Understanding speech and language delays or disorders in children

Speech and language is a key development area that affects a child’s emotional development, social interactions, behaviour and academic skills. Therefore, it is not uncommon for key stake holders, such as parents, grandparents and teacher, to get anxious when their children are not communicating as well as same aged peers.

Whilst, it is common for children to develop at different paces, most children do reach specific milestones within a specified time frame. Parents can refer to developmental guidelines or our previous post Understanding Speech and Communication for these time frames.

So, if there are specified times, should I wait it out?

The above is a question that may resonate with many parents with children with speech and language delays. This question may come up at several different points in time – when first noticing or observing for potential areas of concern, considering whether to make an appointment with a specialist and/or when considering following through with recommended treatment or assessment options.

However, an important factor to consider is brain development. A child’s brain develops at a profound rate during the foundational years. Hence, time is of the essence when it comes to intervention.

Therefore, it is recommended that parents consider an assessment by either a Psychologist or Speech and Language Therapist as soon as they suspect that their children are not developing at age expected levels. Early detection and intervention have been shown to result in positive outcomes.

There is also a distinction between a delay and disorder. Only through an evaluation with a Speech and Language Therapist would one is be able to ascertain if their child has a delay in speech/language development or disordered development. Whilst there is no harm in helping children who may grow out of the delays, there are detrimental risks in waiting for a child who may not.

The following are potential problems that may emerge from speech and language delay:

• Difficulties with social interaction in school
• Delays in reading and literacy (as reading requires knowledge of speech sounds)
• Low self-esteem and confidence and, elevation in anxiety and low mood
• Behavioural issues

Sometimes, speech and language delays can also be signs of other developmental disorders (e.g. autism or social communication disorder). It is, therefore, crucial to detect early and provide the necessary intervention as soon as possible.

How can speech and language therapy help my child?

Speech and language therapy can help in the following areas:

• Receptive language (i.e. understanding what was said)
• Expressive language (i.e. verbally communicating)
• Pronunciation and articulation of sounds, letters and words

Parental involvement in therapy also is crucial in the effectiveness of therapy.

What can I do in the mean time to support my child with speech and language difficulties?

1. Getting the interaction going by: OWL

• Observe – watching your child closely in order to see the things she is interested in. You will notice how and why she communicates and what she responds to.
• Wait – waiting will allow your child time to send messages in their own way. It will also give your child to take in and think about what you are saying/doing.
• Listen – when you listen carefully to your child’s sounds, words, or sentences, you learn about what she can already to and what you can build on. Listening is valuable tool for when your child is using echolalia.

2. Keep talking to your child

Expand your child’s vocabulary by conversing with your child as much as you can and reduce baby talk. Describe to your child what you are doing, where you are going, what you are going to do, what you have just done.

3. Use books

Read age-appropriate books that are of interest to your child. Point and talk about the pictures or illustrations in the books.

4. Sing to your child

Sing songs and nursery rhymes to your child. Music and movement are a great way to engage and bond with your child at the same time.

5. Learn and practise gestures and sign language

Children begin communicating by using gestures before they verbalise. For instance, they point at objects, raise their hands when they want to be carried, clap when they are happy, and wave to say goodbye.

Children with expressive language delays can benefit from learning simple gestures or sign language for a start. Some common sign languages include “eat”, “drink”, “more”, “all done” and “thank you”. However, signs and signals should always be used together with speech and language development – and not a substitute for it.

6. Limit screen time

One of the causes of comprehension delay is psychosocial deprivation, which means the child does not spend enough time talking with adults. Research has shown that screen time impairs and delay a child’s speech and language development. So, as much as possible, do replace screen time with face-to-face communication.

7. The four I’s

• Include your child’s interest. Notice what your child is doing and then join in. Bring what your child looks at into your shared space.
• Interpret. Treat whatever your child does as if she were intentionally sending you a message Say or do things “as she would if she could”
• Imitate. Follow your child’s lead by copying her actions and sounds. It will be easier for your child to imitate you if you use a toy this is the same as, or similar to, hers
• Intrude. Insist on joining in on what she is doing, even if she doesn’t welcome you at first using the following:

The “keeper” strategy; Hiding and Searching; Get in the way and; Join in and play. Intrude to carry on conversations and or when child goes off topic and/or insists on his topic.

8. The Four S’s

• SAY Less. Simplify what you say. Use short, clear labels, and sentence.
• STRESS. Exaggerate key words. Put key words at the ends of your sentences. Use FUN words.
• Go SLOW. Pause between words and phrases. Be natural.
• SHOW. Show with real objects, actions and gestures, pictures and, printed word.