I first began to worry when my daughter was just 1 year old. She was barely babbling and had yet to say her first word. What did I do wrong? From my medical textbooks, I knew that children with speech delays were sometimes a product of parents who didn't speak to their child enough — I spoke to mine all the time. Was it not enough? Was I saying or doing the wrong things?
As a physician, I was embarrassed that my daughter's speech was delayed. Then I was embarrassed that I was embarrassed. Let it be clear that I was in no way disappointed in my child. I was embarrassed because I thought her speech delay was my fault. I saw it as a reflection on my parenting abilities. I knew she was intelligent; her gross and fine motor skills were advanced, as was her receptive language. I knew she wasn't autistic — she had no other signs. So why couldn't she talk?
Over the next year of her life, I did a lot of research, spoke to some colleagues for advice and support and saw two different speech language pathologists. Unfortunately the first appointment with a speech language pathologist, when my daughter was just 12 months old, did not go so well. I had gone for suggestions and reassurance and instead was told my daughter had a mild to moderate expressive language delay, and I felt I was not given the help I needed. I felt judged, worried and incredibly sad. I left the appointment in tears. A few months went by, and very little changed. My daughter had said her first word ("Dada") by 13 months and picked up a few more shortly after that. However, I knew the words weren't as clear as those of other toddlers her age (for instance, "baba" meant most things — ball, bubbles, blankie and Barney, to name just a few), and there were many sounds she still couldn't make (such as m's and n's). By 18 months, grunting and pointing were still more common than actual speech, and the frustration was obvious when she couldn't get her point across.
It wasn't until she was 19 months old that we started speaking with a different speech language pathologist. When my daughter was 22 months, we met with the pathologist in person, and oh, what a difference it made! I was given reassurance that my daughter's speech fell within the normal range. Not only that, but I was finally given help.
I learned what normal meant — that some children speak in full sentences by 18 months of age, while others don't start forming sentences until 2-1/2 years. Both are considered normal development, and learning to speak on the later side of normal does not mean your child is any less intelligent.
I learned the depth of language — that speech and language are not synonymous. There are two parts to language: expressive and receptive. If your child understands two-step commands by 18 months old (for example, "Go get your shoes, and bring them to me"), then there is no problem with their receptive language. Does your child point? Do they know some baby sign language? Do they take turns babbling with you? Well, guess what — these are all signs of expressive language. In fact, most speech language pathologists consider one sign to equal one word when counting up how many words your child knows. So your child may be less "behind" than you think.
I was also given helpful (not judgmental) tips: If your child says "baba" for ball, then instead of saying "not baba, say ball," reinforce the correct word by saying something like "do you have a ball?" By telling them they're wrong, it will only frustrate them further and make them afraid of disappointing you. Most likely they already know it's not a "baba," but their tongue can't figure it out yet. Give them time. It will come.
With time and support, I am happy to say my 25-month-old's speech has exploded. We may need to see a speech language pathologist again in the future for help with phonetics (as she can't say the sound "f" and often doesn't finish words), but I am no longer afraid of the process, and you shouldn't be either.
DO: Speak with your physician about your concerns right away so your little one can be properly evaluated to rule out more serious medical causes.
DO: See a speech language pathologist for helpful tips and support.
DO: Get your child's hearing checked to make sure that isn't the problem.
DO: Speak slowly in two- to three-word sentences while looking straight at them. Even if they understand larger sentences, they might not be able to follow what your tongue is doing to make the sounds.
DO: Encourage babble. Babble with them using different sounds, like "bababa," "mamama," "dadada," "nanana."
DO: Repeat the same word you want them to say three times while holding or pointing to the object.
DO: Sing to them. Even when you're not singing a song, alternate the pitch of your voice when you're talking. It helps them focus and remember more.
DO: Give positive reinforcement whenever they try to say a word, even if it doesn't sound right.
DO: Stop comparing your child to someone else's. Chances are there is something your child can do before theirs.
DO: Know that most studies on language delay only begin with children 3 years and older, simply because there is such a large spectrum of normal before that.
DO: Give your child time to grow up and learn at their own pace.
DON'T: Ask them to repeat what you're saying (example, "say water"). This will only frustrate them and cause them to go quiet.
DON'T: Talk about it all the time. Your child can pick up on when they are disappointing you.
DON'T: Blame yourself.
Remember, if you are ever concerned, then speak with your health care provider. There are a lot of resources for early language development in the community — find out what they are in your area.
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