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  • Writer's pictureEmily Coursen


Welcome to Nurture Speech & Language! I'm so happy you are here. You can check back regularly for blog posts that go in depth about my most commonly asked questions regarding speech therapy, as well as informational posts relating to my specialties, early intervention and fluency.

For my first post, I wanted to dive into the question I get asked most frequently by parents: how do I know if my child needs speech therapy?

This is a broad question, one that has many different answers that depend on all of the unique aspects of your child. Two children might exhibit similar characteristics, yet only one of them may need speech therapy. This depends on factors such as age, gender, family history, medical history, temperament, and many others.

Before your child even says their first word, a lot of things need to go on beneath the surface. They need to demonstrate their intention to communicate, by pointing, making eye contact, or using other gestures that you understand is an attempt to say something to you. They need to show attention and focus to their environment, by playing with toys for a sustained period of time, or observing you complete a task. They need to have a solid functioning working (short-term) memory. The path to saying their first word is hard work, and their first word is just the tip of the iceberg!

Here are some basic milestones that a typical child's speech and language development will follow:

> A child says their first words between 10 and 18 months.

> By age 2, they are using 2-4 word sentences, repeating words overheard in a conversation, making animal noises, and using words such as "more" and "no" to make their wants known.

> By age 3, they are asking, "what's that?", carrying on a "conversation" with other kids, adults, and self, and have a vocabulary of about 450 words!

These milestones only fall under the category that we call "expressive language." Expressive language is what we say using words and gestures. Receptive language is what we understand. Children can have a delay in expressive language, receptive language, or both.

Because there are far too many milestones to include in one blog post, I have attached some resources that include more comprehensive lists of typically developing milestones to this post.

Overall, my advice for parents deciding whether or not to seek out speech services is "go with your gut." If you feel that your child might have a speech and language delay, it can never hurt to bring them to a speech therapist for an evaluation. My other advice is the earlier the better. I cannot overstate the importance of that enough. Many pediatricians will tell parents to "wait and see" or "they will catch up when they're in school." For a lot of kids, that may be true. But for some, they need intervention in order to catch up, and it is crucial to receive that intervention as early as possible, while language is still developing.

I also want you to take away one thing from this post: every child is unique. You know your child better than anyone else. Many parents get caught up in comparing their child's development to other children - whether it be siblings, other kids at Mommy & Me groups, or friends' children. While comparison can be helpful every once in a while, it is best to remember that children can develop language at very different rates and in different ways. "Norms" and lists of milestones can be informative, but at the end of the day, numbers do not capture your child's unique personality, strengths, and weaknesses. We have to look at the whole child and their environment before we determine whether they have a delay, a disorder, or just a difference!

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