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
Comment by courtney on 22 October 2008:
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
Comment by Laura on 22 October 2008:
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
Comment by courtney on 22 October 2008:
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
Comment by karen on 4 February 2009:
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
Comment by Laura on 4 February 2009:
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
Comment by kelly on 5 February 2009:
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
Comment by Hilary on 3 March 2009:
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?
Comment by Laura on 3 March 2009:
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
Comment by Hilary on 3 March 2009:
Laura,
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.
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”
Hilary
Comment by Laura on 3 March 2009:
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
Comment by Ed on 9 March 2009:
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!
Comment by Laura on 9 March 2009:
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
Comment by Ed on 9 March 2009:
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.
Comment by Bobbie on 10 March 2009:
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?!
Comment by Crystal on 10 March 2009:
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.
Comment by Laura on 10 March 2009:
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
Comment by Laura on 10 March 2009:
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
Comment by Jo on 17 March 2009:
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.
Comment by Laura on 17 March 2009:
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
Comment by Heidi N. on 10 August 2009:
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
Comment by Laura on 11 August 2009:
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
Comment by Heidi N. on 12 August 2009:
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
Comment by Teri on 30 September 2009:
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
Comment by Laura on 3 October 2009:
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
Comment by AM on 20 November 2009:
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……..
Comment by Laura on 20 November 2009:
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
Comment by Katlyn on 13 January 2010:
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?
Comment by Laura on 14 January 2010:
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
Comment by Jessica on 2 February 2010:
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?
Comment by Laura on 3 February 2010:
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
Comment by Jen on 25 April 2010:
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?
Comment by Jayme on 26 April 2010:
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?
Comment by Laura on 26 April 2010:
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
Comment by Laura on 26 April 2010:
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
Comment by Michelle on 11 May 2010:
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
Comment by Laura on 12 May 2010:
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
Comment by Anonymous on 8 August 2010:
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!
Comment by Jill on 15 August 2010:
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!