Development

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What is Early Intervention?

Much has been written about the importance of a child’s first five years of life.

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Is My Baby’s Speech Development Typical?

Even though your child can’t yet answer your questions, it’s still important that you talk to it from the minute its born. First, your baby will simply love hearing your voice. And second, listening to you talk – the pattern of your voice, the fact that certain sounds are attached to certain objects – will help your child learn how to talk itself! Remember, all babies develop at their own pace, so use this simply as a guideline.

Red Flag

Developmental Red Flags for Speech Skills
All the funny sounds your baby makes gets it ready to say its first word. How can you tell if your bab’s language skills are developing the way they should? Look for this flag. If you notice these behaviors with your child, discuss your concerns with your doctor.

Suggested play to help a baby develop its speech skills:

When you hold your infant, trying singing a song. Your infant will enjoy the repetitive nature of a melody it hears again and again. Add the soothing movement of a rocking chair and see who falls asleep faster, you or your baby!

It’s never too early to read. Snuggle together and read your baby a book with clear, colorful pictures. Talk softly and point to the cow, the birds or anything else on the pages. Your baby will learn at an early age that reading with you is a special time.

Point out common sounds. You might not think it’s special when the phone rings or a car honks its horn, but everything is new and exciting to your baby. Point out these environmental sounds, “Do you hear that? The phone is ringing.”

Face to Face. When your baby is awake, cuddle it so it can see your face. Talk for a little bit. If your baby coos, squeals or makes any other sound, react to those sounds. You might not understand what your baby is telling you, but you two are having a conversation.

A typical 6-month-old child can (or has already mastered):

  • Squeal
  • Laugh
  • Respond to sounds, music and speech of others
  • Respond to their name
  • Babbles – maybe even 2 consonants

From four months on, you can use your words to stay in touch with your baby. If your child is in its crib and it can’t see you putting the clothes away in the dresser, keep talking. Your child will know you’re there by the sound of your voice.

Make up songs. Changing the diaper? Sing, “Here we go a-diapering, a-diapering, a-diapering, here we go a-diapering so early in the morning.” If your baby is in its high chair having a snack, sing, “Chew, chew, chew says the Mommy...yum, yum, yum says the tummy!”

Play hide and seek. Move where your baby can’t see you. Call its name. “Maria, Maria where are you?” Reappear and say, “There you are!”

Red Flags

By 3-6 months (or earlier):

  • No spontaneous smile or laugh
  • No squealing, cooing, babbling
  • Doesn’t soothe to familiar voice

Most one-year-olds can:

  • Recognize name
  • Say “mama” and “dada” (nonspecifically) and 2-3 words besides “mama” and “dada”
  • Imitate familiar words
  • Understand simple instructions
  • Recognize words as symbols for objects: car – points to garage, dog – barks
  • Babble single consonants
  • Shout for attention
  • Wave hi and bye
  • Demonstrate an understanding of some words by gesturing or pointing

Around eight months, you’ll notice your baby has a lot to say. You’ll hear your baby playing with sounds like, “ba ba ba” and it’ll know that “dada” means Dad.

Explain the grocery store. Your baby will enjoy sitting in the grocery cart looking at all the sights, but remember to talk to him/her about what he/she is seeing. “Look, over there are apples. Let’s get some red apples.”

Give simple directions. When your baby is getting a bath, hand him/her the washcloth and say, “Wash your tummy.” Walk in the room where Grandma is sitting and say, “Where’s Grandma?” When your baby follows directions, make sure you acknowledge and thank him/her.

Eliminate background noise. If you have a television or radio on throughout the day, your baby will have a hard time hearing the gentle ticking of a clock or the birds chirping outside. It will also be easier for your baby to hear the sounds of your words more clearly.

Red Flags

By 12 months:

  • No pointing
  • No single words
  • No gestures/imitation of gestures (waving, clapping, etc.)
  • Not beginning to recognize common objects or people

Typical 18-month-olds can:

  • Use 10-15 words spontaneously
  • Attempt to sing
  • Say “No” meaningfully
  • Gesture to express needs
  • Name one or two familiar objects

Most two-year-olds can:

  • Understand “no”
  • Use 10 to 20 words, including names
  • Combine two words such as “daddy bye-bye”
  • Wave good-bye and plays pat-a-cake
  • Make the “sounds” of familiar animals
  • Give a toy when asked
  • Use words such as “more” to make wants known
  • Point to his or her toes, eyes, and nose
  • Bring objects from another room when asked
  • Repeat up to 4 word phrases
  • Attempt to sing using words
  • Refer to self by name
  • Be intelligible about half of the time
  • Identify pictures using words

Suggested play to help a baby between 12 and 24 months develop its speech skills:

Clap to the beat. While listening to music, show your baby how to move and clap in rhythm. Expose your baby to everything from classical to country to rock and roll.

