My husband (and the other half of teachmetotalk.com!) showed me this online news article several weeks ago and I keep thinking about it and digging a little deeper.
In my entire career, I’ve only seen a few kids with the official diagnosis of Fetal Alcohol Syndrome, now called Fetal Alcohol Spectrum Disorders (FASD), and all were adopted or in foster care. After reading this post and then looking at the study, I know there have been more!
Experts previously believed that FASD affected a relatively small number of children at 1%, but a recent study estimates the number is as high as 3 to 10%.
In this study published in Pediatrics, researchers concluded that 80% of the FASD cases are missed and 7% are misdiagnosed as something else.
One of the study’s authors said that the most common FASD type,or partial FASD, has very subtle physical features, but significant neurobehavioral problems. These problems include decreased attention span, impulsiveness, and of course, learning differences.
Why does this matter?
FASD is as common as autism.
This is not what SLPs know about FASD. Perhaps I should say, it wasn’t what THIS SLP believed to be true! In updating my own information, I thought I’d pass it along to you too!
In case you’re a little on the cynical side (that’s me too!), here’s a post that questions the validity of the study due to limitations – including the reluctance of moms to report drinking during pregnancy.
If you’d like to take a look at the original study, here’s that link at JAMA.
Autism rates appear to be stabilizing in the US.
According to a study in JAMA, rates did not rise significantly from data collected in 2014 through 2016. This was the first time rates did not increase in the past 20 years.
In the US, prevalence rates are holding steady at 2.4% for children and adolescents.
For you data junkies, here’s more info per gender and race:
- 3.54% of boys were reported to have ASD, compared to 1.22% of girls.
- Prevalence was 2.71% in white children, 2.36% in black children, and 1.78% in Hispanic children.
Be a good consumer of research…
Many news outlets are reporting these results WITHOUT reporting other factors could account for the steady rise in ASD diagnoses over the last two decades. These include changes in the way ASD is diagnosed, increased referrals for children with signs and symptoms, raised public awareness through intense media campaigns, and higher environmental risks.
How common is late talking?
The latest prevalence estimates are 10 – 20% of 2 year olds.
(This also means 80 to 90% of kids meet those early language milestones without any problems!)
The most significant risk factors for late talking are:
- GENDER—Boys are at higher risk than girls.
- LATE WALKING – Late talkers have more motor delays when compared with typically developing kids.
- LOWER BIRTH WEIGHTS – Babies born with less than 85% of their optimum birth weight are more likely to talk late.
- PREMATURITY – Babies born earlier than 37 weeks gestation were found to be at higher risk for late talking.
- DELAYED EARLY LANGUAGE DEVELOPMENT – Language abilities at 12 months appear to be one of the better predictors of communication skills at 2 years.
A child’s ability to imitate actions at 18 months old was a better predictor of his language skills at 36 months old than even gestures. *
Toddlers who do not “copy” things other people do will not have the same language skills as peers who regularly engage in imitation.
Sometimes when I talk to parents, they ask for examples of the kinds of actions toddlers imitate. Here are a few common situations that 1 and 2 year olds with typical patterns of development begin to imitate:
- household chores like pretending to dust, sweep, cook, or cut the grass
- personal care activities like pretending to apply make-up or shave
- community outings like pretending to drive, go to the doctor, or shop at the store
- everyday activities like pretending the remote control or a block is a phone or a spoon is a sword
When toddlers don’t naturally begin to try to imitate others, it’s a red flag. We have to help them build their cognitive experiences through play and everyday activities so they have something to imitate!
In most cases, we also have to spend time directly teaching them to imitate. This can be hard to do, but I can show you how! Check out my book Building Verbal Imitation in Toddlers. If you’re a therapist or need want to see in-depth examples with real kids with delays, take a look at my course Steps to Building Verbal Imitation in Toddlers.
(*Zambrana, I. M., (2013). “Action Imitation at 1½ Years Is Better Than Pointing Gesture in Predicting Late Development of Language Production at 3 Years of Age.” Child Development 84:560–573.)
Words from the American Academy of Pediatrics about screentime…
“Media in all forms, including TV, computers, and smartphones can affect how children feel, learn, think, and behave.”
“Because of their immature symbolic, memory, and attentional skills, infants and toddlers cannot learn from traditional digital media as they do from interactions with caregivers, and they have difficulty transferring that knowledge to their 3-dimensional experience. The chief factor that facilitates toddlers’ learning from commercial media (starting around 15 months of age) is parents watching with them and reteaching the content.”
“…For children younger than 2 years, evidence for benefits of media is still limited, adult interaction with the child during media use is crucial, and there continues to be evidence of harm from excessive digital media use.”
