The answer to that is both yes and no.  Here are the norms. 

Parents should understand at least 50% of what a toddler is saying by their second birthday.  By age 3, parents should understand most (90%) of what a child is saying.  By age 4, strangers should understand most (90%) of what a child says. 

For those of you who aren’t familiar with typical speech sound development, let’s begin with a quick review of the basics.  

Babies begin to use vowel sounds to coo during the first months of life.  Then babies begin to add consonant sounds and combine them with vowels to begin babbling between 7-9 months.  Babbling is using a string of consonant-vowel syllables.  Most early babbling includes reduplicated or repeated syllables (”mamamama”).  Near the end of the first year or shortly after, many babies begin to use approximate real words.  They also become more sophisticated in their babbling and can sequence syllables with different consonant-vowel combinations.          

Bilabials, or lips sounds, /p, b, m/, are usually the first consonants to emerge.  (FYI - This is the reason that ”Mama” and “Papa” are universal parent names!)  Other consonant sounds such as /n, h, w/ are also “early” developing consonant sounds.  Most children, or 75%, have mastered using these consonant sounds and all vowel sounds in words by their second birthdays.  Consonant sounds that generally emerge before and around age two-and-a-half are /t, d, k, g/ and “ng” and /s/ at the ends of words.  Some sources report that /f/ also emerges around 2 1/2;  some cite between 3 and 4 years.  Later developing consonant sounds that emerge during the preschool years are /r, l, z, v/ and  “ch, sh, j.”  The sound “th” is usually the last consonant sound mastered after age 5.          

Jargon emerges in most children between 12-18 months.  Jargon is defined as unintelligible strings of sounds that mimic adult speech.  Some parents refer to this as ”gibberish.”  Sometimes parents get upset when they hear their children using lots of jargon.  Actually jargon is an indicator that a child is learning to sequence sounds and is trying to copy conversational speech.   However, in the absence of other “real” words, it can be unsettling for some parents. 

Many parents ask, “How should I respond if I don’t know what he’s saying?”  My advice is to reword what you think he intended to say to ask for clarification.  Hopefully, he’ll try to correct you if your guess was wrong.  Other advice is to encourage your child to SHOW you what he wants or is talking about.  If your child becomes overly frustrated when you don’t understand, you may be able to slide by with nodding or offering a general comment such as, “Oh!”  However, if your child is adamant about telling you something or asking you for things you don’t understand, “faking it” may not work.  

This is one reason I love signs or even pictures, especially for difficult words your child asks for routinely that you never get on his first (or seventh) attempt.  If he keeps asking you for something and you finally “get it,” store a mental “audio clip” of the word, or take a picture of the object so you can use it to help the next time.                  

Being understood is an important part of communicating.  But let me interject a word of caution.  Until a child’s language skills, that is the number of words he’s using and how he combines those words into phrases and sentences, are at or near an age-appropriate level, intelligibility should not be the sole focus for speech-language therapy OR for parents at home.  Overcorrecting a 1 or 2 year old child’s speech errors can lead to frustration and a shut down of progress faster than anything else you can do to a new talker.

What should you do when your child mispronounces a word?  Model the word correctly and move on.  Your child asks, “Tootie.”  You say, “Cookie?  You want a cookie?  Here you go!”  

Actually, before you start to work on specific consonant sound errors, there are other more important factors you should consider to make your child easier to understand.  

First Targets for Intelligible Speech in Toddlers 

1.  Is my child using the correct number of syllables in a word?

Consider the child who says “ba” for ball, balloon, and blanket.  You’re going to be able to understand him better if he is able to use “ba” for ball, “ba oo” for balloon, or “bwa ee” for blanket.  Even though these words aren’t “perfect,” you’ll probably be able to figure out what he wants more easily than if all the words sounded the same.    

If he’s leaving off syllables (not just individual sounds, but entire syllables), start here first. 

Tips for working on syllables - clap or pat the floor as you say the word to help him hear and feel the difference.  Try words with repetitive patterns (reduplicated syllables) such as bye-bye, Mama, Dada, boo-boo, Bubu (for bubble or brother), and nana (for banana or grandma).  Some kids get so into this that they “double” everything - dog-dog, car-car, etc…  It’s cute at first, but be careful, or you’ll have to fix that later!   

2.  Is my child using correct vowel sounds in words?

As stated previously, most children with typically developing communication skills use vowel sounds correctly by age 2.  If your child is substituting vowel sounds or leaving off vowel sounds in words, this can be an indicator of motor planning problems, or apraxia. 

Work on vowel sounds by exaggerating them in words, and using new ones alone as “sound effects” in play.  For example, if your child can’t say an “ee” such as “green,” “baby,” or “whee,” pretend to be scared during play and let out a big “eeeeeeeeeeeee.”  This is also one of the vowel sounds that you can “help” him learn by pulling out both corners of his mouth into a smile.  “Cheese” is usually an effective cue not only for picture taking, but learning this vowel sound.

Other vowel sounds you can provide a tactile (touch) cue are “ah” by pulling his chin down with your finger and “oo” by pulling in her cheeks to help her round her lips. 

I use lots of animal sounds to work on vowels and really exaggerate the vowel sound.  Think - mooooo, baaa-baaa, meee-ooooow, woooof-wooof, etc….          

3.  Can my child use 2 different vowel sounds in words, or does he always copy the first sound for the next syllable?

Learning to “change” the vowel sound for a new syllable in a word is especially difficult for some toddlers.  You may continue to hear him say “Coo coo” for cookie, “o po” for open, or “ca ca” for cracker.  Work to help him hear and say those differences.  Again modeling exaggerated vowels is the best way to do this. 

Your child’s SLP may be able to help you come up with “modifications” of particular words that may not be completely correct, but sound “closer” to the intended word.  For example, for a child who can’t say “cracker,” you may teach “ca uh” as an in-between more intelligible version of the word.  (Some children have difficulty using different consonant sounds in words until age 2 1/2, but most have mastered this by age 3.)            

4.  Is my child learning consonant sounds in the beginnings of words and syllables?

Usually beginning consonant sounds come first, but in some children, they continue to omit beginning sounds while adding some ending consonant sounds.  It is very difficult to understand children who use words and phrases with predominantly vowel sounds.  I have several children doing this at any given time on my caseload.  Children who are using mostly vowels absolutely need speech therapy to help them learn to use more consonant sounds. 

Your SLP will be able to teach you and your child “cues” to help him learn additional sounds.  If you’re working on this at home, you can try the following ”tricks.”

Many experts “name” the sounds for young children rather than calling them by the letter.  For example, /m/ can be called a “motor” sound, or a ”yummy” sound.  A /p/ can be called a “popper” sound or “lip” sound.  These names can be found in many early articulation books, or better yet, talk with your child’s speech pathologist.

If you’ve heard your child use consonant sounds at the beginning of one word, or even in a word you couldn’t understand, using these sounds that he can already produce in at least one context is generally easier than teaching new sounds.          

5.  Is my child using ending consonant sounds?

This is the question about articulation that I’m asked the most.  Final consonant deletion occurs in many children until 2 1/2 to 3 years of age.  Easiest ones to work on include /p/ and /t/, both unvoiced consonants.  If your child is producing /k/, you may also try this sound.  The voiced consonant sounds /b, d, g/ should not be early final sound targets because your child may end up adding a vowel sound at the ends of words such as “bug -u” or “bed-a” in an effort to produce this sound.  Once your child is using unvoiced sounds, the voiced sounds should emerge on their own. 

I also work on /s/ since this final sound carries so much grammatical information.  For example, children need final /s/ to make words plural such as “cats” and “books.”  Using plurals is a language concept that emerges around age 2 1/2, so /s/ is an important sound. 

Many children begin using /s/ as a lisp.  Although it’s an incorrect way to produce /s/, it’s very common until age 4 or so.  You can target this by telling your child to “hide his tongue behind his teeth” or to say “smile and hide your tongue.”                   

Other Hot Topics Related to Oral Motor and Articulation Issues - Pacifiers and Sippy Cups 

If your child is using a lisp, it may also be an indicator that he’s developing an open bite, that is there’s a gap between his upper and lower teeth.  This can be attributed to prolonged use of sippy cups or pacifiers.  Although it’s messy, your child should switch to an open cup or straw when he’s at the table or in another place that you can clean up easily.  Save the sippy cups for the car. 

Your child should NEVER go to bed with a sippy cup or bottle, no matter how convenient it is to help him to sleep.  Leaving the cup or bottle between your teeth while sleeping is what leads to the open space AND tooth decay, especially if you’re using milk or juice.  I’ve known several two-year-olds who have gone to see a dentist before age 3 with a mouth full of little black teeth.  Not a pretty site.  If you can’t kick this habit just yet, at least switch to water. 

Straw drinking is great for oral motor and sensory skill development.  Look in the toddler dishes/utensils section of the major retailers for many options for these cups.  Sports water bottles are also a good option.    

I think it’s okay to use a pacifier for sleeping until age 2 1/2 to 3, but excessive use during the day is not recommended if your child can calm down without it.  If your child has sensory issues and using sucking to help him regulate, keep the pacy without feeling guilty.  

It’s a myth that pacifiers prevent children from talking.  Most kids try to talk with it in their mouths and then take it out if their parents insist that they don’t understand them.  If your toddler is addicted, try to limit it to naps, bedtime, and when he really needs it to see if having an open mouth will help him vocalize more.  I don’t let children keep pacifiers in when I’m in their homes seeing them for therapy unless they are falling apart without it.  Many children I see work so hard during treatment that they need it to calm down after we’re finished.  Many parents of children I see need them to have it for times when no other option works to wind down a jacked-up toddler and end a tantrum.  As a mom, I’m just fine with that.                       

