How to tell if your child has a speech, language or communication need

How to tell if your child has a speech, language or communication need?

Children develop speech, language and communication skills at different rates, some develop quickly, while others may take longer. You are the expert in your child. You know their likes and dislikes and motivations for communicating with others. This article explains what language milestones you should look out for and when to refer to a Speech and Language Therapist.

Some children's language skills don't develop at the same rate, or in the same way, as other children of the same age.  You may notice that your child isn't meeting the language developmental milestones for their age. This might be because they can’t say what they want to or they don’t understand the words that are being used.

Your child’s language skills might be developing as you would expect, however they have unclear speech or difficulty pronouncing certain speech sounds in words - this is known as a speech sound disorder. You can read about the different types of speech sound disorders here.

Your child may need support with other aspects of their communication:  

  • Looking and listening - children need to be able to learn to look at an adult and to listen in order to learn to communicate. They learn to listen to sounds around them including sounds that make up words. Children do not automatically know how to listen, it needs to be learned like any other skill.
  • Social communication - using communication for social reasons for example knowing how to start, maintain and finish an interaction, being able to ask for help, turn taking in conversation and understanding and using non-verbal communication appropriately.
  • Play - pretend play is particularly important as it when they start to recreate their own and others actions, for example putting food on plate and feeding teddy.
  • Understanding of language - understanding is often over-estimated by parents and carers. This is because a child can follow an instruction using non-verbal understanding, for example by gestures and following cues from the situation. By 2 years, children are starting to be able to follow instructions containing two key words, for example ‘let’s give teddy an apple”.

Language development can be thought of as a wall - each brick supports the other bricks and strengthens the whole wall, just as each communication skill supports the development of other communication skills.

What language milestones should you look out for?

By 1 year old most babies will:  

  • Look for and be able to find where a sound is coming from
  • Start to use gestures to communicate such as wave goodbye and point to request
  • Babble and take turns talking with you
  • Say at least 1 word

By 18 months most toddlers will:  

  • Play alone, although they will like to be near a familiar adult
  • Engage in simple pretend play
  • Follow 1 step instructions
  • Babble and use at least 20 single words (although they may not be clear)
  • Copy gestures and words from adults

By 2 years most toddlers will:  

  • Engage in pretend play, for example by feeding teddy
  • Follow 2 step instructions
  • Say around 50 words
  • Start to use 2-word phrases, for example ‘daddy go’ and ‘all gone’

You can read more about the stages of speech and language development here .

Speech sound development

  • By 18 months a child’s speech is normally 25% intelligible
  • By 24 months a child’s speech is normally 50-75% intelligible
  • By 36 months a child’s speech is normally 75-100% intelligible (Bowen, 2011)

(Intelligibility, in this instance, refers to the how much an unfamiliar listener can understand rather than a close family member)

Find out if your child’s speech errors are age appropriate here.

When should I refer to Speech and Language Therapy?

The right time to seek advice about your child is when have any concerns about their communication development.

  • If your baby doesn’t respond to sound or isn’t making any vocalisations
  • By 12 months if your child is not yet attempting to communicate (this includes non-verbal communication i.e. pointing, simple gestures, looking at you then to an object then back to you) for different reasons, for example to request or make their needs known, to comment on an item of interest
  • By 18 months if your child has difficulty following simple instructions and/or has difficulty imitating sounds
  • By 2 years if your child is not yet engaging in pretend play, communicating with single words or following 1 step instructions

Top tips for doing your own research

There's a lot of information out there, if you are searching for answers, make sure you keep the following things in mind…

  • Always look for the author’s credentials, are they an expert in the field?
  • Check the date of publication, is it current or will knowledge have moved on?
  • Check if the research study has been peer reviewed - this means it has been evaluated by peers who have expertise in the subject area
  • Use your common sense - beware of clickbait titles
  • Ask for help - ask a Speech and Language Therapist about evidenced interventions

If you have any concerns about your child’s speech and language development speak to your Health Visitor or GP.

Written by Aine Barrett, Speech and Language Therapist

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