Make small sentences. When your baby hands you its cup and simply says, “Juice,” turn it into a small sentence. Say, “More juice?” This will encourage your baby to start making its own two word sentences.

Ring, ring, it’s for you! Next time a relative calls, ask them to talk to your baby. Your baby won’t talk back but it will be delighted to hear Dad or Grandma’s voice on the other end of the phone.

Bring out the animal in you. Read books about baby animals and practice the sounds they make. Then you can be a Mommy cow and your baby becomes a baby cow. You’ll have fun mooing at each other.

What did we see? When you get home from the park or running errands, start talking about something you saw, it can be helpful to explain what you saw to another person. “Tell Grandma about the fire engine we saw.”

Play the help me game. Asking your baby to help you throughout the day helps it connect more words to the objects they represent. When you are getting dressed, point to your shoes and say, “Can you help me by getting my shoe?”

Wash from head to toe. When you are giving your baby a bath, name all of the body parts as you wash them. Make your baby’s head nice and clean, rub the dirt off its belly, don’t forget to clean the toes!

Reading is everywhere. Most parents take the time to read books to their babies, but remember to read wherever you are. If you are in a restaurant, read the menu together. At the grocery store, point out the words above the fruit to show that you are reading.

Red Flags

By 18-24 months:

  • Not using at least 15 single words
  • Not beginning to use 2 word phrases
  • Not able to follow simple instructions

Most two-and-a-half-year olds can:

  • Use 50+ words
  • Answer questions
  • Refer to self as “I” or “me”
  • Communicate mostly with speech and shows frustration when misunderstood

Most three-year-olds can:

  • Identify body parts
  • Carry on a ‘conversation’ with self and dolls
  • Ask “what’s that?” And “where’s my?”
  • Use 2-word negative phrases such as “no want”
  • Form some plurals by adding “s”: book, books
  • Speak 450 words
  • Give first name, hold up fingers to tell age
  • Combine nouns and verbs “mommy go”
  • Understand simple time concepts: “last night”, “tomorrow”
  • Refer to self as “me” rather than by name
  • Try to get adult attention: “watch me”
  • Like to hear same story repeated
  • Possibly say “no” when means “yes”
  • Talk to other children as well as adults
  • Solve problems by talking instead of hitting or crying
  • Answer “where” questions
  • Name common pictures and things
  • Use short sentences like “me want more” or “me want cookie”
  • Ask questions starting “when”, “where” or “who”
  • Be understood 80% of the time
  • Use vocabulary of 200+ words
  • Repeat five word sentences
  • Can often make words into the plural – e.g. “She ‘doed’ this...”

Suggested play to help a toddler between 2 and 3 years develop its speech skills:

Take field trips. Your child will enjoy going to new places. This doesn’t need to be expensive. For example, take a bus to a different part of town, walk by the big buildings, then sit on a bench and watch the buses and trucks drive by. Even better, see if you can find a construction site! Little boys and girls both love to watch back hoes in action.

Make sock puppets. No need to make this an elaborate craft project. Simply put a sock over your hand and pretend to talk to your toddler. “I’m Suzy the sock. I love to keep your toes warm.” Encourage your toddler to talk back (as him/herself, or as another sock).

Sing songs. If you don’t remember songs from your own childhood, go to the library and pick up a book with “Twinkle, Twinkle, Little Star” or “Ba Ba Black Sheep.” Your toddler will love to sing the song for someone else in the family.

Wash a baby. Give your toddler a plastic tub and a plastic doll and have him/her wash the doll or, he/she can bring the doll into the tub. Name the doll parts as they are washed, “You did a good job washing the baby’s feet!” Praise your child for taking such good care of his/her baby.

What did I hear? Try this at night. When the house is quiet, listen with your child for interesting sounds. “What’s that?” “It’s the refrigerator motor.” This is good to do on a summer night when you might hear crickets, wind chimes or a dog barking.

Make a photo album. Fill this book with pictures of people and pets that your child knows. As your child is looking at the book, ask him/her to tell you a little bit about the people or pets that he/she sees.

Play the forgetful game. You child will laugh when you give everyday household items silly names. Point to his/her bed and say, “I forget what this is. Is it a car?” Your child will enjoy telling you the real word. The sillier you are makes this even better!

Read, pause and ask. When reading a book, take the time to stop and ask questions. Point to the illustrations and ask your toddler what he/she thinks will happen next.

Red Flags

Close to 3 years:

  • Not able to communicate in short phrases
  • Not able to understand simple multi-step instructions

Most four-year-olds:

  • Can tell a story
  • Have a sentence length of 4-5 words
  • Have a vocabulary of nearly 1,000 words
  • Can name at least one color
  • Understand “yesterday,” “summer”, “lunchtime”, “tonight”, “little-big”
  • Begin to obey requests like “put the block under the chair”
  • Know his or her last name, name of street on which he/she lives and several nursery rhymes

Suggested play to help a toddler between 3 and 4 years develop its speech skills:

Where do they live? Help your child learn directions by talking about where animals live. When you see birds flying, mention that they fly up in the sky. See a bunny? Ask your child if it can find their bunny hole, under the ground. When you see a rock, ask your child if he/she thinks any bugs live under it, then pick up the rock to find out!