If you have other questions, please feel free to post a comment.  Laura           

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There Are 91 Responses So Far. »

  1. Laura,
    If I may ask your opinion…Sydney had her school district evaluation in august. The SLP used a test (d-sat? I forget the name)to test her errors. Sydney had errors 80% of the time. Is this a good gauge of severity?(I consider her severe…) We are holding a new IEP next week and I am not sure if I should ask for an AAC eval (siting severity)or just try PECS and not worry about pursuing AAC for now. I am afraid if I don’t get it written in early on it may difficult later on. Also, when asked to say a word with a final consonant “hop” for example, she instead says “pu” or “up”=”bu” pop=”ot” is this considered final consonant deletion or substitution?
    Thanks!
    Courtney

  2. Courtney - I’m not sure exactly what test you’re referring too, but errors 80% of the time on any measure would seem to indicate a severe problem. I think you should go ahead at the IEP and discuss AAC if you think you might want to pursue this in the future since you may very likely have to ask for this several times before the school system relents and says yes. They may want to try PECS first (because it’s easier and cheaper), but if you go ahead and start discussing it now, you’ll have more of a paper trail to assist you in the future.

    Just so you know, I am not an “expert” in the law or dealing with the schools, but I have attended my share of IEP meetings as a mom since our oldest son (now 19) had dyslexia and had an IEP thru his junior year in high school. My advice about anything related to IEPs is to ask for the moon initially, and then be willing to compromise when it’s truly not a deal breaker issue. In our experience, we often had to ask for something several times before it was done, and even talk about using a legal advocate to get results. But every school system is different, so be prepared for the worst, and you won’t be shocked or disappointed.

    Okay - about her off-target word attempts -an SLP could likely classify it several different ways. When the consonant is not there in the targeted position, it’s considered deletion, but when it is there but wrong, it’s a substitution. Some of her substitution errors can also be further classified from a phonological processes perspective, so then you will hear a couple of different terms used. This should be important for the therapist to clarify for herself as she makes treatment decisions, but I don’t know if I’d get all hung up on that if I were you, unless you’ve turned into a speech-junkie yourself, which does happen to moms occasionally!

    I think you said earlier that you’ve had her assessed and her diagnoses include both apraxia and phonological disorder. Some SLPs look at this as either/or, but I agree with the experts who say that some children could really have both. Many times a child is initially diagnosed as apraxic and then ends up with a phonological disorder dx by the time they are in preschool because their sequencing issues and imitation skills have improved so that they are left with really horrible artic, which would likely be classified as a phonological disorder.

    Anyway - I probably provided you much more info that you asked for! Thanks for the question - Laura

  3. Laura,
    Thanks so much for the good information! I must admit,I am becoming a speech junkie, but I have a hard time distinguishing the errors/or patterns, really I just want to figure out if she is making consistent errors. Her therapists have all said at different points “she needs more vowels” so I want to work on that. her new therapist is teaching us the tactile cues,and giving us great at home tips. I feel inspired to start some serious mommy therapy:) Her IEP is next week, I will think I will be asking about the AAC evaluation.
    Courtney

  4. Hi Laura,
    I have an 18 month old that is using limited vowel sounds (no long vowels) and only first syllables in words. Her consonants are maily /b/, /d/ and /m/. I am a speech pathologist, but for the school setting. I am aware of apraxia, and it has crossed my mind, but i am wondering if there is still a chance she will improve and “grow out” of this. Receptive language is excellent. She does use jargon often.
    Thanks,
    Kelly

  5. Kelly - She’s awfully young, so I’d try not to worry about this yet. How many words does she have? I’d keep the focus on language - language - language and try not to make it about speech just yet. That’s hard if you work on artic all day long! You can also read thru the apraxia articles for ideas to work on those vowel sounds in play. I’m also working on a DVD about apraxia in toddlers and young preschoolers, so if you’re still worried by the time she’s turning 2, you may want to check that out. Hope these ideas help, and feel free to e-mail back with any other thoughts/concerns/questions. I LOVE to talk to other SLPs!!!! Laura

  6. Thanks for the response, Laura. It is hard not to worry when you are an SLP yourself!! She has about 10 words, but those are the ones we know she is saying. She attemps to say a million others, but, as your article gave the example, she says “ba” for who knows how many words!!! so i don’t really count those “words”. I appreciate the tips for the vowel and for adding syllables–she is doing well otherwise, so we will just “play” and cross our fingers! :) Kelly

  7. Hi Laura
    I have a 17mo. old girl who is not making any long “ee” vowel sounds. I actually don’t think I’ve ever heard her make and “ee” sound when babbling or jargon. She has about 8 clear words. Should I be worried?

  8. Hilary - Don’t worry about it yet since she’s really young and you’ve only mentioned this as the only sound she can’t do. However, but do help her learn to make the long “ee” sound. I like to try it with animal noises. I usually practice long “ee” while we’re playing with a monkey. You can also try it with “cheeeeeese” for pictures.

    If she’ll let you, you can also gently guide her mouth to make this sound too by placing your fingers on either side of her lips and pulling them wide like she’s smiling. Say a big “eeee” while she’s doing this and encourage her to imitate. Some young children HATE having their faces touched, and when this happens, I do not continue to do this since making her mad will actually negatively impact how she will try in the future.

    Good luck with these ideas! If you find something else that works, please share it with us. Many children find that sound really difficult. Laura

  9. Laura,
    Thank you. I started feeling like my daughter was the “only one,” since many friends children seemed to have this right away i.e. “daddy, key, kitty etc.”
    I have been reading through old posts and have come across some great ideas. I’m going to mention this board to some clients who I know kids are in speech…
    My daughter automatically think monkeys say “oou oou ah ah” :) but I will work with her on the cheese etc. We like to make funny faces in the mirror so maybe that’s when I will try to touch her face. I don’t want to make learning negative. Oh and I forgot to mention. We started signing at an early age (6mo.) which she picked up quickly. She has a HUGE signing vocabulary. Could this be impacting her speech or spontaneous words? I’m pregnant and worried about teaching my next baby signing. Thank you again for your response and very helpful information.
    Hilary

  10. Hilary - Lots of research tells us that children who sign do NOT talk later, so please don’t think it’s the case and skip signing with your next one. If you had not signed with your daughter, can you imagine how frustrated she’d be right now with only a handful of spoken words and no way to tell you what she wants? My advice is to keep signing and don’t look back. She’ll drop the signs in lieu of words since it’s much easier and faster to talk. Unless a child has selective mutism which is very, very, very rare, they really do opt to talk when they are cognitively and physically able to pull it all together. She’s got some words, so it’s just a matter of time before her spoken vocabulary catches up with and then surpasses the signed ones. When she does stop signing, you’ll be glad she’s moving along, but you’ll also probably miss the signs and look at it as her “rite of passage” into older toddlerhood, so get her cute signs on videotape while you can! Laura

  11. Laura,

    Our 21 month old daughter is a jargon expert. The only intelligible words she uses are da/da, da/de, uh/oh and a host of exclamatory vowels. Aside from /d/ her only consonants are a gurgly /g/ mixed with a crackly /k/. No signs of /p/b/m/.

    She wasn’t speaking at all a few months ago but after reviewing your DVDs and spending time on the floor, as you put it, she started talking a lot.

    Now she will point to something, crank out an entire sentence of gibberish, and then stare at you waiting for an answer. If I watch her carefully while she speaks I note that she tends to draw down one side of her lower lip asymmetrically in a position that I find difficult to mimic.

    Her receptive abilities seem ok but it’s hard to tell because she cues off of so many contexts. She is very communicative, interactive and playful. I have tested her hearing with a tone generator and she responds to a normal frequency range.

    We plan on raising these issues during her 2 year pediatric appointment but we would appreciate your unofficial opinion in the meanwhile.

    Thanks!

  12. Ed - So glad the DVDs are helpful to you! Please discuss this with your pediatrician; however, know that you can usually refer yourself to your state’s early intervention program. She may not qualify yet for therapy because she’s still so young, but her sound system does warrant a look by an SLP. If you opt not to do this with your state program, I’d still see an SLP who specializes in treating very young children at age 2. Even though language should still be your focus, and by that I mean words/vocabulary development, if she’s not expanding her speech sound use in words by 2, I’d want her looked at, and again by a person who specializes in young children. Jargon is age-appropriate for her right now, and I love that she’s communicative, interactive and playful. From what you’ve said, you’re on the right track with her! Keep up the good work!!! Laura

  13. Thanks Laura,

    That’s what we figured, that 2 was about the right age to have her evaluated if she hasn’t progressed. We will keep working with her in house until then.

    And yes the DVDs are very helpful. We can read all day but seeing the knowledge put into practice makes all the difference.

  14. Hi, Laura. My son is 2 years old (29 months) and he does words clearly. He babbles a lot and if he wants something he pulls me to but whines as he does it. Early Intervention is working with him now and he recieves speech therapy (which I can see some difference) but he stills doesn’t say “mama” or lets me know what he wants and it really breaks my heart. He is scheduled to go to a Developmental Pediatrian to evalutate him. I hope they don’t give me any bad news. I can tell he wants to say words because he grunts but it just won’t come out. Will this DVD help a little cause I really want help?!

  15. My child is 18 months, and he can only say dada, dog and done, and only sometimes. He still cant say mama. He throws things around as a way to communicate. And mostly watches the wheels on his truck spin around all day. He doesn’t hug back, or kiss or say bye bye. He wont even do back and forth vocalizations with me. My husband is very upset at even the mention of the word autism. I want to know if I should get early testing for him.

  16. Bobbie - I wonder if you meant to say, “He does not say words clearly” in your original post.

    Let me give you what DVDs I’d recommend for you based on what he’s doing -

    1. If he’s not following simple commands consistently or interacting with you regularly other than to pull you to what he wants, I’d order Teach Me To Listen and Obey 1.

    2. If he’s following some very basic commands, but still doesn’t seem to understand most of your directions or conversation, I’d order Teach Me To Listen and Obey 2.

    3. If how he understands language is okay, but it’s just how he talks that’s a concern, I’d recommend Teach Me To Talk.

    4. If there are both concerns with how he understands AND how he communicates, get Teach Me To Listen and Obey 1 and Teach Me To Talk. I’d prioritize them according to what you’re most worried about, but some parents are often confused and think that the reason he’s not talking is purely an expressive problem when comprehenion, or not understanding, is the real reason his language is delayed.

    You should also ask your current therapists what’s the bigger concern for him - receptive language (or understanding), expressive language (or talking), or both. That should let you know where to focus most of your time and energy at home.