Bottom line… The words “evidence of harm” are serious! Rethink your patterns about screentime for little ones! It’s not as educational or as beneficial as we think!
Read the full position statement at aap.org.
Research tells us that 70 to 80% of late talkers will outgrow a language delay if it’s ONLY an expressive delay. This means no delays or red flags in other areas like receptive language or social interaction issues like fleeting eye contact or limited joint attention.
This is good news, BUT it still means that 20 to 30% of kids will not catch up. This delay can significantly impact a toddler’s ability to learn academic skills like reading and writing since those skills are language based.
Bottom line… don’t “wait and see.” Get intervention going as soon as you suspect a delay! You don’t want to regret not taking any action!
Did you know…experiences change a child’s brain!
During the birth to 3 period, new brain connections form at rapid-fire pace of 700 a second!! (zerotothree.org)
What you do with a child matters – even simple, everyday things like feeding her, giving him a bath, playing together, and even just talking as you hang around the house. ALL these things change the architecture of his or her little brain.
This is good to know! This means that when we need to help a child learn something new that’s been hard (like TALKING!), we can change how things are going by changing a child’s experiences.
Let that sink in for a second.
Things you do together with a late talker can make a big, big difference! I hope that inspires you today!
Do you know the 2 factors most associated with kids with ASD who become functional communicators even after age 4?
By functional communicator, the study specified that children attained phrases or fluent speech.
It may not be what you think!!
The two factors were: (Wodka, 2013)
Higher non-verbal IQ
Less impaired social interaction skills
My favorite line in the study was this:
These data also implicate the importance of evaluating and considering nonverbal skills, both cognitive and social, when developing interventions and setting goals for language development.
If you want to read the results for yourself, take a look here.
I can help you with those strategies if you need some guidance!
Teach Me To Play WITH You is an entire ‘how-to’ book for targeting social interaction with toddlers.
Structured teaching and improving play skills are your BEST strategy for working on non-verbal cognition. Is It Autism? Treating Toddlers and Preschoolers with Red Flags for ASD has sections and directions for both.
Echolalia is actually a positive prognostic indicator for kids who are on the spectrum. Of children with autism who acquire speech, 85% of them have a history of echolalia (Prizant 1987). When we work with kids who quote movie lines, books, and even previous conversations, we need to remember this AND we need to make sure their parents see the silver lining…
THIS CHILD KNOWS HOW TO TALK!
We just need to tweak it so that he understands what he’s saying and can use all of those words to communicate with others.
If you’d like more information about echolalia, I have some great resources for you!
Read my post Echolalia…What It Is and What It Means for an explanation and description of echolalia.
For very practical treatment ideas, read my post Echolalia…What To Do About It.
There’s a great section about treating jargon and echolalia in my course Is It Autism? Treating Toddlers and Preschoolers with Red Flags for ASD. You’ll see examples and get an initial treatment protocol that’s been very effective for me in my work with young children.
Did you sing today? I hope so! Do you want to know why?
Besides being an activity that (most) toddlers love…
“Music and music experiences support the formation of important brain connections that are being established over the first three years of life (Carlton 2000).”
This means that singing is an EVIDENCE-BASED PRACTICE.
Every single time you break into song with a child, you’re helping build the circuitry for social and language development. You’re setting the stage for WORDS.
Not to mention, singing with children has tons of other benefits too that encompass all areas of early development including physical, cognitive, and literacy skills. Still need more evidence? Check out this article from zerotothree.org – Beyond Twinkle Twinkle: Using Music with Infants and Toddlers.
It’s well-known among speech-language pathologists that gestures precede words in language development.
Here’s a study that gives us that proof (for those of us who become obsessed with reading the “evidence.”) The conclusion was…
Toddlers who produced a gesture for a particular object learned to say that word (on average) 3 months later.
Granted, this study was for a small group of verbal toddlers who were transitioning from single words to phrases, BUT it has functional implications for treatment for pediatric speech-language pathologists who work with late talkers. Our take-away message is this…
PAY ATTENTION TO GESTURES!
When we see a toddler show us, give us, or point to an object, his little system is ripe for learning!
It could just be that he “needs” that word and is more receptive to learning it.
It could be that he’s revving up himself to be able to retain the word to talk about it.
It could be that he’s telling us…”Hey! I need you to tell me what this is!”
Nonetheless, he’s letting us know… “This word is important… so teach it to me!”
Yes, my little friend, we will!
If you want to know more about the importance of gestures and language development, check out my post Gestures Predict First Words.
the critical window for learning language is birth to 5. Around age 5, a child’s brain is already hard-wired for many things language-related, including grammar and pronunciation. This is why early intervention is so important when we suspect or identify a language delay. “Wait and see” is never, ever a good idea. Get in there and get language going! Read more about brain development in children at Zero to Three.