Make a weather report. Have your child look outside every morning and tell you the weather. If you have a large calendar, your child can draw a sun on the calendar when the sun shines or rain drops when it’s raining. On cloudy days, your child can draw clouds on the calendar.

Happy birthday! Start a tradition of making birthday cards for your relatives. Your toddler will enjoy making the card. He/she can draw a picture and decorate it with stickers. With your help, your child can even write Happy Birthday. Then mail the card. Your child will feel proud when the recipient thanks him/her for the special card.

Become an author. Your child can start to make up its own stories. Write them down on paper as he/she tells them to you. Have your child draw a cover, attach the pages and you just made his/her first book. You might even want to laminate the pages so your child can read it again and again.

How many can we find? Traveling in a bus or car is the perfect time to play this game. Start with animals. “I wonder how many animals we can see today.” Then start pointing out all the dogs and cats you see. Don’t forget the dog on the billboard or store sign. Playing how many pumpkins can we find is fun around Halloween. On a rainy day, you might loose count if you look for umbrellas!

Play copy cat. Develop memory skills and have fun by having your child copy your actions. Tell your child you want him/her to copy what you do. First, pat your head. Then tell you child to do what you did. Next, flap your arms like a bird. Have your child pat his/her head and flap his/her arms. Add a clap and a wink. See how long you can go!

What comes next? When you’re reading a book that your child loves, pause for a moment and see if he/she gives you the next word. Do it periodically as you’re reading.

Most five-year-olds:

  • Have sentence length of 4-5 words
  • Use past tense correctly
  • Have a vocabulary of nearly 1,500 words
  • Point to colors red, blue, yellow and green
  • Identify triangles, circles and squares
  • Understand “In the morning”, “next”, “noontime”
  • Can speak of imaginary conditions such as “I hope”
  • Ask many questions, such as “who?” and “why?”

Suggested play to help a toddler between 4 and 5 years develop its speech skills:

Plan an excellent adventure. Decide with your child a new place you want to visit. Read about it if you can, and talk about what you hope to see when you’re there. It might be a park you’ve never been to, or a museum. After you come home, ask questions about what you saw and did.

What does it feel like? Put a few objects in a bag. Without looking, have your child pick an object and describe it to you. See if your child can guess what it is. Try a screw, a big feather, measuring cup and a cotton ball.

Look for cloud pictures. Take a blanket outside, lie down and watch the clouds go by. Talk about what you see. “Does that fluffy one look like whip cream?” “Look over there. I see an elephant’s head!”

End the day on a happy note. Every night when your tuck your toddler in bed, ask “What was you’re the best part about today?” Ask questions to encourage your child to tell you more. Then tell him/her your best moment of the day.

Give your child an office. Your child watches you do “important tasks” like pay bills, balance the check book and schedule appointments. So, give your child a mini office so he/she can do the same. All you need is a calculator, toy phone, note pad, pencils, paper and envelopes. A computer keyboard is a nice touch. Pretend with him/her, ask what time he/she will be going to work and then call him/her on his/her toy phone.

Guess the animal. This is fun for the whole family. Cut out some photos of animals from magazines. Turn the pictures upside down and have one person at a time choose a picture. Everyone asks yes or no questions to guess the identity of the animal. “Does it fly?” When a person correctly guesses the animal, it’s his/her turn to take a picture and answer the questions.

Red Flag

These are some common questions caregivers ask speech language pathologists in Early Intervention. If you have concerns regarding your child’s development, please contact your pediatrician and schedule an evaluation with a speech language pathologist.

My child is 2½ years old and is stuttering. What should I do?

Stuttering, or disfluency, at this age is very common. Normal disfluency can occur between the ages of 1½ and 5 years of age. These disfluencies usually indicate the child is increasing his or her receptive language (understanding of language) and/or expressive language (use of language). At this age, stuttering can come and go as your toddler’s skills are developing.

Common disfluencies for children this age are syllable repetitions (ca- cat), using interjections (um, er), repeating whole words or phrases (“Mom mom I want a drink.”) and they are usually calm during the disfluency.

Children who are at risk for stuttering can demonstrate repetition of a word 3 or more times, substitution of “uh” for vowels in words (cuh, cuh, cuh, cat), prolongations (ccccccccat), the pattern during a prolongation/repetition is not smooth and facial/body tension during disfluencies and communication is noticeable.

If you notice your child stuttering, do not call attention to it. Give the child time to independently complete his or her thought. Do not put pressure on the child and talk with him or her at a relaxed rate of speech. If you begin to notice the “at risk for stuttering” patterns, you should contact your pediatrician and schedule an evaluation with a speech language pathologist.