    I understand your concern about the Dev Ped visit, but ALL knowledge is a good thing, even if it hurts a little to hear any bad news. You’re doing a great job by getting him evaluated now while he’s young and when therapy seems to make the most difference. I hope things go well for you all! Laura

  17. Crystal - Generally the earlier a problem is identified and treatment is initiated , the better a child’s outcomes long-term. However, 18 months is very, very young. Sometimes children who have a handful of words don’t qualify for services and then initiation of treatment is delayed if a state requires that there’s a minimum time to wait before being reassessed. You could try really, really working with him at home for another couple of months, and then if he’s not responding by learning new words and adding new speech sounds (since it sounds like /d/ may be his only consonant), then I’d definitely have him evaluated at that point.

    I’m not telling you not to worry, but I am saying that he’s very young. However, you should take a really proactive approach right now by working wtih him at home to be sure that you’re not letting time go by with only worry and no action. Read the articles here on the website for ideas, listen to the podcasts, and check out the DVDs if you’re not making any progress implementing what you read. Sometimes seeing an SLP work with a child is what it takes to help a parent know what might be a more effective way to go about teaching a toddler language through play. Either way, I wish you the best of luck! Your little boy is fortunate to have a concerned mother in his corner! Laura

  18. Hi Laura I’d appreciate your thoughts on my 19 1/2 month old daughter. (We live in the UK). She didn’t babble until about 8 1/2 months and until a month ago she had no recognisable words. Whilst she is very vocal with lots of babbling and jargoning, she now says just a handful of words, mostly similar sounds - done, down, gone, da (for yes) car and “lo” (hello). She will also make some animal noises when prompted - moo, mow (miaow), oo oo (monkey) and waf (woof). But other than that, she uses the generic “dats” or “gats” for everything she wants, or if she spots something she recognises like a bird or dog. She will say this over and over until she gets the response she wants. When she babbles she very rarely makes b, p, c/k or m sounds (or sounds like r, sh, ch, but I realise these probably come later anyway). Her hearing has been checked and is fine, and she seems to understand pretty much everything that is said to her! I know she is still very young but I am starting to worry about the possibility of verbal apraxia so I’d appreciate your thoughts.

  19. Jo - At 19 months old, she’s still very young, so I’d not worry about a specific diagnosis just yet. I realize that your system of healthcare is different in the UK, so you may not have access to an SLP or SLT as they are called there, for a while yet. If you could see someone privately, you may have your fears alleviated AND get some specific ideas for how to work with her specifically.

    In the meantime what you CAN do is read ideas here on the site and use those to work with her at home to develop more language. Focus on learning new words, not necessarily new speech sounds, should be your goal at this point. Although you’re concerned about her lack of consonants in words, she’s really too young to target specific sounds just yet UNLESS you are doing this in the context of play. There are LOTS of ideas for ways to do this here on the site in all of the expressive language articles and articulation category. Read, read, read!

    If you need to “see” the strategies I recommend, or if they’re not successful after a few weeks, check out the DVD Teach Me To Talk.

    Hope these ideas will help! Laura

  20. Laura,

    I have a 23 month old son who is having articulation issues. He leaves the first sound off of most of his words, especially if the word starts with a consonant blend (snake- ake, blue-oo, two- oo, cat-at, hat- at). He is very bright and his vocabulary seems to be expanding appropriately. He has about 100 words. It is difficult to understand him, but we are usually able to figure out what he is saying based on context clues. I am a little worried, but I also realize he is very young. I don’t know if this has anything to do with his articulation, but he also has an open bite that he developed from pacifier use, although he is no longer using his pacifier. I would really appreciate a response because if he does need intervention I obviously want to begin sooner rather than later. Thank you,
    Heidi

  21. Heidi - Thank you for your great question! At 23 months I wouldn’t be too concerned about articulation just yet. Leaving off consonant blends in the beginning/initial position of words is very common, even in older toddlers and preschoolers. However, he should be including some initial sounds like /m/ in Mama, /b/ in bye bye, /h/ in hat, etc…

    By 24 months parents should understand about 50% of what a child says, so it seems like you’re falling in that typical range.

    The open bite could potentially affect his articulation, but not in the way you’re describing. In this case most children usually sound (and look) like they are carrying and using their tongues in a more forward position, like what most people would call a lisp.

    I’d keep modeling words with initial consonants. Listen for consonants he includes at the end or middle of words, and try to elicit words with those sounds in the initial position. If this isn’t better by age 2 1/2 to 3, then I’d have him evaluated at that point. In my opinion articulation really shouldn’t be the PRIMARY focus for treatment until a child is 3 or so. Sometimes really unintelligible 2 1/2 year olds can benefit from therapy with an articulation focus, but for most children, waiting until after 3 makes the most sense. Of course this doesn’t mean you shouldn’t try to model words with these sound patterns at home and encourage him to repeat you. Keep it light, playful, and fun though rather than “work.” Hope this helped! Laura

  22. Laura, Thank you so much for your response. I will follow your advice and continue to model words in a fun and playful way. Also thanks for doing such a great job with your site. I have really enjoyed reading the articles and your very thought-out and leveled responses to people’s questions. Thanks again. Heidi

  23. Hi there,
    My son is 25 months. In general, he is a very social, engaging, communicative little guy. Our issue is that he is REALLY not intelligible. I have learned to “speak his little language” so well, that it seemed like his speech was improving. But I have now had 2 pediatricians rec. I have him evaluated. I have….I’ll get to that in a sec.
    His receptive skills are excellent.
    He has a vocab. of about 100 “words”. But there is not even one that I can think of that ends in a consonant that he can “complete”. none. I would say he gets the right vowel sound 90% of the time. He makes all kinds of substitutions at the beginning of word too, because his consonants are very limited and not consistent….he has b/d/m/p very good; he has some words that begin with n, w; but he substitues these sounds a bit too.
    He also “mixes up” sounds….Up is “puh”.
    He does have about 60 signs (which helps immensely.) He also has developed “sounds” for several words that he can’t say. for example, instead of saying “snack”, he clicks his tounge. for “orange” he makes a chewing gum movement with his mouth. He makes animal noises for animal names. truck sounds for the word truck, etc.
    He does not have apparent chewing/facial expression issues.

    On his Early intervention evaluation, the SLP feels he needs speech therapy, but on their test he comes no where near qualifying for services. She said he has a few signs of possible motor planning issues; but cannot make a diagnosis of that at this point. So what do I do? I can have him evaluated privately, but our insurance will not cover therapy. I can work with him myself, but I’m soooo not qualified. I worry that he will fall farther and farther behind.

    Thanks for any suggestions.
    Teri

  24. Teri - I do think you’re wise to begin to work with him at home at this age since you can make a HUGE difference. Have you checked out my new DVD for working on sounds at home? It’s called Teach Me To Talk with Apraxia and Phonological Disorders and is loaded with tips and strategies parents can use at home. If you need more specific ideas, please ask! Laura

  25. Hi,
    My 7 months daughter had a tongue tie…we got it operated but still she skeeps her tongue towards oneside when making babbling sound…………Is it normal or do I need to consult some doctor.

    Wht you think will she be good and clear with her speach……..

  26. AM - When your tongue deviates to one side, it usually indicates muscle weakness. However, lots of people learn to talk with a slightly weaker tongue and compensate quite nicely. If she doesn’t begin talking between 1 and 2 or if her words are very, very slurred, I’d see a speech-language pathologist at that point. Until then, don’t worry. She’s very, very young. Laura

  27. Hi Laura,

    I am currently a CFY and working in EI home based therapy. I definitely don’t want to be giving “bad therapy”! Do you have recommendations for materials, courses, etc? I feel that I have a good foundation from graduate school, but I want to be good at more than just the basics!

    I also have a specific question,
    Most of my caseload thus far has been children who are not using many words or pairing words together and I am comfortable with that and my kids are all making progress. I recently picked up a child who is 32 months old, and has a large vocabulary and is putting words together into 3 word sentences. So language really isn’t the concern. But his articulation is terrible. AFter 2 months with him I still am looking to mom for a lot of interpretation. He is mainly leaving out syllables, dropping end sounds, and he also has vowel errors. So far I have been working on syllabels and vowels. I just feel a little lost with doing artic therapy in the home setting. I feel fine with artic once the child is older than 3 and coming to my office. My district is currently pushing a “no bag” approach and routines-based intervention, which is making me even more uncomfortable. If I could bring my own toys so that I could think through specific target words/sounds, I would feel a lot better. But I have to go into the home and just “wing it” and follow the child. Do you experience this? Do you have any suggestions for how to provide good artic therapy without being able to bring my own materials?

  28. Katlyn - Thanks for your great questions! I am going to answer your questions next week on Thursday, January 21 at 2 pm during my podcast “Teach Me To Talk with Laura and Kate.” Tune in for what I hope will be helpful suggestions for you! If you’d like to call in for this discussion, email me at Laura@teachmetotalk.com and I’ll send you specifics. Laura

  29. Hi Laura,

    My daughter is 27 months and starting speech therapy this week. Her main problem is articulation and lack of word combinations, but there’s one thing she does that none of the speech therapists or her doctor have ever heard before. Ever since she began talking she puts an “uh” sound in front of her words about 95% of the time. “uh-mama” “uh-ball” etc. Also when she’s frustrated or not being understood she’ll do it two or more times. “uh-uh-uh-mama” I was wondering if you had ever heard of this or knew what it might be?

  30. Jessica - I have had a couple of children do this before and in both cases, I noticed that parents were labeling everything “a car,” “a ball,” “a cookie,” or even, “That’s a ball,” “Here’s a book.” In both cases when we focused on NOT saying “a” the child stopped doing it as often. Try to analyze your language when you talk to her and see if you’re doing this unconsciously. Try other combinations too like “more crackers,” or “juice please.” This could be it, or it could be something unique to your daughter! Let me know when you figure it out since this is very interesting to me as well!! Laura

  31. Jessica and Laura,
    My 2 and a half year old son does the same thing, for example he’ll say, “uh-milk”. He started early intervention at 9 months of age because he was barely making any sounds at all. He didn’t coo or babble. He didn’t speak his first word until almost 20 months. Now at 2 and a half, he no longer qualifies for early intervention because he talks constantly! However, his pediatrician is very concerned since I’m the only one who understands him. I’m currently waiting for an appointment to have him evaluated by a SLP. There are many consonant sounds he needs to work on. “Backer” for “cracker”, “nack” for “snack”. My husband doesn’t even understand him much of the time. How concerned should I be?

