Tools, information and advice to help you understand and support your child's communication
Children's communication charity offering a wealth of information and support http://www.afasic.org.uk
Charitable organisation offering provision of equipment and ongoing support services http://www.communicationmatters.org.uk
Coalition of not-for-profit organisations supporting those working with children with communication difficulties http://www.thecommunicationtrust.org.uk
Support for children who stammer http://www.stammeringcentre.org
Advice and support for children and adults who stammer http://www.stammering.org
Information, advice and support for children and adults with Autism http://www.autism.org.uk
Dispelling some of the common myths surrounding speech and language therapy
As babies get older they need to learn to move their mouths in different ways, to smile, chew food, experiment with babbling sounds and gradually learn to talk. Dummies get in the way of the regular practice of babbling that is crucial for learning to make the quick mouth movements needed for speech. The more practice children get at babbling the better their awareness of their mouths and the better their speech is likely to be. Prolonged dummy use can contribute to delayed babbling and first words. It also increases the risk of dental problems later on.
Dummies can be helpful for comforting babies. As the baby gets older it is recommended that:
There is much research that evidences the positive effect signing systems have on a child’s language development.
Signing with your child can help them understand what you are saying and may give them a way to express themselves whilst speech is still developing. Having a signing system therefore means that the child can get their message across effectively without becoming frustrated or giving up when talking is difficult for them.
When signing with your child, always use speech at the same time- use signs to support only the key words of your spoken sentence.
For many children using a signing system, the child will learn to sign key words to get their message across and then learn the spoken words to use alongside these signs. Signing often then drops away naturally and speech remains.
Signing supports rather than hinders speech and language development.
As a child’s speech develops, it is common that they are able to imitate a sound in isolation (on its own) but still have difficulty pronouncing that sound in words and sentences e.g. they can copy the sound ‘c’ but still say ‘tat’ instead of ‘cat’. This is because the child has a learnt automatic pattern for the sound which can be overridden when focusing on that sound alone, but is so habitual that it is difficult to change during connected speech when they are thinking about what they are saying rather than how they are saying it. The child may need help to learn to say the sound in connected speech. This begins with practising the sound in isolation e.g. ‘k’, then in simple sequences with vowels e.g. ‘koo’ / ‘eek’, then in words e.g. ‘cat’, ‘book’. This may require intervention from a Speech and Language Therapist. As a general guide, see below for what sounds are typically produced in words at what age.
1 year: m, n, p, b, w
2 – 3 years: t, d, k, g, ng
3 – 4 years: f, s, l, y, z
4 – 5 years: v, sh, ch, j, th, r
It is common for the consonants ‘w’, ‘l’, ‘y’ and ‘r’ to be interchanged between the ages of 4.5 and 5 years.
Some later developing sounds such as ‘r’ and ‘th’ often do not develop until 7 years.
There is a lot of variation within typical speech development. If you are concerned, seek advice from a Speech and Language Therapist.
Helpful things you can be doing if you are concerned about your child’s speech development are:
Although it is helpful to remind older children to give their younger siblings opportunity to talk, it is unlikely to be the only reason for the delayed talking of the younger child. There are many factors that can contribute to delayed talking, for example, a family history of speech and language difficulties, premature birth, reduced opportunities for practising talking, developmental disorders. If you are concerned, seek advice from a specialist as soon as possible. Early intervention is crucial in supporting speech, language and communication development.
Speech sound difficulties are not an indicator of a child's cognitive ability. Children who have a difficulty with speech sounds can have a mental ability within the typical range expected for their age.
There are several factors that can impact on the listening ability of young children, some of which are explained below.
The typical development of attention and listening skills:
The ability to listen to an adult whilst doing an activity/ task is known as dual attention and is a skill that is not typically established until 5 years old. If your child is under 5 years and appears not to be listening to you, it is likely that they will be focused on an activity of their own choice and will find it difficult to shift their own attention from doing to listening. You can help them by getting down on their level, being face to face, repeating their name and using a gentle physical prompt (tap on the arm) if necessary. Wait until they are looking at you and you have gained their full attention before asking a question or giving an instruction.
Conductive hearing loss:
Glue ear is a common childhood condition in which the middle ear becomes filled with sticky glue-like fluid. This prevents the tiny bones in the ear from vibrating properly, in turn preventing the child from hearing sounds typically. If your child suffers from a build-up of ear wax or has frequent ear infections it is recommended that you consult your child’s GP. Glue ear can impact on a child’s speech and language development.
Environmental noise levels:
The child's environment can have a significant impact on their ability to listen. A child in a noisy environment may find it difficult to filter out the background noise in order to listen to speech. The same applies for background noise such as the television or radio, or even the washing machine being on. When children are bombarded with noise they find it difficult to listen. You can create the optimum listening environment by keeping background noise to a minimum, choosing a time of day to play with / read to your child when there are minimal distractions and when you are able to provide one-to-one attention. Small changes such as choosing a different room to sit in (one with a carpet and soft furnishings, so your speech sounds do not ‘bounce away’) can have a big impact.
Currently, children routinely receive a hearing screen at birth and on school entry. If you are concerned about your child’s hearing you should visit your child's GP, who may be able to make an onward referral for a hearing screen if necessary.
As a child’s speech and language develops, it is normal for them to make mistakes. Children learn through listening, copying and experimenting with sounds and words and putting them together to make sense of their language. Making mistakes, then correcting and rehearsing is all part of typical development. It is also typical for many children to go through a period of dysfluency (stammering) as they are learning to talk, particularly during periods of rapid language growth as their speech tries to keep up with ever increasing vocabulary and sentence structure.
