Thanks to Family Development Centre for sponsoring this post and providing this advice free of charge to the parents who submitted questions.
Last week I asked everyone to send me their questions about speech and language development. I spoke to an expert, Natalie Corbett Sampson of Family Speech and Language Services (part of the Family Development Centre here in Halifax), on your behalf to have her review the questions and provide some advice. She tackled your queries about stuttering, lisps, talking milestones, sound substitutions and more with information that will be valuable to many parents dealing with the same issues.
If you would like her help with your child she offers free initial consultations to ask questions and to help you determine if her centre is the best fit for your needs (pssst...they have a “therapy” bunny and kitty, so, yeah, I think any kid would love going there!).
Thanks to Family Speech and Language Services and the Family Development Centre for sponsoring this post and providing this advice free of charge to the parents who submitted questions.
SPEECH AND LANGUAGE MILESTONES
Megan.: When should you be concerned that your child isn't talking yet? My 21 month old can say dada, mama and nana but that's about it. He's very smart and knows/understands when we talk to him...just hasn't started talking back yet. Our doctor said its not a huge deal right now, especially because he understands and can communicate his wants/needs to us...but also doesn't want us to "ignore" and end up with our heads in the sand
All kids develop at their own rate, of course, but we look to general developmental milestones to see if a child is ‘on track’ or falling behind. With respect to speech and language, between 18 and 24 months children have developed a vocabulary of about 50 words, including nouns and verbs, and are starting to put two words together with some frequency. There are kids who talk later for reasons no more malignant than personality, but waiting to see if a child is ‘just a late talker’ may lose time to address a greater issue. A screening can put your mind at ease and give you ideas of how to push his communication along.
Kelly: My almost four year old girl substitutes consonants such a too-tee for cookie. She tends to do it with sounds farther back (g, k, etc). She has an incredible vocabulary but I don't believe she can form these sounds in isolation.
Sound substitution is a common articulation error and /t/ for /k/ is frequent. Whether or not a sound is targeted for therapy depends on age. I will work on /k,g/ (these are velar stops) with a four year old, for example, because we expect them to use /k,g/ accurately by four. I would not work with a four year old who is substituting /f/ for ‘th’ (how cute is it when they say ‘fumb’?) because ‘th’ develops at a later age. Screening for speech patterns is warranted.
LISPS AND PRONUNCIATION
Alison R: We saw a SLP and audiologist last year when my daughter was three regarding speech concerns I had. At that time we only had an assessment and were told no concerns and that she would outgrow it. Fast forward a year, she is now four. The pronunciation has improved and she is way easier to understand but still talks with her tongue out or between her teeth. I was also like this as a child and required SLP support. Should I be looking for a re assessment now or wait until she is older?
Kelly.: My almost 7 year old boy has a lisp. He was in therapy - home based where I did all of the exercises - but he CAN make clean <s> sounds but he often spreads it wide and his tongue comes between his teeth. When I make him aware of it, he can make a pure sound, but day to day his tongue comes though his teeth. What to do next?
It sounds like what you’re describing is an interdental lisp or a ‘messy /s/’. This doesn’t often affect intelligibility but makes the speech sound young. Addressing a lisp early may avoid solidification of a habit but it can be a tricky sound to target. My approach with young children is to explore their ability to produce an accurate /s/. If the child is stimuable [able to imitate correct production of a speech sound], I’ll try some therapy. If not, I suggest waiting for some maturity and try again. With kids older than six I’m more persistent. I’ll push them harder to get a clean /s/, and do more work to correct it in running speech. Speech is a motor process that creates and uses habits and motor memory. Try to tell a story but switch all your /f/s to /b/s. It’s nearly impossible. The process of therapy increases automatization of accurate production in units of increasing complexity (isolated sounds, syllables, words, phrases and then sentences). Only when it’s automatic can a child attend to the message they are trying to express and use a correct production. Unfortunately, some people never correct a lisp; there are adults who still produce /s/ between their teeth.
INITIAL CONSONANT DELETION
Stephanie: My 23 month old has a large vocabulary but she has the odd habit of dropping the beginning sounds of words which makes it hard for others to understand her. It isn't limited to certain sounds, she says many words this way. For example, Grampie is "Ampie," for watch this she says, "atch is," for want toast she says "ant oast!" I've never heard another kid do this. I know she's still young but is it a cause for concern or something she should be seen for?
Typically speech therapy, or targeting accurate pronunciation of speech sounds, is not beneficial before age three as younger children haven’t developed the attention and self awareness necessary for learning, practicing and using new sounds in place of errors. This would be true for a child who uses /b/ instead of /f/, for example. However, what you’re describing is a general speech pattern called Initial Consonant Deletion and it can have a major impact on the child’s ability to be understood causing frustration. For blanket patterns such as this, therapy can be beneficial at a younger age and addressed through play. A screening or assessment is warranted.
Alison P: Is a sudden stutter a normal part of speech development? My almost 2.5 year old has developed a stutter suddenly (over the past two weeks). She seems to sometimes catch herself and try and slow down. Is this cause for concern, or just her brain working faster than her speech can keep up with at the moment? Thanks!
Tina: I would love to know more about stuttering... how common is it and how worried should we be if our child develops one? My three year old son has one that comes and goes - sometimes it's really bad and other times not so much. Sometimes it stays for a while and other times it's just a day or too. Is this normal?
Stuttering can be developmental. That means that it appears during preschool years and disappears – often just as suddenly – as late as puberty. It can also be perpetual, a challenge the child will carry into and throughout adulthood. Girls are more likely to outgrow a stutter, as are children with no family history of stuttering. Children who start stuttering after three years of age are less likely to outgrow the condition. Discriminating between developmental stuttering and lifelong stuttering can be difficult so an assessment is always recommended. In the meantime, fluency can be supported through good listening techniques: undivided attention and patience.
For more information about Family Speech and Language Services please visit their website and book a free initial consultation to ask questions about their services and to determine if you feel they are a good fit for your family’s needs.
Our expert is Natalie Corbett Sampson. Natalie is a certified Speech and Language Pathologist and she has been helping local families improve their communication skills for over ten years. She has a Bachelor of Science in Biology from Acadia University and a Masters in Communication Disorders from Dalhousie University.
She worked with both the autism team and the general population as part of the Nova Scotia Hearing and Speech Centres, and then she founded her own centre, the Family Development Centre, which is a collection of professionals in Halifax who provide quality team-based and best practice services to individuals and families in the community. Part of this centre contains the Family Speech and Language Services. On top of being all of these things, she's also a mom to four children, a novelist and a photographer.