  32. My son is 20 months old and has about 10-15 unprompted words he says daily; while his word sounds are consistent, many of them do not contain ending sounds. He says “du” for duck, “bo” for boat, “joo” for juice etc. In addition, he will attempt to say new words and his beginning sounds are great, but then other days he acts like he can’t say those new words anymore. I am concerned when he will say a word like “bo” for boat for a month, and then he loses that word and won’t repeat it when prompted for a couple months, and now he is saying that word again. There are several words he has mastered and now acts like he can’t say when prompted. Is this normal language development or a behavior I should be concerned about?

  33. Jayme - It’s no big deal that he doesn’t have ending sounds yet since he’s not even 2. It’s also great that he’s now saying words he seemed to “forget” and hopefully those other words will return soon too. However, “losing” words is never part of typical language development. Keep an eye on this and if it persists, you will want to be concerned.

    Most children with typically developing language have a language explosion between 18 and 24 months. If this doesn’t happen and he’s not using 2 word phrases frequently by his 2nd birthday and doesn’t say 50 words on his own, THEN you can be concerned. Until then have fun teaching him how to talk! Laura

  34. Jen - Lots of children who were late talkers also have speech sound/articulation and intelligibility difficulties. Parents (BOTH of you!) should understand 90% of what he says by 3. Strangers should understand 90% by 4. You’ll find out what you need to know about specific sounds with your SLP eval.

    There’s also lots of information about working with him at home here on the site and in the Teach Me To Talk with Apraxia/Phonological Disorder DVD should you need extra some tips.

    Congratulations on your success with him improving his language! Speech intelligibility will come in time too!! Thanks for your question! Laura

  35. Hi,
    I have a question regarding my 31 month old daughter. Her daycare teacher recommended a speech eval for articulation. She is a very good and fluent speaker with more words that I can count at this point. She started putting 2 word sentences together and now at 31 months she srings together multiple sentences to describe complex ideas (like how she planted a seed and it grew into a flower). I didn’t see it until I looked for it, but she does have some problems with articulation - most notably she says “lease” instead of “please”, “lack” instead of “black” and “way” insead of “away”. I think she sometimes leaves off the constant sound at the end of words, but I cant think of a recent example. I took her to the pediatrician who told me that she thought her speech was totally understandable, but it doesn’t hurt to have an eval. I called the county to have her eval, but they are not sure they can get her in by the summer. Should I go with a private speech therapist and pay out of pocket, or wait. To me the problem wasn’t even noticiable, but if it is a problem, I don’t want to wait one more day to correct it. What would you do? Do you think this a major problem? What is normal at this age? What can I do at home today to start improving this?
    thanks,
    Michelle

  36. Michelle - All of the errors you describe are common and well within normal limits for a 2 year old (not using consonant blends and clusters and omission of final consonant sounds.) I wouldn’t worry at all for now. If it’s really a problem, other people will start to point it out to you. If more than a handful of people notice, then there could be a problem.

    If she’s not including most ending sounds at 3 and doesn’t get those pesky consonant blends and clusters by 5, then get the speech eval. Otherwise, keep talking and listening to her. It sounds like she’s doing great to me!!! Laura

  37. Hi,
    My name is Roxana and I have a 32 month old boy. He has been seeing a speech therapist for the last 9 months and on his first session he was able to say, “ready, set go”. I found this therapy very promising, he learned how to say some words that now he doesn’t repeat anymore. He also has a problem with articulation, the “B,P and the M sound (on some words), are hard for him to say. He has no problem saying “MAMA” but when it comes to other word starting with “m” he just doesn’t say it. I don’t know if this is behavior he displays since I have a 1 year old as well. The therapist recommended a set of horns and straws. I also read about fish oil being helpful on children with apraxia and late talkers. I feel really frustrated for not being able to understand his jargon, especially when he learned to identify the letters and some words by the age of 10 months. I thought he was going to be ahead by learning all this, but his speech hasn’t improved as much as I expected since he started seeing the therapist. Any suggestions, thoughts, comments? Thanks!

  38. Hello,

    I have a 2 1/2 month old son who is delayed in his speech. He has a friend who is only 9 days younger and she had over 100 words at age 18 months, so I’ve been aware of this for some time as my son only had about 5 words at age 2. I’ve been working with him myself and have been considering speech therapy. I have seen an explosion in his vocabulary over the past 6 months, but I’m not sure if I should still be concerned about him falling behind as I’ve read they should have 300 by age 3. He currently has over 100 words and can say his alphabet, his colors, and numbers 1-10. His comprehension has always been excellent and I’m thrilled with his improvement, but am wondering if you would be concerned about his articulation? He only has about 20 words that are clear and correctly pronounced and they are easy words( yes, no, mommy, daddy, eat, etc. Some words are clear as a bell but he doesn’t say them correctly. “Tepe” for tape, “ceke” for cake. He says “pwease” for please, “wion” for lion, “hoise” for horse, “coin” for corn. I can certainly see a pattern of “l”, “r” “a” with some words. Others I don’t understand. He can say ball and baby, but subsitutes “dackhoe” rather than backhoe.

    Anyway, I would greatly appreciate your input. Do you think I am doing him an injustice by not calling a therapist?

    Thank you so much for your time and thoughts!

  39. I have a little boy who will be three in early november. He can say mama, mommy, daddy, nana (sister), makes lots of animal sounds, up, down, cup, bubble, pop, in, out, boat, house, and some others but generally has his vowels wrong and most often deletes initial sounds entirely. He likes to start words with ‘d’ or ‘m’ and will omit end sounds of ’s’, ‘t’. I am being pushed by our language pathologist here to put him in a group setting but he is allergic to almost everything and gets sick easy.. which makes that not such a great thing in my book. What can I do to help him along? He does do some syllables and his sister can seem to understand him fine. lol Generally he will say “duck” for duck, truck, stuck; sometimes he will say “mup” instead of up; he’ll say “dack” instead of snack and stuf like that. But then we still get a lot of gibberish. I would appreciate any help I could get. Thank you!!!

  40. Hi, my niece is 30 months old and is not saying a word. I must admit she was on the pacifier for a very long time. She sucked it probably all day everyday. She finally got off it back in March 2010. The parents took the child to the doctor, which with testing found out the child had fluid in her ears. The parents had the procedure done to remove the fluid early this year but she’s still not talking. I can tell she totally understands everything that someone is saying from her actions. She does scream and make noise gestures when she’s upset or want something. Also a few months after she was born she tended to keep her mouth open alot. It hurts because she can’t say what she wants or if someone is hurting her. The parents are young adults and don’t know what to do. She doesn’t appear to have down syndrome. I would like to know possibly what’s causing her not to talk and what can be done. From the bottom of my heart please help me help my niece.

  41. Toy - I liked this question so much that I talked about it on my latest podcast - show #88. Please listen in for my advice and ideas. Thanks so much for writing! Laura

  42. Dear Laura,

    Thank - you for a great website! I have a 27 month old little boy who is not adding final consonants to many of his words. He has a good vocabulary with over 200 words and can put sentences together, for example, “I go Michael’s(his brother) school)”, but he’ll say ‘ho..’ for hop or hot and ‘ca’ for cat. His receptive language skills are excellent, so I don’t think it’s a hearing issue. I can probably understand 40% of what he’s saying.

    Do you think I should wait until he’s 3 or do you think I should get him checked out earlier? I’m a psychologist myself so know how important early intervention is (but also know that that makes me a bit more paranoid than usual:)!

    Your advice is much appreciated.

    Jacqui

  43. Jacqui - Many children don’t add final consonants until closer to 3, so I wouldn’t worry about that at all right now. His language skills sound great, and he’ll probably start to include those final sounds in a few more months. Until then, model, model, model those ending sounds with a little exaggeration. It should be easier for him to produced unvoiced ones first - like /p, t, k/ and then begin to add the other early voiced consonants after that /m, b, n, d, g/ and then add a variation of final /s/ to start to do plurals. However, every kid is a little different in how they aquire those. Check back for some specific advice if he’s not doing those at say 34 months, and then you can up the ante a little. Until then, model and DON’T WORRY!!!!! Laura

  44. Wow, thanks for your quick response! You are obviously a mum yourself and understand how mums worry:) Will certainly follow your advice.Thank - you again.
    Jacqui

  45. Hi Laura,
    I read your site all the time! Great information!!! I have a 23 month old son. He has a large expressive vocabulary (over 200-300 words) and makes 2-3 word sentences. However, I’ve make myself sick with worry over one particular thing he does. For *some words* (about 10 give or take) he deletes the initial consonant if he doesn’t yet have it in his inventory. For example: shoe = oo, light = ight, frog = og, toe = o. I read that initial consonant deletion isn’t normal. He’s quite intelligible for his age … with the exception of the few words where he leaves off the initial consonant. I’m just wondering if this is normal or is a problem? Thanks.

  46. Hi Laura. The information on your site is great!

    I have a 24 month old girl who is just now starting to put together 2 words. Her 2 word combinations are along the lines of “It empty”, “it hot”, “he mix” and 2-3 other combinations. Within the past few weeks she has picked up new words at a remarkable rate; I couldn’t even begin to count them and yet the ability to string the words together has not really presented itself. Would you consider this unusual or something to be concerned about? I have also noticed an increase in her speaking what sounds like a foreign language; perhaps this is jargoning? If so, is that something to be concerned about?

    Many Thanks!

  47. Hello…

    I am a SLP. I am working with an almost two year old boy. He understands everything and seems to the know the names of many items in his environment. (He says the words with the correct vowel sounds.) He points to get his needs met. The only word I have heard him say correctly is “mom”. Otherwise, he uses no consonant sounds…only vowels. I have taught him to sign “please’ and “more”…(I have only seen him 3 times.)…. I have tried animals sounds..he will not imitate me. Any ideas of how to get him to progress from grunting? Thanks. Leslie

  48. Dear Laura,

    My son is 35 months and has a large vocabulary. His only problem is articulation of sounds /s/,/f/, /ch/ and /sh/. He cannot end with consonants well either. He can make these sounds correctly when I single them out, but once you add in a few more syllables, he starts dropping them out again. He pronounces /s/ with a lisp. He also gets his lip movements confused ending with puckered lips for words that he has difficulties pronouncing (he thinks that’s the proper way to move his mouth for getting a sound right).

