does my child need speech therapy?

As parents, we live with a never-ending litany of worries about our kids: Are they eating enough vegetables? Getting too much screen time? On track for their developmental milestones?

As both a mom and an SLP,  I have those same concerns, and while I can’t help a child learn to love brussels sprouts or to dislike cartoons, I can help you recognize if your child’s speech and language development is on track.

Here are some warning signs that might indicate that an evaluation by a speech-language pathologist is warranted:

Any age:

  • Family, friends, and/or caregivers find it suddenly harder to understand the child
  • Their speech is slurred or they have difficulty controlling their breathing for speech
  • They speak loudly in a high-pitched voice (and not just when imitating a TV character)
  • They go from rarely being able to produce sounds to speech that is barely understood
  • They are unaware of sound variations, or show frustration and/or anxiety about their seeming inability to control their speech

By 12 months:

  • They don’t point at objects
  • They don’t use gestures such as waving or shaking their head

By 15 months:

  • They have not used their first word (this can be a word approximation such as “buh” for “ball” or “do” for “doggie”)
  • They don’t respond to words such as “no” and “bye-bye” appropriately

By 18 months:

  • They do not use at least 6 to 10 words consistently
  • They do not appear to hear well or to discriminate between sounds

By 20 months:

  • They don’t use at least six consonant sounds, especially “p, b, m, n, w, and h” 
  • They do not follow simple directions such as “Come here”, and not just when frustrated

By 24 months (2 years):

  • They have a vocabulary of less than 50 words
  • They are less interested in social interactions than they were before 

By 3 years:

  • They are understood by family or caregivers less than 50% of the time
  • They can’t produce vowel sounds (a, e, i, o, u) and/or the consonants p, b, m, and w in words 
  • They get overly frustrated when they’re asked to repeat themselves so others can understand them, and sometimes even refuse to continue talking

By 4 years:

  • Strangers only understand them about 50%  of the time 
  • They can’t correctly produce the sounds “t, d, k, g, and f”

By 5 years:

  • They can’t be understood in all situations by most listeners 
  • They can’t correctly produce most speech sounds 

The good news is, when a speech or language impairment is identified early, a child can have a much better experience.

Jill Shook, MS, CCC-SLP

Meet Jill Shook, MS, CCC-SLP:

Jill Shook, MS, CCC-SLP owns a solo private practice in Pittsburgh, PA. She created a course for SLPs starting out in private practice and shares therapy tips and resources on Facebook and Instagram.  Email her at [email protected]

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