However, in typical development, these errors correct themselves as the child has more exposure and practice. If errors do not start to correct themselves by the expected age intervention may be necessary.
Research indicates that early intervention is the most effective in the case of children with speech and/ or language disorders and this is why speech and language therapists often take a hands-on approach to providing assessment, and if necessary, therapy early on. Helping children with speech and language difficulties later in life can be more challenging and these children may miss out on opportunities to succeed both academically and socially if they do not receive specialist support. The best advice is to seek advice from a speech and language therapist if you are concerned. A speech language therapist can help to evaluate whether your child’s speech and language skills are age-appropriate, and if not, advise you on the best next steps to take.
Many children learn two or more languages at the same time without developing speech and language difficulties. The plasticity of the brains of young children means that they are prime candidates for successful dual-language learning. In fact, there are potential benefits to learning two languages such as improved vocabulary, greater phonological awareness skills, and well-developed listening skills.
Typically, the same developmental milestones are expected in bilingual children in terms of vocabulary development, grammar usage, and pronunciation as in children who speak only one language.
Common concerns of parents and teaching staff supporting bilingual children:
It is important to understand that these behaviours are typical of children learning more than one language and are actually a positive sign of language development – the child is practicing both languages as they gain more and more exposure to the languages. Such behaviours fade as the child moves through the stages of typical language acquisition.
It may be useful to know that:
A child with a speech and language disorder will have difficulties with both languages, but this is not due to the fact that they are bilingual. If you are concerned about the language development of a bilingual child, seek advice from a Speech and Language Therapist. It is likely that the therapist will be able to provide assessment of the child’s first (native) language to inform whether or not there is a speech and language delay or disorder. This assessment will be done jointly with an interpreter.
Typical development of language understanding does not indicate typical development across all areas of speech and language. It is possible for a child to have a delay or a disorder in just one area or across several areas of development including attention and listening, language understanding, expressive language, speech sounds, and social communication.
As well as recognising the distinction between language understanding and other areas of speech and language development it is also important to recognise the difference between pure word understanding and the ability to interpret words in context. Your child may appear to understand spoken language when he/ she is in fact responding to you appropriately based on knowledge of his/ her familiar routine and the context in which you are communicating.
If you are concerned about any area of your child’s speech and language development, seek advice from a Speech and Language Therapist. A specialist will be able to provide a screening assessment and then, if necessary, further assessment of individual areas of speech, language and social communication.
For more information on typical development across all individual areas of speech and language development, visit http://www.talkingpoint.org.uk/progress-checker
Although supporting children to develop accurate production of speech sounds in order to ‘pronounce’ words so that they can be understood is part of the role of a Speech and Language Therapist, it is only one of the many goals we may aim to achieve through intervention.
Generally, the aim of speech and language therapy is to reduce the impact of speech, language, communication or swallowing difficulties on an individual’s wellbeing and their ability to participate in daily life.
“Speech and language therapy provides life-changing treatment, support and care for children and adults who have difficulties with communication, or with eating, drinking and swallowing”. (Communicating Quality 3, Royal College of Speech and Language Therapists, 2006.)
Speech and Language Therapists work in partnership with individuals, their families, educators and other professionals to support the individual to achieve their potential for communication, or to reduce the risks associated with swallowing difficulties.
Our service supports children with a range of speech, language and communication needs including speech sounds (pronunciation), understanding language, expressing wants and needs (this may be verbally or non-verbally), interacting with others, and talking fluently. Functional communication is what we aim to achieve for all children. However, for many children, this is not through speech. Many children require the opportunity and support to communicate in other ways such as through signing or use of symbols and pictures.
Communication does not necessarily mean speech and we, as Speech and Language Therapists, do not necessarily just work on ‘speech’ – our job is far more interesting than that!
For some speech and language difficulties, frequent one-to-one therapy is recommended. However, therapy comes in all shapes, sizes and styles.
The length, frequency and group size of sessions will depend on the child’s individual goals, cognitive skills, attention levels, and motivation.
Some children are not able to attend to longer sessions or may become overloaded with too frequent therapy.
Speech therapy is also not only about what happens in the session, but how children are supported to practice to generalise learnt skills to use in the real world. For example, a child may have developed the skill, through therapy sessions, to listen to and follow an instruction containing 3 key words, but this is only a useful skill if they can generalise it to listening to and following instructions in their home and school settings. Similarly, a child may learn how to produce the sound ‘k’ in words when focusing on this in one-to-one therapy sessions, but this is only beneficial if the child has the awareness, motivation and opportunity to practice the sound in general conversation outside of therapy sessions.
Many children benefit from group rather than one-to-one therapy. For example, if the child’s aims are to develop social communication skills, a small peer group will provide opportunity for the child to practice fundamental communication skills such as initiating and turn-taking. A stereotypical image of speech therapy is a single child sitting across a table from the therapist drilling speech sounds, but quality therapy sessions come in all shapes and sizes. One-to-one therapy is not always the most effective form of intervention for children who need to practice with their peers or who benefit from reinforcement from others. For example, a child with difficulties with social communication skills may have greater success practicing with others in a similar boat, or with peers with whom they will eventually generalise those skills with, rather than role playing with a therapist.
The speech and language therapist will advise the most effective type of intervention for your child, whether this be weekly one-to-one therapy, monthly reviews with advice regarding how to support the child’s development outside of therapy sessions, or group work in the child’s educational setting.