Barbara Whitney was stunned when her pediatrician said her 3-year-old daughter was speech-delayed and needed therapy. "More often than not," Whitney says, "she would just ignore the person who spoke to her or hide from that person. Her ability to verbally interact with peers her age was becoming more and more difficult for her, and she would try to evade her peers whenever they said something to her."
"Not having adequate language often affects children's abilities to initiate and maintain friendships," notes Vivian Lam, M.S., CCC-SLP, owner of Elocution Seattle, PLLC. Language development influences the ability to learn, think and interact socially, and a result can also significantly affect behavior, self-esteem and quality of life.
In addition, says Daelene King, M.S., CCC-SLP, director of The Learning and Language Clinic in Seattle, "Research has repeatedly shown that early language development is among the best predictors of reading skill throughout the grade school years. Preschoolers with speech-language delays are at a much higher risk for learning disabilities.
"Dyslexia, for example, is now understood to be due to a specific language disorder and signs of this are evident in the preschool years," King says. "There are also some key language skills that are necessary prerequisites to literacy development.
A delay in phonemic awareness -- a child's ability to discriminate sound boundaries in words -- is the most common cause of reading disorders in the U.S., she adds. However, if the problem is identified early and addressed, "delays in literacy acquisition can often be fully prevented," she says.
According to Lam, early intervention is key since "the critical window for language learning is from 0 to 7 years. The first three years are particularly important as neurodevelopment is extremely rapid. In addition, there are many pre-linguistic skills that a child needs in order to develop strategies to learn speech and language."
While it is "virtually never too late" to help a child improve their speech and language skills, King adds, it is better to intervene as soon as possible.
As a result, parents must be able to identify and address potential language delays early and, if necessary, become assertive advocates for their child. Parents should notice how much of their child's speech is understood by adults outside the family. They should also watch their child playing with others and compare the child's communication and social skills to the range of his or her peers.
"Be aware of developmental norms such as the guidelines published in this article" (see sidebar), "and take steps to get speech and language skills formally assessed if delays are suspected," King recommends.
A year after her daughter's evaluation, Whitney is relieved. "I believe getting her into speech therapy at age 3 was the best decision we ever made. She no longer appears threatened by the attempts of others to speak or interact with her, children or adults, and her self-confidence has vastly improved."
Whitney's message to other parents: "Don't be afraid to raise your concerns with your pediatrician or to ask for a speech evaluation."
- By 6 months: Smiling, cooing, responding when spoken to, taking communicative turns.
- By age 1: Babbling, gesturing, imitating sounds, following simple instructions.
- By age 1 1/2: Using at least one word, recognizing names of familiar objects.
- By age 2: Using 50 words meaningfully, two-word phrases, 50 percent of speech understood by strangers.
- By age 2 1/2: Using many two-word phrases, following directions without cues, asking what and where.
- By age 3: 80 percent of speech understood by strangers, 200-word vocabulary, asking variety of questions.
- By age 4 to 5: Following multi-part directions, mastery of basic grammar rules, 2,000-word vocabulary, 90-100 percent of speech understood by strangers, role-playing with peers, telling simple stories.
- Over age 5: Speaking in complete sentences without stuttering or lisps, following oral directions, communicating easily with friends, controlling speech volume.
At any age, seek help if your child demonstrates a loss of previously demonstrated language skills, shows obvious difficulty or extreme frustration at attempts to communicate, is overly frightened by sudden loud noises, doesn't make eye contact, is not responsive to voices or seems to frequently ignore people.
Consult your pediatrician or a certified speech-language pathologist if you suspect any delays.
For children under age 3, referrals to early intervention services -- including screening and evaluation -- are available through WithinReach, 206-284-2465.
For children older than 3, free evaluations are offered by every school district in the state.
The state covers treatment costs for eligible families who don't have adequate insurance.
You can also obtain general information from the American Speech-Language-Hearing Association (ASHA) at 1-800-638-8255.
Laurie Thompson is a freelance writer and stay-at-home mother of two.
Originally published in the November, 2004 print edition of ParentMap.