Why Can’t My Child Talk?

“My son will be three in a couple of months and is still not talking. Will he ever…?” Some may answer that this is normal and kids will learn to talk when they are ready. However, not talking at 3 years is NOT typical. It could be nothing; just a "late talker", but it could be something… Some late talkers do outgrow this phase. Unfortunately, some don't! The problem is that it isn't always easy to know which child will outgrow it and which child will go on to have long-term difficulties. Good comprehension is certainly one of the factors that help us determine if the child will catch up - but it is not the only factor. We have to be aware that not all children are the same and, unfortunately, one late talker is not the same as another.

Child development is influenced by genetic factors (the genes passed on from their parents) and events during prenatal life, however it is also influenced by environmental factors and learning. Child development includes:

• Cognitive development (ability to learn and solve problems)
• Social and emotional development (interacting with others and self-control)
• Speech and language development (understanding and using language, reading and communicating)
• Physical development (fine and gross motor skills)

Milestones for speech and language development

If your child is not on track with the following speech/language development milestones, you should talk to his/her pediatrician. Here are the milestones to look for in normal speech development:

Red flags of speech, language and communication problems

A child's failure to reach speech and language milestones as expected may be a "red flag" or warning of a development problem. It does not necessarily mean there is a problem, but nevertheless, he or she should be evaluated by a health professional. Language delays include problems understanding what is heard or read (receptive language delays) or problems putting words together to express themselves (expressive language delays). Some children have both speech and language delays.

Red flags for a speech or language delay include:

• No babbling by 9 months
• No first words by 15 months
• No consistent words by 18 months
• No word combinations by 24 months
• Slowed or stagnant speech development
• Problems understanding your child's speech at 24 months of age
• Strangers having problems understanding your child's speech by 36 months of age.
• Not showing an interest in communicating

Also talk to your health professional anytime you or another caregiver has concerns about your child's speech and language development or other problems that affect your child's speech or understanding of language, such as:

• Excessive drooling
• Problems sucking, chewing or swallowing
• Problems with control and coordination of lips, tongue and jaw
• Stuttering that causes a child embarrassment, frustration, or difficulty with peers
• Poor memory skills by the time your child reaches kindergarten age (5 to 6 years). He or she may have difficulty learning colors, numbers, shapes or the alphabet.

Other red flags include:

• Failure to respond normally, such as not responding when spoken to. This may include signs that the child does not hear well, for example, not reacting to loud noises.
• A sudden loss of speech and language skills. Loss of abilities at any age should be addressed immediately.
• Not speaking clearly or well by age 3

Why do speech and language problems develop in some children?

For most infants and children, language develops naturally beginning at birth. To develop language, a child must be able to hear, see, understand, and remember. Sometimes, there is a reason that a child has a speech and language problem. For instance, the child may have a language delay because of trouble hearing, central auditory processing disorder, or because of a developmental disorder such as autism, ADHD, etc. Often, there is not a clear cause. It is important to track your child's speech and language development. Many speeches and language problems can be overcome with treatment, especially when you detect the problems early.

What will a speech-language pathologist do?

According to the Malaysian Association of Speech and Hearing (MASH), a speech-language pathologist (SLP) or speech therapist, as we are commonly known in Malaysia, is a qualified health professional specialising in assessing and providing therapy for people with communication disorders such as stuttering, speech-language difficulties and social skills issues. SLPs also work with patients who have feeding and swallowing difficulties due to a congenital condition or from other medical conditions such as stroke and cancer. SLPs are also involved with providing intervention for voice disorders. SLPs often specialise in different client groups or in terms of specific disorders. Some SLPs work mostly with children while others work only with adults. There are some who are able to do a mixed caseload as well. A SLP will have to do an initial assessment for all cases, regardless of whether it is an eating difficulty, voice issue or communication difficulties. This is to determine the patient’s baseline and identify if the patient requires therapy and, if so, which areas should therapy target first. Depending on what the results of the assessment are, the SLP will then recommend an intervention plan best suited to the patient. This can include:

• One-to-one, individual therapy
• Group therapy
• Patient/caregiver training

What can parents do

Parents don't have to rely on the predictions of others or to guess that their child will be just like their friend's child and eventually catch up in language development. If you are concerned about your child's communication development or feeding skills, consult with a SLP.  The SLP can administer tests of receptive and expressive language, analyse a child's utterances in various situations, determine factors that may be slowing down language development, and counsel parents on the next steps to take.

Here are some parenting tips for helping along your child’s speech, language and communication:

• Start talking to your child at birth.  Even newborns benefit from hearing speech.
• Respond to your baby’s coos and babbling
• Play simple games with your baby like peek-a-boo and hide and seek
• Listen to your child. Look at them when they talk to you. Give them time to respond.
• Describe for your child what they are doing, feeling and hearing in the course of the day.
• Encourage storytelling and sharing information
• Don’t try to force your child to speak
• Read a book aloud
• Sing to your child and provide them with music. Learning new songs helps your child learn new words and uses memory skills, listening skills, and expression of ideas with words.
• Expand on what your child says. For example, if your child says, “CAR!” you can say, “You want CAR. Oh, blue car.”                                         

References:

http://www.asha.org/public/speech/disorders/LateBlooming/

http://www.hanen.org/About-Us/What-We-Do/Early-Childhood-Language-Delays.aspx

http://www.childdevelopment.com.au/home/170

https://www.nlm.nih.gov/medlineplus/ency/article/001545.htm

http://mash.org.my/

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This article is contributed by Miss Nichahlini Sounderajan, Speech-Language Pathologist, B.Sc (Hons) Speech, Science National University of Malaysia from SI World. The company was established back in 2006 and to-date, they have 11 professional therapy centres nationwide. The company is committed to providing sensory integration therapy, occupational therapy, speech therapy and physiotherapy, which aim to help those with special needs achieve a better development both physically and psychologically. To learn more about the company, visit their website at http://www.siworld.com.my or find out where their branches are here.