Look Who's Talking

Introduction

When a child is born, parents eagerly anticipate a variety of milestones: the first smile, the first words, the first step. Every new mother and father knows children communicate their emotions and needs long before spoken language appears on the horizon. Thus, although speech is a distinguishing feature of mankind, communication between individuals involves more than mere words. This article:

• explains the development of communication
• offers guidance for parents wanting to encourage their child's speech
• provides information about possible speech delays
• offers suggestions about what to do if your child has a language problem

How communication is related to language

We take for granted the role communication plays in our daily lives - from how we learn to how we interact socially. Both professionals and parents know that early communication skills provide the foundation for development of later, more advanced skills and integration into the world of both play and work. However, communication does not depend on age alone, but on different abilities, physical development, and the accumulation of experiences.

Infants communicate from the moment they are born - for example, crying when they are hungry, smiling when they are content. Thus communication involves more than just talking and the development of communication starts long before speech is established. In general, communication is the synthesis of three different components:

• Receptive language: what we understand. Receptive language refers to the input system of language. It is the comprehension of information based on what we see and hear. Receptive language skills begin as early as birth and get stronger with each stage of development.

• Expressive language: how we verbalize . Expressive language can be seen as the output system of language. It refers to how information - thoughts and feelings - is expressed. The development of different sounds and combinations of sounds to form words enables knowledge to be expressed and shared with others. Expressive language becomes more complex as the child increases the variety of sound combinations and word combinations, and adds the rules of syntax and grammar to make "output" more elaborate and meaningful.

• Nonverbal skills: gestures and facial expression. We cannot discuss aspects of language without including the development of the many nonverbal ways one obtains and provides feedback. Gestures and facial expressions as well as body language influence how our messages are perceived. Children learn to use nonverbal language skills long before they are able to verbally produce words that convey meaning to their listener.

Children develop language skills at an astounding rate. Amazingly, all these skills begin to develop in the newborn/infant stage, and rapidly progress in the first few years of life. A child of one month can respond to voices, at three months can coo in response to pleasant sounds, and at four months can turn to find the sound source in a room. He will use pointing and reaching to indicate needs, use facial expressions to show happiness, defiance, and confusion, and he will imitate and emulate his parent's actions/speech patterns. Within the next year that same child will move from these simple skills to putting sounds together to create his first words to mastering a vocabulary of 100 words. By age three a child has an understanding of close to 50,000 words, and generally has most of the communicative skills needed to function in society.

Developmental Milestones

Developmental milestones are meant to serve as an estimate or average of how most children develop. In reality, development is flexible. Parents must keep in mind that development happens within a range of time, not at a specific day or month. In addition, like all developmental timetables, there is a good deal of variation between children as each child develops skills at her own pace. For example, if Brenda said her first words at 10 months, and Bruce said his first words at 13 months, both children are still within the expected range of development.

The following are some general guidelines for language development in the first three years. The list describes what can be expected at different ages.

6 months

• makes different sounds; lots of vowel sounds and some consonants, especially in play
• laughs, gurgles, coos with familiar people and in response to pleasant voices
• turns to look for new and unfamiliar sound s
• vocalizes for attention

12 months

• uses jargon; babbling combinations that sound more like real speech with inflection changes
• enjoys interactive games such as peek-a-boo
• responds to simple instructions or questions such as give me your hand, where is your nose
• has a receptive vocabulary of about 100 words
• is able to recognize objects/some pictures by their name; points to the car
• understands "no"
• waves goodbye
• makes sounds of objects or animals; vrroom for car, meow for a cat
• usually has 1-2 single words; as parents we always hope this is "mama" or "dada", but it could just as easily be "ball" or "juice"

18 months

• may use 10-15 single words
• hears well and discriminates sounds
• imitates words and sounds more frequently
• points and gestures in conjunction with sound production to indicate needs
• follows simple commands
• may begin to "sing" simple tunes

2 years

• understands simple questions and commands
• identifies body parts, clothing items, common objects and actions
• puts 2 words together "want cookie" "me have" "my ball"
• asks "what's this?" or "where's my?"
• can refer to self by name
• begins to consistently use negatives "no want" "not right"
• listens to short stories and identifies actions/characters in the book
• has a spoken vocabulary of up to 300 words

3 years

• uses words to relate observations, concepts, ideas
• understands time concepts; yesterday, lunchtime, tonight
• matches and names colors
• identifies some letters
• often talks during play; even when he's by himself
• knows name and addres s
• can recite some nursery rhymes and sing songs
• can tell a story, although sequence may still be mixed up
• asks questions frequently
• has a sentence length of at least 3-4 words
• can produce / m,n,p,b,t,d,w,/ without difficulty
• can probably count although may still not understand quantity

Encouraging your infant's language development

Parents can do many things every day to stimulate a child's language and speech development. From the start, it is not only natural but also helpful to respond to your infant's gurgles and noises with your own sounds, words, and nonverbal gestures. Using different sounds and inflections as well as words while caring for your child increases his familiarity with the building blocks of language and introduces him to a wealth of vocabulary. It is the one time you are allowed to, and should, talk all day without another adult being in the room. Even though your child is not talking, she derives tremendous benefit from interpersonal interaction. She learns from your imitation of her facial expression, elaboration on events in the outside world, description of activities you are doing together, and use of a diverse vocabulary.

