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Tuesday, February 17, 2009

Words of Wisdom on Speech and Language

By Rachel H and Guest Blogger Emily H

I would like to introduce you to our Guest Blogger today, Emily Halsey. Emily was a sorority sister of mine at Appalachian State. Six years later, we ended up as neighbors in Winston-Salem. Emily now lives in Greensboro with her husband, Scott, and two children, Emma Kate (5) and Henry (2). Emily graduated with a BS in Communication Disorders and a minor in Psychology from ASU, and then went on to receive her MS in Speech-Language Pathology at James Madison University. She has worked as a Speech Language Pathologist for the past 12 years in three different cities - Greensboro, Winston-Salem, and Fayetteville, Arkansas - in school systems as well as with private speech and language centers - and with patients of all ages from children to seniors. She has also provided evaluation and remediation services for clients who had a wide variety of speech-language disorders, additionally patients whose diagnoses included autism, cerebral palsy, pervasive developmental delay, and legally blind.

I have asked Emily to share with us some of her Smarty wisdom on Speech and Language problems most commonly occurring in children.

Hi Moms! My name is Emily Halsey. I am currently a stay-at-home mom who does some part-time contract work, but long ago, in a land far, far away, I was a full-time speech-language pathologist! I was trying to think of the most common concerns that my mom friends express concerning speech and language, and I came up with three main concerns. I’ve addressed each one briefly, but as I always tell my girlfriends, go with your gut! You know your child better than anyone, and if you have that nagging feeling in your head, it certainly can’t hurt to consult a professional.

North Carolina provides free screenings, evaluations, and if children qualify, therapy services, to children who are 3 years old and over through the school systems. You would need to talk to someone who handles preschool referrals if your child. If you call your school system’s information/help desk, they can steer you in the right direction. Qualifying guidelines do differ between the school system vs. private practices. Therefore, if a problem is mild, your child doesn’t qualify by school system guidelines, and you still want to address the problem, you can contact a private practice/therapist to see if they can provide treatment for your child. There is also a great deal of information on the Internet, and I did check some of my facts with a few Google searches! I hope this information is helpful to all you Smarty Moms!

Concern One: Is my child talking as much as he/she should at this age?
By age 1, a child will typically exhibit a vocabulary of between 3-20 words for labeling familiar objects/people. They will still use lots of gesturing at this point, often combined with a word or a vocalization (ex. Uh, uh). Using sign language with or without spoken language is also an acceptable form of object labeling, although you should definitely encourage spoken language.

By age 2, children are usually using up to 50 different words, mostly nouns, and are beginning to combine 2-3 words in a single utterance. They should be able to say their own name, produce animal sounds, and use “no” appropriately. (I think they are all masters at that!) Also, a child may have a “word” for an object or person that only you understand, but if he/she uses it consistently and appropriately, it is still considered a word in their vocabulary arsenal. When kiddos are this small, they are not expected to pronounce everything perfectly.

By age 3, children can be using up to 800 words, answering and asking various Wh-questions, and can answer simple how and problem-solving questions.

One thing I often see, even in my own family, is that parents, grandparents, and older siblings often anticipate a child’s wants and needs or speak for them. It is important to require children to verbalize for themselves, even if you say the word and ask them to repeat it. Something I still do with my son (Henry, who just turned 2) is to require him to at least say and/or sign “please” before receiving the object of his desire! It won’t kill them to do without that cracker until they ask for it instead of just grunting or pointing! Another thing I wanted to mention is that I often hear parents say that their children seem to understand a lot more than they are saying, which is completely normal, especially at these young ages. Lastly, remember that all children develop at different rates, and just because you know another child who is “talking up a storm” doesn’t necessarily mean that your child is “behind” in their development.

Concern Two: My child is not pronouncing certain sound(s)correctly. Does he/she need therapy?
By age 2, you should be hearing the sounds p,b,m,h, n, and w in your child’s speech production. By age 3, those sounds are typically mastered (b may take up to age 4) and you should be hearing k,g,d, t, f, and y in your child’s speech. By 3 ½ to 4, children should have these sounds mastered as well (t can take longer).

