Early Identification of Speech-Language Delays and Disorders
"Why is speech-language treatment needed? My baby doesn't talk yet." "Everyone in our family was a late talker. My child will talk when the time is right." "Why worry now? Speech and language services will be available when school starts." "Treatment? Looks like they are just playing games to us."
You may have had similar thoughts or comments. Usually, there is concern about a child's speech and language skills if there is no speech by the age of one year, if speech is not clear, or if speech or language is different from that of other children of the same age.
What is Early Identification?
It is estimated that at least 2% of all children born each year will have a disabling condition. Many of these children will have speech and/or language delays and disorders that may have a significant effect on personal, social, academic, or vocational life. Although some children will develop normal speech and language skills without treatment by the time they enter school, it is important to identify those who will not. Many people falsely believe that speech-language treatment cannot and should not begin until a child begins to talk. Yet, research has shown that children know a great deal about their language even before the first word is said. For example, children can distinguish between their native language and a foreign language, use different nonverbal utterances to express different needs, and imitate different patterns of speech through babbling.
Early identification includes the evaluation and treatment provided to families and their children under three years old who have, or are at risk for having, a disability or delay in speech, language, or hearing. A child can quickly fall behind if speech and language learning is delayed. Early identification increases the chances for improving communication skills.
Who Should be Evaluated?
Children identified as at-risk or high-risk, such as those from neonatal intensive care units, should be tested early and at regular intervals. Other risk factors include diagnosed medical conditions, such as chronic ear infections; biological factors, such as fetal alcohol syndrome; genetic defects, such as Down Syndrome; neurological defects, such as cerebral palsy; or developmental disorders, such as delayed language. Children with no obvious high risk factors should be evaluated if their speech and language is not similar to that of other children of the same age.
How is the Evaluation Done?
Evaluation may be formal or informal and include any combination of standardized tests; direct observation of play and interaction with caregivers; reports by parents, teachers, or physicians; and collection and detailed analysis of spontaneous speech samples. Several sessions as well as ongoing evaluation may be required to obtain enough information to make an accurate diagnosis. The early intervention team may consist of the speech-language pathologist, audiologist, psychologist, neurologist, electrophysiologist, otolaryngologist, pediatrician, nurse, and social worker. Because speech-language delays and disorders may be due to a variety of causes, each professional makes valuable contributions to the evaluation
What is Speech Language Treatment?
From the results of the evaluation, certain services may be recommended. Prevention includes those children who have been identified as at-risk for a communication delay or disorder because of low birth weight. Services may be provided before a specific diagnosis has been made. Remediation increases function in identified areas and may serve to prevent other related problems. For example, remediation of a language disorder can help offset learning disabilities.
Language activities are experienced in a natural setting. These activities are presented at the child's developmental level. Responses are consistently stimulated. Output is rewarded. Play may be used to teach communication, language models or rules of conversation, such as taking turns.
If you are concerned about a possible speech-language delay or disability, consult a speech-language pathologist. A list of certified speech-language pathologists in your area may be obtained by calling the American Speech-Language-Hearing Association's toll-free at 1-800-638-8255.