My son was 3 years old when I realized he wasn't developing at the same pace as other children.
He understood everything I said to him, but he could verbalize only a handful of words in return: Mama, no, bye-bye, Bobo (the name of our dog) and fish, which always ended with a drawn-out sssshhh sound that wrapped itself around my heart. I was slowly noticing the other toddlers at the park and library story time were in possession of a far greater vocabulary, and some of them were speaking in complete sentences. Yet no matter how hard I tried to get my son to repeat even the simplest words, his responses were unintelligible.
He was struggling and I didn't know why. I felt like I was failing him, so I decided to have him evaluated by our local school district after my mother told me a friend had done this with her own child. This was when I learned my son's limited vocabulary was actually a sign of speech delay,
Carol Berkowitz, the division chief of general pediatrics for the Harbor-UCLA Medical Center, says if your child doesn't meet specific speech milestones — including saying the words dada/mama by 10 months; a vocabulary of three to five words by 12 months; and a vocabulary of 50 words, including two-word phrases, by 24 months — it could be a sign of a speech delay.
In addition, the American Speech-Language-Hearing Association says parents should look for the following signs of a problem:
- Not smiling or playing with others from birth to 3 months.
- Making few sounds and very few gestures, such as pointing, by 7 to 12 months.
- Not understanding what other people are saying from 7 months to 2 years.
- A lack of interest playing or talking with other children at 2 to 3 years.
- A lack of interest in books or drawing by age 2½ to 3 years.
If you do suspect your child has a speech or language deficit, early intervention is key. Ask for a referral from your pediatrician, or make an appointment to have your child assessed by a licensed speech pathologist. You can also have a child evaluated through your state's early childhood intervention program by contacting the special education program in your school district.
Kim Scanlon, a licensed speech pathologist and a member of ASHA, urges parents to trust their instincts. She says, "If a parent is worried about his or her child's ability to communicate and say words, then I advise seeking speech therapy services as early as possible . . . early intervention during these critical first few years of life has the potential to rewire the brain and change the child's developmental trajectory."
In my son's case, I set up an appointment for a free evaluation through the local schools. His speech delay was significant enough to qualify him for a free speech-therapy based preschool program three days a week. I also was fortunate to have medical insurance that covered twice-weekly visits with a private speech pathologist.
The first changes I noticed in my son were behavioral. Before enrolling in speech therapy, he was prone to frequent outbursts and temper tantrums. "Temper tantrums and biting are often noted in youngsters with speech delay," Berkowitz says. "It makes sense since they cannot articulate their wishes or express their frustration."
My son's teachers encouraged him to convey his wants and needs through signs and gestures. They taught him to rub his tummy when he was hungry, or flap his arms to call my attention to a bird outside the window. I learned to calm him down when he was upset by simply asking him to point to what he wanted. He wasn't necessarily going to get the requested item, but at least he knew he was heard and understood.
You can also help your child by speaking aloud to them as much possible, including reading. Scanlon also recommends giving a child choices instead of asking open-ended questions, to provide your child with words to imitate and repeat. And it's important not to overly anticipate your child's needs, Scanlon says. Allow them to use words, signs or gestures to ask for that toy they'd like to play with to encourage and reward direct communication.
If your child is in school, work with the teacher to make sure he feels comfortable and empowered in the classroom. Hannah Grieco, a former elementary school teacher and education and disability advocate in the Washington area, says many speech-delayed students are anxious and insecure about their verbal abilities. Grieco says she doesn't call on those students unless their hands are raised, to avoid the pressure of putting them on the spot.
Grieco recommends a combination of private speech therapy and special education services through the school district for school-aged children. She encourages parents to have their child evaluated and to get an independent education plan (IEP) in place.
My son benefited from working with a speech therapist in front of a mirror so he could visualize what his mouth needed to do to make the correct sounds. She taught him to press together his lips to make an mmmm sound, and how to shape his mouth and position his tongue to make an oh sound. It was hard to see him work so hard to learn skills most children acquire naturally, but also gratifying to see his steady improvement. Every child's journey is different, but by the time my son started kindergarten, he no longer needed speech therapy.
And remember, Scanlon says, you're not alone.
"If you're still waiting to hear your little one utter a word, stay hopeful and know that there are many other parents who feel just like you."