They will "grow out of it." Speech delay or not?

As a pediatric speech-language pathologist, I hear this statement frequently from parents, “My pediatrician said his language is behind, but thinks he will grow out of it. He wants us to wait and see.” As I’m trying to disguise my eyebrow raise and eye bulging as a facial glitch, inside I’m thinking, “Waiting for…a child to get behind? Waiting for…the magic pill to kick in?”

True, some children are delayed and will catch up, but only about 50% of toddlers with slow expressive language will catch up to their peers by the first grade (Bishop and Adams 1027). Slow talkers are also more likely to demonstrate behavior problems, learning disabilities, and poor social skills. Understandably, I know this is a hard pill to swallow for parents. My child is not communicating like the other children. What did I do wrong? I’m here to tell you two things:

1.) It is not your fault

2.) The waiting game is a dangerous game to play

Early intervention goes along way in all areas of health. Would you seek help early if you felt like you had a cavity? Would you wait till you couldn’t hear the voices of your family members before seeking help from an audiologist? The earlier a child receives intervention the easier it is to catch up, and the better the prognosis. Since children with delayed speech or language delays can’t participate fully during activities and conversations, they may fall even further behind if they are not provided with the help they need.

When should you seek help?

If you are concerned about your toddler’s language development, consult a Speech-Language Pathologist. The bulk of language learning takes place in the first five years of life. In these years, brain development is the most rapid and children are more receptive to learning ("Communication Development").

Signs of a language delay or disorder

Language and speech milestones are indicators of typical development. When milestones are not met near the predicted time, a child may need extra help to catch up.

By 18 months

• Does not understand simple commands like, "Come here"

• Does not produce at least 15 single words

• Words should include nouns (“milk”, “puppy”), verbs (“go”, “eat”), adjectives (“hot”, “cold”), and social words (“hi”, “bye”)

• Does not respond with a word or gesture to a question such as “What’s that?" or “Where’s your shoe?”

• Cannot point to two or three major body parts such as head, nose, eyes, feet

By 24 months

• Says fewer than 50 words

• Words are not easily understood

• Does not consistently join two words together like "Mommy go" or “ shoes on”

• Does not imitate actions or words

• Does not pretend with toys, such as feeding a doll or making a toy man drive a car

• Does not point and name items of interest

By 30 months

• Says fewer than 300 words

• Does not use familiar action words like “hug”, “eat”, “fall”

• Does not use some adult grammar, such as plurals (babies) and verb endings (doggie sleeping)

• Does not follow 2-step directions

• Produces speech that is unclear even to family members

By 36 months

• Does not tell simple stories about his/her experiences

• Does not produce 3-word sentences

• Does not ask and answer simple questions

• Speech is not 75% intelligible to a stranger

If you have noticed one or more of these signs in your child, it's important to take action right away.

A ‘wait and see’ approach simply delays treatment that can make a huge difference to a child who needs it. Call your local Speech-Language Pathologist if any concerns arise, and they will be able to guide you on steps to take to foster language development.

RESOURCES

Bishop, D. V. M. and Adams, C. "A Prospective Study of the Relationship between Specific Language Impairment, Phonological Disorders and Reading Retardation." Journal of Child Psychology and Psychiatry, vol. 31, Nov. 1990, pp. 1027–1050. doi:10.1111/j.1469-7610.1990.tb00844.x

Communication Development in Children with Language Delays. Hanen Centre. 8 June 2017, www.hanen.org.

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About Lauren Szot

Lauren Szot, M.S., CCC-SLP is a certified Speech-Language Pathologist and owner of Tall City Speech, LLC in Midland, TX. She specializes in working with pediatrics with complex communication disorders as well as partnering with the family in a home setting. Lauren has a passion for helping children find their voice.