    I’ve been bringing him to a speech therapist. He hates it and he hates practicing with me at home.

    He’s got allergy and his nose is often stuffy. We’re using a special spray already to help his adenoid. It’s helping but combined with his innately low voice and articulation problem, his speech is muffled and not too intelligible.

    What should I do?

    Thanks,
    Joyce

  49. Joyce - The sounds you’re describing are all later developing consonant sounds, so don’t worry yet. Keep modeling them IN WORDS so that he can hear the sound correctly in context and encourage him to imitate the entire word, not just the sound. Final sounds do usually come in by 36 months, and it sounds like these are emerging for him, but not perfect yet.

    No offense, but it sounds like both you and his SLP are making his therapy all work and no fun which is NOT developmentally appropriate for his age. He’s still very, very young, and all of his therapy should be play-based with toys and in context in daily routines. If you’re using flashcards or focusing on it too much, then no wonder he hates it! As he should, since he’s still a toddler! If you’re not sure how to make speech ound practice a part of play, check out my Apraxia DVD for ideas.

    Most of all, make sure he has fun with you regardless of how his speech sounds. He needs to feel loved and adored even when he’s hard to understand and even when you’re working on intelligiblity:) If you’ll make it more about playing, he’s going to want to practice more often. Good luck! Laura

  50. Hello!
    My son is 20 months and has a problem with consonant sounds. He has over 100 words and can talk in short sentences (i.e. “Bring yellow tractor home too?” “Mommy get shovel [for] Ronan”). But the only consonant sounds he can make are b, d, p, t, m, n (and sounds that are not quite f and not quite w). It seems to me that he used to do some other sounds but lost them somehow (s, k, and h). Also it is very difficult to understand him. For instance the above sentences would be “Bih neenoh twadoh um too?” and “Mommy deh ah-foh Nohneh” I notice a lot of words have no consonant at the beginning: ih = fish, ed = red, uh-een = sunscreen, oh-doh = stroller. Is that normal, given his level of language development? I spend a lot of time repeating his words correctly (i.e. “Oh, you want Mommy to Get the Shovel for Ronan!”) and playing games like “do you see the ffffffffffffffish? Here comes the ssssssssssnake!” Should I just wait and the consonants will come, as my doctor tells me, or should I be trying to help him more? Are there more things I could do?
    Thanks so much!

  51. Marianne - For 20 months, he sounds like he’s well within the range for normal. Language development is much more important than articulation, or speech sounds, at this point in his development.

    The errors you’re describing all seem to be with later-developing consonant sounds meaning that LOTS of 20 month olds can’t produce those sounds yet. However, /h/ and /w/ are usually early to emerge, so pay attention to those sounds in play. I teach /h/ by “making clouds” on glass doors and windows while first saying /h/ alone and then at the beginnings of words like “Hi”, “Hey” and “Help!” “Whee” and “water” (or even “wa wa” if a child will imitate that but not the more difficult adult version) and crying like a baby with “wah wah” are my my go-to words for working on /w/.

    Keep modeling those sounds for him without lots of attempts to “correct” him. When he says a word incorrectly, repeat it back to him as it should be. It sounds like you’re doing that already which is fabulous.

    The intelligibility guidelines are pretty generous. Parents should understand 50% of what a 24 month old says (even with errors) and nearly all (90%) of what their 36 month old says, and based on what you’ve said, you can understand him, even if his articulation is not accurate.

    You both sound like you’re doing very, very well. Keep up the good work!!! Laura

  52. Laura,
    What a helpful article! Thank you.

    My son is 29 months old. He has an incredible language of his own. He cannot make some consonant sounds (f comes to mind). He sometimes uses correct vowels, but often not. He does use 2 syllables at a time. Some of his most often used words are: kai (strawberry), oh-sh (charlotte, his sister, or sorry), emmy (henry, his brother), pie (potty), his has a blurred pee-pee/bee-bee that means either pee-pee or baby, depending on context, putz (pretzel), tay-tay (thank you), eesh (shoes or teeth), nana (Hannah, nana’s dog), borscht (horse), buzsh (buzz), mape (grapes).

    He, just today, strung 3 words together (”no sing mama” and “mo muck (milk) peas (please)). His 2 word phrases started perhaps 2-3 months ago. I also noticed today that he say “go mommy” while handing me something (here you go, mommy).

    He blends words together, kind of a sentence, but all at once, never changing. “I-wan-dat-one” or “I-wan-dat” all at once. It never changes to “I want milk” or anything like that.

    Almost no one can understand him, except immediate family. Even we only understand him perhaps 10%? of the time.

    This is frustrating for all. It involves him grabbing us by the hand and dragging us everywhere to show us something.

    My older son was late to talk. His speech didn’t really take off until 35 months. Before that, it was single words, but not very many. And not all this jibberish! My older son was also good at choosing a different word if we didn’t understand him. For example if he said “muck” and we didn’t get that he wanted milk, he’d say “cup.” My younger son did that, again, for the first time today. He was jibbering about something & pointing. We didn’t get it. So he said “puh-puh” and we saw the purple toy he wanted.

    I had him evaluated by the state’s free intervention program. He didn’t qualify for the program (needed to be 50% delayed). But they said he was 25%, in the 18-20 month old range (this was last month). They said that we could probably go either way, with or without speech therapy. That speech therapy would help speed things along, but that he’d probably catch up without intervention.

    Do you have an opinion on whether or not I should look further into speech therapy? Do you have any suggestions on things we could do at home to help him?

    Thank you so much for reading my novel! I appreciate your time and effort.

  53. Hi Laura
    My 5yo daughter often drops the beginning sounds of words. She will say words like “otato” instead of potato, or “acause” instead of because, or “orgot” instead of forgot. But, when you correct her and ask her to repeat the word correctly, she will ie she has no trouble pronouncing the words when asked, she just doesn’t use the correct words in everyday sentences. Should I be concerned, or should I just keep correcting her and give her more time?

  54. Hi Laura,

    My 19 month old daughter only says about 20 words total; only 10 of which she says frequently (mama, daddy, ball, etc). She does a lot of jargoning, but isn’t saying many new words. Should I be concerned?

  55. Hi Katie. She is technically within normal limits, but at the low range of what’s considered typical development. I’d model familiar words that are easy to say to facilitate imitation of new words. While she certainly won’t qualify for services right now, I’d be concerned enough to increase the amount of time you’re spending “working on” language. For ideas, keep reading the website and check out my DVD Teach Me To Talk so you can SEE the strategies in action. Laura

  56. Hi Laura,

    Thank you very much for your helpful website. I have a 25-month-old daughter whose articulation seems to be much poorer than other children her age. I would estimate that anywhere from 10% to 40% of what she says is intelligible to me, depending on how much context I have to work with. Her receptive vocabulary is beyond incredible. Even when she was about 10 months old, I could name practically anything on the page of a book we were looking at, and she would accurately point to it (e.g., “Where’s the cloud? Where’s the tree? Where’s the squirrel?). She said her first words (Mama and Dada and Nana) at a normal age, but then she stalled out on saying new words until she was almost 2. When she hit about 21 months, her expressive vocabulary exploded and she started talking up a storm, and she can now combine words to make a sentence, and she can recite whole songs and poems from memory (e.g., Baa, Baa Black Sheep). However, there are a lot of sounds she seems incapable of producing, or she will produce them inconsistently. She has trouble with vowel sounds, like the long /e/ (e.g., “baby” is “buh-buh”), and a sound that she can make in one context (e.g., the /m/ in Mama) she won’t say in another context (e.g., “milk” is “bock”). Most of the time, if she can’t say a word, she just makes a “hmm” sound rather than attempt it. I think what concerns me is the fact that her attempts at most words aren’t even in the ballpark. For example, “flower” is “ba-bum.” (maybe not the best example, since I know /fl/ is not an early-developing sound.) “Water” sounds like “wong.” “Cracker” sounds like “daddy.” Sometimes she’ll be talking so animatedly, with hand gestures and everything, but I’ll only be able to pick out one word here and there, so I can’t understand her message. Occasionally she’ll get frustrated if she’s not able to point to what she wants or is trying to convey, and I feel terrible. Maybe the best way to describe her speech is this: if you asked her to repeat a sentence, she could repeat it so that you would think to yourself, “Okay, I could kind of see the resemblance to what I just said…” but if she were to come up to you out of the blue and say the same sentence, you would probably have no clue what she just said. I hear other children her age (and younger) talking, and they just sound so much clearer than she does, so it’s making me wonder if she needs early speech therapy. Should I be concerned?

  57. Readers - If you’ve entered a comment and don’t see it, I accidentally deleted several tonight. Please repost! Sorry! Laura

  58. One more quick note about my daughter: She almost consistently substitutes /ck/ for the final /d/ consonant, e.g.:

    bed = back
    mad = back (she often substitutes /b/ for the initial /m/ sound)
    head = hack

    However:

    sad = dad
    read = mmmp (another “not in the ballpark” attempt)

    She doesn’t seem to do this for other final consonants, though. I noted in one of your articles that final consonant substitutions could be cause for concern because it indicates abnormal phonological development…

  59. Hi Laura,
    Im a little worried about my 21 month olds speech. He says many words and copies nearly everything we say but he seems to miss parts of many words. Some examples are baap (grape) bapa (grandpa) oot (toast) ba (bye) at(cat) keekee(cookie) tantu (thankyou)uck (stuck) ick (sick). He also rarely answers yes or no or nods/shakes head instead just repeating half my question eg would you like to go out? “out?” can you get your shoes? “shoes?” and gets them. He has no problems doing things that I ask so it seems his hearing is fine its just his speech im a bit concerned about. Am I just expecting too much and worrying or do you think speaking to someone would be a good idea?

