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Assessing your child's need for speech therapy

Last Modified: 8/17/2018

Parents often express concerns about their child’s cognitive and motor skill development. Are they interacting as much as they should be? Are they speaking enough? Are they speaking correctly? We invited Rhonda Anderson, NP, PPG – Specialty Pediatrics and Cindy Barger, MS, CCC-SLP, outpatient speech language pathologist, The Parkview Pediatric Rehabilitation Clinic, to share their recommendations for assessing and promoting communication skills with your little one.

What are some common causes of a delay in speech development?

“There are a number of related things, including prematurity, any concern about hearing, a low birthweight, any exposure to neurotoxins in utero or lead poisoning, a family history of impaired speech, brain injury, meningitis or some sort of illness. Speech impairment is also linked to delayed feeding or swallowing issues, a tongue tie that hasn't been identified or incoordination. Sometimes we see school-age children, if they don't like school, struggling with speech as a sign they might be having an issue in class. I recommend the ASHA website as a great resource for parents.” – Cindy Barger  

Are there any tips for prevention?

“Parents are typically first to notice a delay in developmental milestones with their children.  When a parent feels that his/her child may be delayed, it is very important to discuss those concerns with his/her healthcare provider.

Staying up to date with routine well-child checks is also extremely important. During these office visits, developmental milestones are reviewed. Many parents are asked to fill out an Ages and Stages Questionnaire. This developmental screening can identify early delays in all areas of development, including fine motor, gross motor, social/personal, communication and problem solving. Well-child checks are recommended at: 2 weeks, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 24 months, 30 months, 36 months and yearly there after.” – Rhonda Anderson

Are there any guidelines parents can use to gauge their child’s progress?

“Certainly. A child should typically start babbling by 4-6 months old. They should be paying attention to words – learning parent's names, for example – by 8 months. They should be using early words by 7-9 months and true words (where you can clearly understand them) by 10-12 months. Their vocabulary should continue to expand as they grow and they should be using longer sentences and getting sentence structure put together. As they near school age, you want them to associate specific sounds to letters.

Memory is also very important for speech development. By the age of 3, they should be able to remember a 3-digit span and understand opposites. By 4-5 we want them to be able to tell a little story. By 5 they should be able to tell a pretend story, have an expressive vocabulary of about 2,500 words, know basic pronouns, participate in a conversation and have the capability to work with early reading and writing skills (sounds and symbols).” – Cindy Barger 

“Parents can screen their child at home for speech delay by using many useful developmental milestone checklists such as this website.” – Rhonda Anderson

Are there any additional warning signs?
  • Your child does not seem to understand simple instructions
  • Recurrent infections, especially ear infections
  • Poor interactions with other children his/her age
  • Difficulty understanding your child’s words
  • Avoids eye contact
  • Watches or mimics other’s activities prior to starting on his or her own after given instructions.
What should a parent do if they suspect an issue?

“If there is a sign of early communication delay, the first recommendation would be to have the child assessed by an outpatient speech-language pathologist (SLP).   These therapists work closely with your child to help with all oral motor functions.  Speech-language pathologists will work with your child on expressive (being able to say what we need) and receptive language (being able to understand what we hear). If a speech delay is identified, the SLP will recommend goals for the child to work toward through outpatient therapy. Early intervention is key, finding a delay early can help resolve the delay before it becomes more of an issue when the child begins school.” – Rhonda Anderson

“Contact your pediatrician or primary care physician. If they provide an order for speech therapy, we can start the process with a specialized pediatric therapist and address the concerns.” – Cindy Barger 

What can parents expect during the therapy process?

“We start by assessing the child’s comfort and skill level with sounds, swallowing, feeding, language, social skills, comprehension and vocabulary. We really try to make it child-focused with a lot of play (depending on age). A child's job is to play; that's how they learn. So we work through their goals and, if they're working on sentences, we might model that and a bit beyond to get them to expand. We do a lot of turn taking and back-and-forth activities because that's what language is (conversation). We incorporate activities the child is interested in and focus on their cognitive skills with variety of stimulating activities.”  – Cindy Barger 

How can parents promote healthy speech development?

“Read, read, read and talk, talk, talk! With younger children, you want to use simpler language. Match the level your child is speaking and maybe a little bit ahead of that. For example, if they are talking in 2-word sentences (“Book cat.”) you might try a 3-word sentence (“Read cat book.”). I also really encourage singing. It actually helps with so many things … organization and language and math. It's a great activity.” – Cindy Barger 

“Interacting with your child is the most successful way of helping them with any type of developmental delay. Encourage him/her to ask or ‘use their words’ when he/she expresses any needs and read together daily. Reading will help increase vocabulary and identifying new words.  Singing or talking together in front of a mirror can help the child visualize lip placement for developing vocabulary. Making funny noises, blowing kisses, and clicking your tongue to your child and encouraging the child to repeat the noises can be beneficial for motor building.  Teaching and learning simple sign language for basic needs can decrease frustration when verbal communication is delayed for both the parent and the child.

If speech delay continues to be an issue and an SLP is currently working with your child, an auditory evaluation may be beneficial. If a child cannot hear words well, he/she will not be able to express them well.  Talk to your healthcare provider if you feel that your child may have a hearing deficit and would like to explore a referral to an audiologist.” – Rhonda Anderson

The Parkview Pediatric Rehabilitation Clinic is located at 3439 Hobson Road, Fort Wayne, Indiana, 46805. Call (260) 373-7925 for more information.


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