Sounds such as r,l,s,z,sh,ch, and v generally develop a bit later, and mastery may not be seen until age 6 or later. If there is a sound you think your child should be able to produce but doesn’t, one thing you can do is to see if he/she can repeat the sound after you show him/her how to produce it (just don’t drive it into the ground!). This is called being stimulable for a sound. If your child can do this, then it is a good sign that they will probably begin producing the sound on their own sooner than later. If they cannot, it is an age appropriate sound, and the problem persists, you may want to consider consulting a professional. Also, if there are multiple sounds your child cannot produce, if they are doing things such as leaving the ending sound off all words, or if their speech is completely unintelligible even to family members, an evaluation of their speech production would probably be in order. You should remember that when children are young and language is emerging you are going to hear sound errors and most of these are perfectly normal.

Concern Three: My child seems to stutter all the time, and I’ve just started noticing it.
Most of the time, this problem is completely normal as a child’s language is developing and is called pseudo stuttering. You may hear short repetitions of words or sounds, pauses between words, or substituted sounds. This problem often comes and goes, and may increase when your child is excited, stressed, or tired. A major change such as a move or a new sibling can also trigger stuttering. Be sure not to interrupt your child when he/she is speaking to you and give him/her time to finish what he/she is telling you. Most often, this problem will improve and/or correct itself within a 6 month period. If the problem persists longer than this, if you are seeing longer repetitions or hesitations in your child’s speech that occur most of the time, and/or if your child seems nervous or anxious about speaking, it is probably a good idea to consult a speech pathologist.

Thank you, Emily for all of the wonderful information you have shared with us today. If you have any additional questions or concerns, Emily has graciously shared her contact information with us. Email us here and we will send her information along to you. Emily is also available for consults and tutoring.

And if you have a question for Emily that you can share with other Smarty Moms, please post below!


Michelle S said...

Wow! I knew I loved this site! I had just been googling all week looking for an answer just like your #2 concern. Problem solved. Thank you!

Anonymous said...

I agree with the "Go with your gut". Moms know when something isn't quite right. I did take my child to a SLP when she was young and we had her problem fixed within a year. I was happy that we got the problem taken care of early on.

Summer said...

Thank you so much, I have been looking all over for a concise explanation of the phoneme mastery. You don't happen to have it as a chart do you? When should you worry if a child is leaving off final sounds in a word? For example instead of saying Horse, our two year old says HOR? Is there a layman's book you can reccomend?

Emily Halsey said...


Thanks for your comments. I do have several charts, but I did some googling, and if you type in "acquisition of speech sounds" and google that, the second entry was actually a download of a Microsoft Word document for that very thing. If you can't find it or have trouble downloading it I would be glad to get you a copy of what I have. Just thought this way you would have your hands on it quickly! I also wanted to pass along some info a fellow therapist and friend shared.If your child is 0-3, they can receive evaluations and therapy free or on a sliding scale through NC's Infant-Toddler Program. The services would be provided through the Children's Developmental Services Agency, which every NC county has.

Katie M said...

Hi Emily,
Great post. I have a question: My nearly 5-year-old daughter sometimes talks out of the side of her mouth with certain words and also sticks her tongue out with certain words. Most of the words that make this happen have the "ch" sound, or something similar. My mom suggested she go to a speech therapist. When and how do you know you need a therapist vs. waiting for your child to outgrow a situation?

April said...

If you have a concern about any developmental delay including speech before the child is 3 years of age, you can contact your local early intervention program and they will also provide free evaluations and in some cases speech therapy as well either free or on a sliding scale based on income. If you live in the Winston Salem area, you can call Winston Salem Children's Developmental Services Agency and refer your own child. The referral number is 713-7412. The WS CDSA serves Forsyth, Stokes, Surry, Davie, Davidson, and Yadkin Counties. If you live in Greensboro area, contact the Greensboro CDSA.

Emily Halsey said...

This is in response to Katie M's question. Without actually hearing your daughter, it sounds like what you are describing is called a lateral lisp and/or a tongue thrust. This is seen with "sh, ch, s, and/or z" sounds. My daughter, who is 5 1/2, has a tongue thrust. She sticks her tongue out when she says "s" and "z" sounds. The "ch" is a later developing sound, but in my experience, lateral lisps and tongue thrusts are not typically something that children outgrow. If it were me, I would definitely consult a speech therapist to see what is going on. If you end up looking into a private practice, I used to work for a company in Winston called Speechcenter. Their phone number is 725-0222. Of course I am a bit biased as a former employee, but they are really nice there and see lots of children. Good luck!

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