  60. Laura,
    My little guy is now 27 months old and has only 4 consistant vowel sounds (M, B, D, and N with an occasional H). He has accurate vowel sounds most of the time, but a large vocabulary so it’s hard to know unless he’s pointing what “Mama, ma i u” really means (the man is in the truck). I hate to do the comparison game, but my oldest was singing his whole alphabet by 18 months, and my second sang America the Beautiful on key with all the words by 2. His receptive vocabulary is good, but I can tell everyone is getting frustrated and he’s becoming very high maintenance. Should I worry or did my other two just set the bar to high?
    Julia

  61. Hi Laura, thanks so much for the great website with so much info!
    Was wondering if I could please ask you 2 questions? My boy is 31 months old and is speech-delayed. We are teaching him english and greek (not sure if that has contributed to the delay). He can follow 2-step directions (eg get the toy cow and put it in the box) and can make 2 or 3 word phrases (eg ’some more milk’ or ‘ball fell down’) can recite the alphabet, count 1-20, knows all his colours and shapes and can sing nursery rhymes really well, however you simply can’t have a proper conversation with him. That is, get him to talk just for the sake of talking. He only really talks when he’s playing and you ask him questions relating to the game or he wants something to eat or drink. How can I get him to just want to have a conversation with me (or anyone else)?
    The second question is about his use of jargon. I know he shouldn’t still be using jargon at 31 months so I’m really stressing about this. Although he can say a lot of proper words, sometimes when he talks to himself (usually when he’s pretending to read a book) he talks in jargon a lot. Should I try and discourage him doing this, or does he need to do it for his language development, because he is delayed?
    Thank you so much for your time Laura!

  62. Hi Helen. He’s not conversational yet because he doesn’t have enough words yet to truly respond. Most of what you’ve reported that he says is preacademic or rotely learning concepts - colors, numbers, songs, etc… Stop focusing on that and focus on REAL language. Continued use of jargon at this age usually indicates that a child is having difficulty processing language and truly linking meaning to words. These receptive language/processing issues could be linked to living in a bilingual home and simplifying could make this better, however, the research typically points to the fact that language delays/processing problems occur in ALL or any language the child is learning, so it very likely would happen even if you were monolingual. Keep doing direct teaching with language making sure that he’s making connections with specific words. When his vocabulary improves, both receptively and expressively, he will become more conversational. If you continue to be concerned, please have him evaluated. You may need a professional opinion from someone who can actually see him, and more importantly, from someone who can teach you how to help him. Good luck to you all! Laura

  63. Hi Laura- I have a 34 month old boy who has been in speech therapy through our state’s EI program for about 9 months. He has made HUGE progress and was recently released from the program because his only current speech issue is articulation. Our SLP recommended the “wait and see” approach at this point because he slowly, but surely has self corrected many of his issues. I agree with her, but am still a little worried about my son. His main problem is leaving the first letter (mostly consonants)off of many of his words. It’s very confusing to me because although he can say the correct beginning sound when prompted, he still leaves it off the word when he speaks. It’s also really strange to me because this isn’t consistent for every word starting with the same consonant either. For example, he can say ball and broken perfectly, but then he says his name, Bryce, as “Ice” and balloon as “all-oon”. Although my husband and I and close family members can understand what he says most of the time, outsiders have a difficult time. I have noticed some improvement in the past couple of months (for example car is now correct instead of “ar”), but I would say he’s still about 50% correct, 50% incorrect. In your opinion, should I pursue articulation therapy now or wait it out for awhile still?
    Thanks, Jen

  64. Hi Jen. It will be easier to fix those phonological errors when he’s a little older. When I went to grad school, we would have never worked on articulation with a child under 3 because we felt they just weren’t ready yet, and I still feel this way for the most part. However, omitting initial consonants is not a pattern we see all of the time, and it’s not part of typical development. Your state program may not pay for “artic only” kids, so you may have to pursue services on your own or using your insurance, and you certainly can do that at any time. If you wait until after he’s 3, he likely will qualify for speech through your local public school system. Call your service coordinator from EI and ask about the referral process for that. Let me offer one more explanation too for his error pattern. He may be using initial sounds in new words he’s just learning and be hanging on to those older patterns/errors for words he’s used for a while. If that’s the case, you’ll just have to gently correct/model those older words so he re-learns those with the correct pattern. Hope these ideas help you! Laura

  65. Hi Laura, thanks for all your helpful information! I have 2 issues I’m hoping for advice on. My son is 25 months with a good vocabulary and he speaks in sentences. His articulation is not the best but it seems to be coming along slowly but surely. Lately though, he seems to be purposefully pronouncing things wrong and babbling on in infant-style jargon a lot of the time, something he has not really done before. For example his favourite sentence is “Mommy pick uppy Ronan” but now he’ll say it like “Mah-moo pleh oopeh Noh-noo.” Also he’ll often talk with his tongue out of his mouth (the way school-age kids do when they’re making fun of someone). I feel like he’s doing it on purpose but he fully expects me to know exactly what he’s talking about. Is he just playing or should I be concerned?
    Second, when he wants something he asks for it like “Do you want to drink some milk?” - then I’ll repeat it back to him, and he says yes. If I say “do you want to drink some juice” and he wants milk, he’ll say back to me “do you want to drink some milk”. I tell him, “Ronan says, I want to drink some milk please” and ask him to repeat but no progress. (He has also completely reversed “you” and “I” pronouns…I try to implement the suggestions on your webpage for that, but no progress in 3 months). Should I just wait until he sorts it out on his own, or is there a better way to teach him the proper way to ask a question?

  66. Hi Marianne. What great questions! Has he seen or heard an older child use that smarty pants way of speaking? It’s highly unusual that a 25 month old would come up with that on his own. I also would be a little bit concerned with how he’s requesting and that he’s not instinctively understanding how to answer questions. That along with his issues with pronouns could signal a language processing issue, and if you notice those kinds of things more often, you may want to have an SLP look at him just to be safe. Take a look at ideas in the articles on Echolalia for ways to teach responses that don’t involve repeating the question. Here’s the link:
    http://teachmetotalk.com/2008/06/02/echolaliawhat-to-do-about-it/ For some reason I can’t get it to embed! Sorry about that. If it won’t work, type Echolalia in the search bar in the upper right hand corner of the page and scroll down until you find the articles. Good luck to you! Laura

  67. Hi Laura-
    Thanks for your response about my son (12/14/11). I have seen a lot of improvement with his initial consonant deletion in just the past month. He probably corrects 1-2 words per week. I have noticed now that you mentioned it that many of the words he leaves the initial consonant off are words he has known for a long time. New words tend to be correct. He will be 3 one month from today. My SLP through our EI program recommended waiting until I put him in preschool in the fall and see how he is doing then with the other children.She felt pretty confident that he will continue to self correct and be on track in the next 6 months. Does this sound unreasonable? Should I have him evaluted for artic earlier?

  68. Hi Laura,

    Thanks for a great site! I have a 31 month old son who uses only a very limited number of consonants (mostly substituting d) and does not use any consonants at the end of words, unless he adds on a vowel (e.g. doddy for dog). I took him to a SLP who gave some ideas for working on his consonants, such as creating “sound bags” of things that start with the same letter, e.g. sail, sun, seat, sock, and to bombard him with that sound for short bursts, but seemed to say he needed to be older for speech therapy. Does this sound correct? Also, do you have any ideas for helping with end of word deletion as I think this would improve his intelligibility, otherwise some things just come out as a string of vowels.

  69. Sarah - I do agree on waiting to see a child for ongoing articulation therapy when he’s closer to 3, and I think she gave you good ideas. Many children don’t produce final consonant sounds until they are closer to 3 too, so hang in there and hopefully maturation will kick in, do its job, and he’ll start to use some final sounds. The easiest finals to do are usually /p, t, k/ and perhaps /m, n/ so try to target these sounds with familiar words like up, cup, pop, pup (puppy), out, hat, hot, boot, cook, cake, kick, on, in, moon, man, and mom. I have had good luck with words that end in even later developing consonants like “push” or “shush” because you can emphasize that “sh.” Model the words giving a little bit of emphasis or punch to your final sound. It’s easier with the unvoiced consonants /p, t, k/. You don’t want to overpractice with /b, d, g/ because then the kid usually ends up saying words like Bed-a or Bug - a. Many adults unintentionally overvoice that final sound and add an extra “a” to the word - you don’t want to have to un-do that error!!! If his phonological system is within the range of normal, he’ll begin to add a sound or two in imitation of you and then he’ll use more finals almost overnight since he’ll have mastered the pattern.

    HOWEVER, if he’s not using many consonants at the beginnings of words either, then you’re more likely looking at an issue that won’t resolve with a little home practice and maturation. Leaving off the ends of words does tend to be a developmental error, but missing consonant sounds at the beginnings of words is a less typical pattern. If he seems to have no luck at all improving these with your help at home and especially as he turns 3, then revisit your SLP or find someone who is willing to work with him.

    Thanks for your question! Hope these ideas help!
    Laura

  70. Hi,

    My 3,5 year old boy talks like most kids his age, however, he mixes up his ‘p’ and ‘v’s sounds when the letter appears at the start of the word. Is there a need for speech therapy, or is this likely to correct itself automatically with time?

    Not sure if this is relevant, but our home language is Afrikaans (very similar to Dutch)

  71. Gustav - Both the /p/ and the /v/ sounds are made with your lips and are very common errors for kids at 3. Model or say the correct sound for him in words and gently correct him by saying, “Say it like Daddy. Look at my top teeth on my bottom lip for the v sound. You try it.” It will likely resolve in time. If this is his only error, I’d defintely hold off on all evaluation, but if there are other errors too, or if he’s frustrated when he’s not understood, then I’d go ahead with an assessment to be on the safe side now. If that’s his only error and he’s not gotten it by kindergarten, then have him evaluated at that point. Thanks for your question - Laura

  72. HI Laura,

    I have bought your dvds and have been applying your techniques on my 16 months old girl for few weeks now. She has made some progress for the first week but since then she regressed and started to forget the words she has learned. Before she said “oooo” for ball and nose (sounded the same), “oo-oooo” for balloon, “moo” for cow sound, etc and started to use sign language for more, open, cookie etc. But after a week, she has forgotten most of them and just gives a grunting sound when I ask what something is.. It happened before, she said 5 words (HI, Bye in my language as well as English, and This, Mom and Dad in my language) learned on her own when she turned one, and then after few months stopped saying these except for Mom and Dad.