For play, use bright, colorful books and objects, and choose toys that have some simple cause-and-effect action such as a pop-up toy or an activity box. Throughout the day bring your child's attention to different sounds in the environment, such as the ring of a doorbell or telephone, or the sound of rain falling against a window. Simple games like peek-a-boo and pat-a-cake, and simple music/songs are wonderful for interactive play and sound awareness. Label objects and name people as they come in and out of the child's view to keep her involved and interested. Bring your child to new places. The park, the playground, the zoo or even the mall all provide different environmental sounds and stimuli. Be mindful of overwhelming your child, keeping in mind what is appropriate at different ages. Bringing a six-month-old to a rock concert might not be advised, but singing along to music tapes would be wonderful.

Encouraging your toddler

For toddlers, reading and commenting on stories is an excellent way for them to expand vocabulary, learn the art of story telling, and hear how to sequence or organize ideas and events. Parents should not be concerned with grammar at this age, rather they should encourage the child to expand on his ability by using more descriptive concepts. At this stage, increasing your child's total communication and comfort with language is more important than his accurate articulation or production. Ask your child to expand on his comments or observations, thereby adding new associations, integrating and sharing more information and ultimately improving the quantity and quality of his language. Use music, songs and routines to develop sequences and organization in thoughts and actions. Being a good speech model and caring about your own speech production is also important. Speak clearly, at a reasonable - not fast - rate, and use animation and inflection in conversation and story telling. Taking your child on excursions to the zoo or children's museum and talking about what he sees expands vocabulary and increases sensory information that is part of learning.

Does my child have a problem?

Every parent is concerned when their child's language seems different from others the same age. Remembering that every child develops at an individual pace and that development occurs based on skill levels, not on age alone, is important in differentiating a child who is within expected ranges from a child who is actually delayed. Also, it is not unusual for children to plateau in their language development for a time, particularly as other areas of growth are occurring. From 12 to 18 months, a child's physical development in walking and running are often correlated with a slower increase in their expressive speech production.

Approximately 5-10% of children under the age of three have some delay in their communication skills. Delays are varied and may be seen by difficulty in articulation, language comprehension, processing or expression.

Indicators of possible delay in the child under three include:

• When a child is not producing sounds, or the sounds are very muffled and/or unintelligible, a problem involving hearing ability, mouth muscles, or coordination may be indicated.

• When a child does not understand simple directions or takes longer than the expected amount of time to process information there may be a problem with receptive language.

• When a child is unable to construct a simple two word sentence, or use language to ask a question or request a toy, one suspects difficulty with expressive language. This is the most noticeable area of delay. Children with this problem tend to rely on more nonverbal pointing and gesturing to communicate than spoken language .

What to do if you suspect a problem

Once you suspect a problem, speak to your pediatrician about your concerns. Often, the pediatrician will suggest a hearing test as a first step in addressing the problem. It if seems necessary, she may make a referral to a licensed speech language pathologist for an evaluation. Parent input is extremely important in making an accurate diagnosis. Therefore the pediatrician and speech language pathologist welcome any information supplied by the parent. Through formal testing, developmental scales and clinical observation in a friendly play environment, a speech language pathologist can assess a child's communication skills and suggest the best course of action.

Intervention

Once a child is diagnosed with a speech and language disability or delay it is advisable to see a speech language pathologist for therapy. The type of intervention that will be recommended depends on the needs of the child and the setting. Either individual or group therapy could take place in a private office, clinic, hospital, school or home. For children under the age of there, early intervention services are often available. For children older than three, if the speech language deficit affects their academic performance, the school district may provide services.

Regardless of the specific therapy or setting, parental involvement is a major component of the treatment. Therapists will model new language learning strategies, develop exercise routines for weak muscles, and demonstrate methods that will stimulate language development. However, participation and reinforcement by the parent and/or caretaker is essential for promoting long term language skills outside the therapy situation.

About the Author

Patricia McCaul, M.A., CCCSLP is currently the Supervisor of Pediatric Speech Language Pathology at the Rusk Institute of Rehabilitation Medicine of New York University Medical Center. She is also adjunct faculty at Queens College CUNY and maintains a private practice in New York. She is co-author of several articles on childhood language development and disabilities and specializes in the treatment of speech language and oral motor disabilities of individuals with multiple handicaps.

References and Related Books

Language Development: An Introduction 
R. Owens, Jr.
Allyn and Bacon 1996

Language Development and Language Disorders 
L. Bloom & M. Lahey
Wiley 1978

It Takes Two to Talk: A Parent's Guide to Helping Children Communicate.
A. Manolson
Hanen Center Publication 1992

 

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