Hello – It’s Darcy!
I’m back with answers to your most recently asked questions! Feel free to keep the questions coming in the comments below and I’ll be happy to answer them in upcoming posts!
My child is 16 months and is only saying three words – mama, dada, uh-oh. She is a very intelligent little girl, and seems to fully comprehend everything that we tell her and follows directives fairly well for her age. She recently started making ‘s’ and ‘n’ sounds, but still hasn’t said any other actual words other than her enthusiastic, garbled speech. Should we be concerned about her speech development or give her a little more time to figure it out? We recently met a child who’s a few months older than she is and she hasn’t figured out her speech yet either. When is it too late to get help?
Well, fortunately, it is never too late to get help! However, starting earlier typically results in more improvement in these areas of language that are considered critical for overall cognitive and linguistic development. Speech delays get more challenging as children grow older, as both the caregivers and the child become much more frustrated with the situation. Oftentimes when intervention is provided earlier, children just need a little “nudge” in the right direction to help them with their language skills.
That being said, it sounds like your daughter is continuing to explore her verbal expression which is excellent. Having a wide variety of sounds within her “jargon” (our technical term for garbled speech) is an excellent foundation for future speech. Jargon is good! Encourage it, overlay “normal” speech and interpret what you think she is saying. Jargon should include back sounds (k/g), front sounds (t/d/n) and lip sounds (b/m/p) as well as a variety of vowel sounds (ee/o/u/I). If you notice that her sound repertoire is limited to a few sounds or the same vowel over and over, this could be an indication that she has a speech delay and I would recommend having her evaluated. If she has a lot of variety in her sounds, then its likely part of her normal speech development.
There is a lot of variability in expressive language development between the ages of 12-24 months. There is no real milestone or count of how many words a child should have on a month-to-month basis, however we do know that by 24 months most children use approximately 200-300 words (not perfectly pronounced, but still meaningful words to them and you). Here a link to ASHA’s pages regarding typical language development – as you can see there is a big jump from 1-2 years and then again from 2-3 years.
If your daughter is meeting these milestones, and you see her continue to expand her sound repertoire and her vocabulary over the next month or so, it is likely she will figure out her language appropriately on her own. If she continues to have a limited vocabulary, and does not begin to use new words within the next 4-5 months, or begins to exhibit frustration when other people don’t understand her, it may be appropriate to have her seen by a Speech Language Pathologist who can determine if intervention is indicated.
My son, 4, has a lisp and his teachers and other caregivers sometimes struggle to understand him. What are some ways that I can help him to improve his speech?
Lisps are tricky! They are caused by incorrect tongue placement during production of the /s/ and /sh/ sounds which can make for distortions in conversation. Lisps are best treated in person by a Speech Language Pathologist, who can help your son understand and practice the correct tongue placement (which you can also reinforce outside of the therapy session). This retraining of the tongue, however, can take a while and in the meantime it can still be hard for people to understand him.
A few suggestions – encourage him to slow down. People are able to interpret the speech stream at a slower rate (especially older adults or when people are talking in a noisy environment). If your son slows down, it is likely that people will be able to figure out what he is saying even though his sounds may not be accurate.
Another suggestion is to have him face the person he is speaking with. We receive a lot of information from the lips of the person we are speaking with and it may be easier for others to figure out what he is saying when they can see his mouth.
Finally, encourage teachers/caregivers to be patient with him – it is likely he is becoming more aware of his lisp and we want to encourage his speech rather than hinder it. Its always awkward to have to repeat ourselves because someone doesn’t understand us, so remind your son that this is ok!
Do sippy cups cause lisps or make them worse?
Sippy cups do not cause lisps. However, they can do impact dentition and tongue placement in swallowing which can result in lisps. It would be erroneous to blame sippy cups on every lisp that exists, however if your child has a lisp, definitely eliminate sippy cups (and for all children its an excellent idea to avoid them). The spout of the sippy cup encourages open mouth posture during drinking, as well as forward placement of the tongue during swallowing. This can result in an open bite, open mouth posture at rest, and tongue thrust during swallowing of saliva. It is very difficult for a child with an open bite to create accurate tongue placement for an /s/ or /sh/ as the teeth are spread too far forward.
Instead, encourage your child to use a straw cup, a cup with a slotted lid, or an open cup. All of these encourage lip closure/seal during swallowing and tongue tip elevation during swallowing, both of which help prevent open bite, places the tongue in the normal position for speech and swallowing, and shapes the upper jaw/palate in alignment with the lower jaw. Added bonus is this reduces the likelihood of orthodontic work down the road!
Our son is now 22 months old. Sometimes it seems like he doesn’t understand what we’re saying, which is why I’m assuming he’s not responding to us the way we’d like him to. Sometimes he just gives us a blank stare and runs off. He’s verbal, but more “turkey talk” than actual words. What can I do to encourage and develop his speech? My husband thinks that he’ll talk when he’s ready, but I’m not sure if not getting professional help for him is more detrimental to his development than I’d like to admit. Help!
From reading your question, it seems like there are two different concerns so I will address one at a time. The first is concern with your son’s ability to understand you. His inconsistency with responding to your directions is possibly secondary to him being a toddler and sometimes choosing to do exactly what he wants and not what you want. The other possibility is that he is truly not understanding what you are asking of him, and cant communicate that and so therefore just leaves. Children aged 22 months typically respond best to language describing their immediate situation, such as pictures in a book, toys on the floor, or bathtime routine. They should understand simple commands (take a drink, pat the kitty) or questions (where is your shoe?) but often no more than this. He should be able to point to pictures or objects when you name them, but will likely struggle to follow what you are saying if it is about something not in his immediate vicinity. Take a look at developmental norms for both 1-2 years and 2-3 years to get a sense for where his comprehension should be.
As for his verbal expression, it is not unusual for a child to have a lot of “jargon” (as you call turkey talk) in their vocabulary at 22 months. This is normal, and usually progresses into typical language. By the time they are 24 months, most children will have acquired between 200-300 words, and while not pronounced completely accurately they will be meaningful. There is variance in this, however, as many children go through a language burst between the ages of 26-28 months. An evaluation with a Speech Language Pathologist would hopefully shed some light on his development, as they would be able to highlight any potential areas of concern, and provide you specific personalized suggestions that are appropriate for your family. I don’t think the evaluation itself could be detrimental, as ultimately you and your husband would decide what you do after that (if you pursue therapy or chose to wait).
In order to help your son with his language, the best thing to do is provide a clear, slow model of speech. Read out loud to your child, keeping your faces close together. Isolate words he is struggling with in order to over-emphasize the sounds – for example, if he yells “mommy guck!” you reply “yes – a DUCK” emphasizing and slowing the rate of your speech to help him see how your mouth moves. Play with sounds, encouraging him to repeat syllables after you – animal sounds work great for this! “baa baa says the sheep, moo moo says the cow.” Encourage speech production (even if not correctly produced) and don’t over-emphasis the errors. A child who feels self-conscious or corrected at every turn may lose motivation to communicate verbally. Finally, continue to sing songs, play finger games (“Where is Thumbkin?,” “Pattycake”), and tell nursery rhymes (“Mary Had a Little Lamb, Hickory Dickory Dock, The Ants Go Marching”). These songs and games introduce your child to the rhythm and sounds of language, and he likely won’t be able to resist singing along.
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