    One thing I want to add is that, as I’m bilingual I have been using “both” English and my language when I talk to her. I usually just talk in my language, but when I do use both, I would use full sentence in one and then say it again in the other. We were going to use One parent One language technique with her initially, but then my husband (who only speaks in English) really didn’t talk to her, other than when he reads, he for the past 16 months have been using exclamation (wow, huh, ha, uh’s), or babbling sounds while running around and playing with her. And as I wanted to reinforce English in some of the dvds I’ve been showing her (Your baby can read) I ended up saying both language to her,

    But now I’m wondering if that has done more harm than good. I have most recently noticed she didn’t know most of the words we chose to work on her, so once she learned it specifically, she was able to say it. But now for some reason she has stopped saying it again. Do you think I’m confusing her by putting two words into a same object? I have EI coming to take a look at her eating soon. (they say within 30 day) as she doesn’t chew or swallow solid food well yet. Perhaps that has something to do with it too. It would be great if you could give your thoughts into this.

    Do you think there are issues with my little girl talking?
    What do you think about my talking in two languages to her?

  73. Hi Sylvia. I think you’re confusing “imitating words” with learning words. Even if she repeats you a time or two, it doesn’t mean that she knows the word. She’s not technically forgotten the words; she just hasn’t mastered the words yet. Toddlers your daughters age may have to hear a word 25 times (or more) to understand it and then repeat it dozens of times before she’s able to retain that word and then use it to spontaneously answer a question like, “What’s that?” Keep having her imitate, imitate, imitate at this stage in her development. In order for her to imitate as much as she needs to really learn the word, you need to model, model, model! You may not hear her say those words spontaneously for weeks or even months AND THAT’S OKAY!

    I’m glad she’s getting an eval. Even if it’s for feeding mention your language concerns to the SLP.

    I’d also ditch the educational videos for her to watch and opt for more one on one playtime with you or with your husband. Have him watch at least a snippet of the DVDs so he can see how to use real words. The play sounds are fun and great, but since she’s not picking up words as fast you would like, he needs to help you out and talk to her too! Remind him to keep it simple. Single words are just fine for a toddler this age. He should concentrate on naming the object they’re playing with together and then talking about the actions they’re doing as they play. For example, “Look! Ball! Bounce bounce bounce! I got it! My ball! See? Ball.”

    As far as multiple languages, typically developing children do not have any difficulty learning to understand and use more than one language at a time. Their little brains are hardwired to do that. However, a child with language delays or disorders will have a hard time even learning to understand and process one language. One language may make it a little easier for a child to sort out and assign meaning since there’s only one system to learn, but in the end, if there’s a problem, there’s a problem, no matter how many languages a child hears. Does that make sense to you? Reducing the complexity by sticking primarily to one language is successful for some children, but again, the underlying problem will still be there.

    She’s very, very young and it sounds like you’re such a good, attentive, and responsive mother. Keep using the strategies from the DVDs for addressing her language in play-based activities. Remember too that it may take a while for you to see any measurable results because she’s only 16 months. Your job is to keep pouring those words in there! Thanks for your questions. Let me know if there’s anything else I can help you with Sylvia! Laura

  74. Hi, Laura –

    I’ve just stumbled upon your website today and am so grateful for it already! My son is 15 1/2 months old, and I’m concerned about his speech. He says mama, dada, uh-oh, hot, and deer, and he signs a few words. However, he doesn’t say these words often (I haven’t heard him say “deer” or “uh-oh” in several weeks), and he never says anything on command, in response, or in imitation. He hasn’t had ear infections, and his hearing seems fine. Do you think I should be concerned at this point, or is it too early to tell? Also, he seems to understand everything we say. He follows commands and seems to understand labels of items reasonably quickly(ex: he got a toy vacuum cleaner, and within a day of me calling it a ‘vacuum’, anytime I say the word, he runs and gets it.). Our pediatrician said we’d just keep an eye on him, but if he needs some kind of eval or EI, I want to make sure we’re handling everything as early as possible.

  75. Hi Joelle. I love that his receptive skills are coming along so well. You’re doing a great job with that!

    He likely would not qualify for an EI program at this point since most states have adapted elibility requirements that are so strict that only children with the most significant delays qualify. I’d really focus on helping him imitate words and begin with words you’ve already heard him say. Set up situations for him to use those words. For example, have daddy hide and call, “Dada! Dada! Dada!” Yell “boo” when you find him. As soon as you heat his food everyday, model, “Hot! Hot! Hot!” so that he begins to anticipate this routine and join in with you. Play an “uh oh” game where you’re purposefully and playfully drop items and happily exclaim “Uh oh!” (I would try this game in a new location and novel items so that he doesn’t associate dropping/throwing with a place he’s in all the time. For example, maybe drop items off a porch or a place he doesn’t have access too without you rather than somewhere like from the couch, his high chair, or stairs inside your home.)

    Take a look at the strategies on my DVD Teach Me To Talk too. All of those ideas are for play-based activities. It is not too early to begin to target language in this way during play, but 15 months IS too early for you to be wrought with worry about him if he’s social with you and a variety of people and if his receptive language is moving along.

    Keep teaching new signs too since he needs a way to express himself until his established words become more automatic and he’s more able to verbally imitate you.

    I’m also about to release a new book about Building Verbal Imitation Skills in toddlers, so if he’s not coming along in the next couple of months, you’ll want to implement those strategies.

    Thanks for your question! Laura

  76. Hello, my 25-month-old son was just diagnosed with apraxia a few weeks ago. He has been receiving EI speech therapy since 18 months. When he was diagnosed a few weeks ago, he used 10-20 words and about 30 signs. In the last few weeks, he has been adding new word attempts everyday. He added 10 words on Sunday and is up to about 40 words total. He also said his first two-word phrases. However, he is missing the long “e”, “i”, “d” and “t” sounds. And words have come and gone. Six months ago, he said “Dada” for a couple of days, and then it disappeared. His second word at 16 months was “garden” (pronounced ga-den), and he said it constantly for a month in and out of context, and then it was gone. He said “turtle a few times, but then the “t” sound became “k.” (When you ask him to say “d” now he says “g.”) He also distorts many of his vowel sounds. “Go” comes out “ga,” “bye bye” is “bubba,” more is “ma.” We see some regressions and spurts. When he got sick, the “m” sound turned into “b” for a few days. And even though he has been saying “go” for a month now, yesterday, he started struggling and groping to make the g sound. It came out as “k,k,k…go.” He also has a hard time combining the sounds he has into words. He can make the “m” and “oo” sounds but can’t say “moo.” I’m just wondering what kind of help I need to get him. I’m not sure his current speech therapist is helping all that much. Should I be finding someone Kaufman and Prompt trained at this age? A behavioral method? Should we just keep doing play-based therapy until age 3? I’m just not sure what we can do to help sounds emerge that he doesn’t have and how to solidify the gains he has made. The supervisor of his current speech therapist insists he should not have been diagnosed at age 3, but the outside person evaluating him said he definitely has it. He also leaves off some first and most final consonant sounds. He says “en” for “hen.” “Bo” for “boat.” And he adds a final consonant to some words, like “uppa” for “up.”

  77. Hi Jenocean. Based on how you’ve described him, I think it is highly likely that apraxia is an accurate diagnosis for him. Some SLPs are sticklers and demand waiting until 3. For a case like your son’s, I’d do what his current SLP did and call it like it is. What good will waiting to diagnose him do???? (Off the soap box…)

    I still prefer a play-based approach for toddlers and you can take a look at that in my Apraxia DVD. That being said, I incorporate a lot of sound or word modification into my strategies which is the Kaufman method. I so admire her and routinely apply her sound clinical theory, but I do not use the cards during therapy with toddlers. The cards are essential to help the adult learn to apply the theory - not to necessarily use as the only stimuli in therapy. Toddlers with language delays often run for cover when they see the cards because adults misuse them, so be careful with that part, but her program is very sound clinically and you won’t go wrong with a therapist who is using this theory while still being fun, engaging, AND making progress!

    I also use some tactile cues IF the child can handle it, so I’m not completely opposed to PROMPT, but I’m not PROMPT trained because I don’t think it’s appropriate for many of the children I see and have seen who also have sensory and social issues. If your little boy is not opposed to that kind of touch and it won’t drive him away, consider it.

    There’s more than one way to skin a cat AND to treat apraxia! But I love that you’re looking for what’s the best fit for him. The diagnostic markers for apraxia include inconsistency and platueaus, gains, and losses. He’s had all of those in 25 months, BUT it sounds like he’s making some rapid progress right now, so go for it!

    Mass practice, or getting him to repeat, repeat, repeat is the key to making his words more accurate and more consistent. It’s hard to accomplish with a 2 year old, but you can do it! Ideas for that are on the DVD.

    Hope these ideas are helpful for you! Thanks for your question! Hang in there - Laura

  78. Thanks, Laura, have you seen toddlers like my son fully recover or be able to speak normally with enough intervention? He doesn’t have any other sensory or developmental issues. And his receptive language abilities test above age level. He’s also hard working and focused. He has an amazing attention span for a 25-month-old child.

  79. Jenocean - Yes, I’ve seen toddlers achieve remarkable progress with speech-language skills that are eventually within normal limits who were severely delayed at 2. Kids with true disorders may struggle for a while, perhaps forever. However, every child’s outcome really depends on many factors - the severity range when he started, how early therapy was initiated, how effective his therapy is, and how his parents have been with follow through.

    Regardless, don’t lose hope! Get him in therapy, keep him in therapy, and faithfully work with him at home. Children whose parents are involved and who get early intervention have better outcomes than those who get no services, so in the end, if you’re working with him too, you’re doing all you can. Laura

  80. Hi Laura

    My son is 19 months old and generally his language My son is 19 months old and generally his language development appears age appropriate. The exception is his deletion of the letter ‘h’ at the beginning of words. Eg. saying ‘ot’ rather than ‘hot’. This also happens on occasion with the letter ‘l’. Is this just his own developmental trajectory or should I try to focus on helping him develop these skills?

