How a Speech Therapist Helps Children with Speech Delays

When a child talks less than other children the same age, parents worry: is it just how this child develops, or a reason to see a specialist? Here are the age guidelines to keep in mind, signs that call for a doctor’s visit, what to know about bilingual children and what parents can do. Finding a good speech therapist is covered in How to Choose a Speech Therapist for Your Child: Tips for Parents.

Speech and Language Are Not the Same

Specialists tell apart speech delay and language delay. Speech is the physical act of making sounds with the voice, lips and tongue. Language is knowing words and being able to put them together and understand what others say. A child may know the right words yet say them in a way that is hard to understand, which points to a speech delay. If a child struggles to understand what is said to them or does not form phrases, the delay is in language.

Age Guidelines

• Around 12 months: one word or a few.
• Around 18 months: about 10 words, and the child follows simple requests.
• Around 24 months: two- and three-word phrases, and words such as “I,” “me” and “you.”

These are averages: children develop at different speeds.

When to See a Doctor

Signs that call for a visit to the pediatrician include not pointing or using gestures by 12 months, saying five words or fewer by 18 months and fifty or fewer by 24 months, and losing speech or social skills the child already had. Between two and four, it is a concern if the child cannot follow simple requests, does not join words into two- or three-word phrases, or is hard to understand even for close family. The American Academy of Pediatrics recommends checking language development at 9, 18 and 24 to 30 months. Only a specialist can make a diagnosis.

Bilingual Children

When one language is spoken at home and another outside it, speech development looks different. Research shows that bilingualism is sometimes mistaken for a language disorder. Bilingual children may have a smaller vocabulary than children who speak one language, while other studies find they do better on tasks that call for flexible thinking. That is why a bilingual child’s speech should be assessed with both languages in mind.

If You Live in the US

In the United States, children under three with developmental delays, including delays in speech, can get help through early intervention programs run in every state under the federal IDEA law. A pediatrician can refer a child for an evaluation, and the services are usually free, arranged by the local school district or the county.

What Parents Can Do

• Talk to your child with warmth and enthusiasm.
• Talk about whatever your child is looking at or busy with.
• Read aloud often.
• Watch programs together and talk about them instead of leaving your child alone with a screen.

Many young children with a language delay catch up with their age group by five, but only a specialist can say what to expect for a particular child. Getting ready for the first appointment with a speech therapist is covered in How to Prepare for the First Session with a Speech Therapist.

How to Get Started

In our lessons, the speech therapist first assesses how the child speaks and discusses with the parents what they hope will change, then draws up a plan covering pronunciation, vocabulary, connected speech, reading and writing, and shows parents how to repeat the exercises at home. Lessons are open to children from age 5. A trial lesson costs $8: it is individual and lasts 45 minutes. More about the course is on the Speech Therapy Classes page.