    Thanks

  81. Hello -
    I have the same exact question as Nathan. My son is 23 months old and also deletes the letter “h” at the beginning of words. The other early consonant sounds seem to be in place! Thanks!

  82. May & Nathan - When there are only a couple of consonants missing in a child under 2, it’s really not that big of a deal. To teach /h/ exhale saying the /h/ sound on a window pane and a child’s hand to help him see and feel the sound. Put his hand in front of your mouth as you say /h/. After he begins to imitate /h/, then model it in words like hi, hot, help, etc…. This should do the trick if there aren’t any other underlying more serious speech delays. Thanks for the question! Laura

  83. Hi laura,
    Today is my first day researching different speech delays so please forgive me if my concerns may sound silly or if i use a wrong term. I have read all the questions submitted by other moms and saw a few similiar concerns but felt i needed a more custom answer. My daughter is turning 2 in a few weeks and is very hard to understand. Almost Everything sounds the same but not even real words…. She understands everything we say but her feedback always sounds more like music than words….she can say moma, dada,pees-please, ya, no, i want caca-cracker, nana-banana maybe a few more words in her vocab but not many clear. My main concern is that everything she says is expressed in the correct number of syllabals but sounds nothing like the real thing i.e. “Open it momma”would be bu bu bu momma, actually the ba sound or da sound is used alot with her syllabal method reguardless of what the word really starts with. everyone always thinks she is calling her daddy bc every other object is a dada. Another thing that concerns me is that she knows the entire tune to almost every song and her abc’s but its more like ba ba ba ba e e gh ba baba bab eh eh eh o pa then some humming to fill in the rest. It’s like she knows the entire thing but the poor thing just cant get it out and that breaks my heart. Also noticed she has a hard time switching vowels is words….for ex. She calls her baby a ba ba instead of ba bee. She just learned the ee sound a few months ago to say for ex meme instead of mama but just cant add the second ee syllable at the end ofANY other word besides the one. I have read this page and don’t want to sound repetative to anything you have already answered but i would greatly accept any feedback or advice you could offer me and also open to any additional exercises i could do to help her. I have not taken her to a dr but her mouth does look a little silly when she talks like maybe her muscles are still under developed; she really wont let me look under her tongue so i havent noticed any irregularities there. she has an older sister, almost 3, with about an age 5 speech level according to some of the milestones ive read but she does get time to talk for herself and i do talk to both of them alot and explain and articulate alot especially with the 3 yr old asking so many question lol. You seem so nice and genuine and of all 30 + websites i have visited today yours was by far the most helpful and came the closest to answering my questions before i even got to the forum but that just put the icing on the cake. Thank you so much for loving what you do and i look forward to hearing from you.

  84. Hi Stefanie - Thanks so much for the kind words about the website. Moms like you are the reason I started this site :)

    Without seeing your little girl it would be nearly impossible to pinpoint what’s going on with her. It’s great that she has the correct # of syllables in words, but it is a concern that her vowel and consonant sounds are so limited. I also love that she can sequence sounds for a whole song, BUT she can’t get the right sounds in the right places.

    I don’t think this is due to a physical problem. Although speech pathologists certainly do perform oral motor exams, the errors you’re describing do not seem to be me to be linked to any structural differences UNLESS she has a muscle tone difference. Does her face look a little droopy? Some parents call this “baby fat” when they’re looking at low tone. Does she still drool? Does she hold her mouth open or closed when she’s not talking? Those can be characteristic of low tone too. This is a possibility, BUT without seeing her, I have no idea.

    Based on how you’ve described her, I’d probably lean toward a phonological disorder meaning that she has difficulty organizing how to produce words for words.

    The other possibility is a motor planning issue (childhood apraxia of speech) due to her vowel errors, the inability to change sounds within a word, and the coordination issues you’re describing when you say “her mouth looks a little silly when she talks.” SLPs look for struggling or groping behaviors - if that’s present you’re almost always looking at apraxia.

    I hope this info has pointed you in the right direction. I will say DO NOT FREAK OUT if you look up more info about any of those specific diagnostic terms. Most stuff on the internet is WORST CASE SCENARIO. Again that was another reason for starting this site for parents.

    We have GREAT outcomes for many children in early intervention. To have your daughter assessed by a speech therapist, you can go through your state’s early intervention program or find someone in private practice. If she doesn’t qualify for the state program, you’ll want to follow up with someone who can see her for therapy. Working with someone now may prevent a more long-term issue.

    In the meantime, keep reading for ideas for how to work with her here. You may also want to check out my DVDs. I always recommend that parents start with Teach Me To Talk to show you the general play-based approach, but for her, I’d really recommend Teach Me To Talk with Apraxia & Phonological Disorders. Both show TONS of examples with toddlers in therapy with me, so you’ll see exactly how to play with her to promote progress. If you buy both together at the same time, there’s a price break. Look for that deal at shop.teachmetotalk.com.

    I hope I’ve answered your questions. It’s so hard to be more specific when you can’t see the child. I’ve read emails from moms many times thinking I’d see one kind of kid when I met them in person, only for it to be different than I thought.

    You sound like a great mom. Hang in there!! Laura

  85. Hi Laura,

    I had a question. My daughter is 4 - she’s being seen by a pediatrician and is going to start OT/Speech therapy soon as she is severely delayed in her language. Her twin brother is diagnosed as Autistic Spectrum Disorder, so her language is partially delayed in part because he is nonverbal and she doesn’t attend daycare. My question is about her pronunciation of certain words. I’ll give two examples right off my head - elephant and penguin. My daughter says them ele and refuses to do the second part or if she tries, it sounds more like ‘i like’ so ‘eleke’ instead of elephant and for penguin she always says ‘poohuan’ is the best I can spell it as it sounds. It’s almost like she has trouble with her mouth shape. Any ideas of how to help her or might be causing this issue? She can say car and truck just fine even ‘you ok?’ as she puts it. Any advice would be appreciated and like I said, she’ll be going to therapy soon to help. Thanks for your time!

  86. Hi Laura,
    Thanks for all your great responses! My son is now 30 months. He started reversing “you” and “I” pronouns when he turned two, and that has not resolved despite 6 weeks of speech therapy and my continued efforts. He will sometimes use pronouns correctly, maybe 30% of the time. I feel like I have been doing all the things suggested on your website and this is still going on. The speech therapist thinks it will fix itself in time with continued effort. Do you agree?

  87. Hi Laura,
    My 20 month old son has very good receptive communication. He says a lot, and we understand most of it…all limited to different combinations of ba/pa/tha/da/ga/ka/na. He is just not able to use any other vowel though. For instance, “NO” is “NA”; Water is “datha”. He’s remarkable at filling in words in songs, books, stories in with these syllables. When we ask him to repeat words like “wheeeeee” or “pee” etc, he comes up with something totally different like thaaaaa or paaaa. We do want to get any problem treated soon, but at the same time, we don’t want to get too stressed if he’s developing normally. Our ped seemed to think he is fine at his 18 month visit, but we didn’t raise the issue of his limited vowels then. Do you think he may have a speech problem and would you suggest that we go for a speech evaluation?
    Thanks very much for your response!
    Sowmya.

  88. My 6 month old son (I know, still very young) isn’t making the “b,” “m,” or “p” sound yet. I think he probably should be by now, but I’m not too worried about it. What does worry me, however, is his tongue. He only makes an “uh” sound, and his tongue goes to the right only when he does this. Also, when he sticks his tongue out, it only goes to the right. Is this a sign of something serious or am I being paranoid? I appreciate your help. New mom worries here ;)

  89. Hi Laura,

    I have a 19 month old that says over 20 words by now but most are pronounced poorly. She makes different consonant sounds (p,b,m,c,t,s,y) but her vowels are mostly “aa” sounds. for example my dog name is beto and she would say baba and recenlty it sounds more like papa. She identifies her body parts and was ok at the 18 month check up except she was at ~13 words at that time but within a month she reached more than 20. I’m worry about apraxia. What do you think? By the way we speak spanish at home and she’s exposed to english at daycare.
    thanks so much for your time!

  90. HI there and thank you so much for this site. My son has a large vocabulary and I can understand just about everything he says. He will be 3 years old in 2 months. The issue that started about 3 weeks ago is that he has been repeating consonants at the end of his words…not always but frequently enough for me to be concerned. For example, he will say, “eggs-s-s-s” or dog-g-g-g.” He does it mostly with the letters “s, t, g, d, k and sometimes f.” The pediatrician thinks his brain is working faster than his mouth (motor skills)at this age. She said we can get a referral to a speech therapist when he turns 3. I am wondering if this is something he will simply outgrow. I don’t correct him when he does it, I tend to ignore it because I don’t want to acknowledge it and make it worse. Sometimes I will say, “You mean dog?” Any thoughts on this? Thank you in advance for your help!

  91. Laura, thanks sooo much for the work you’ve been doing! Just reading the articles and comments have helped alot. However, I am unsure as to where to start.
    My 3 1/2 year old is EXPRESSIVE!! She started signing early (9 Mos.), understands, obeys, plays well, but her speech is so garbled that we call it “Karmynese”. Only when stringing words together in a sentence is she hard to understand, but with the individual words themselves, she sounds fine-to her family at least. She will even act out what she is saying if we don’t pick up on it quickly enough for her. No medical conditions are a factor, her pediatrician says her non-verbal skills are excellent, and that in his opinion, she communicates using those skills rather than speech. I’m not sure if singing words or trying to slow down the rate at which she speaks or what will work at this point.
    For example she’ll say :
    “My daddy he went to the store to go and get thedogsome foodandthenhewentbackin histruckandcamehomeand(unintelligible from this point).”
    It’s like she gets so wrapped up in telling and acting out the story that she can’t tell how unnatural the run-ons sound, particularly to someone who’s not used to it.
    I guess you could say I feel like I’m at the opposite end of the spectrum from parents who have children with delays, but all I know is it still hurts to not to able to understand what she is saying 60% of the time, or the looks people give her when all she’s trying to do is simply say “Hello, my name is Karmyn. It’s nice to meet you. What’s your name?”
    She’s so smart, Laura, but I want to help her before she starts pre-school next year, especially since she’ll be in private school,and any therapy will likely be on me.
    Thanks in advance, Natalie

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