Do Late-Talkers need Speech Therapy?

This question has been asked directly to me by friends, neighbors, co-workers several times. In fact, just this past week, 2 neighbors brought this up (one neighbor was a mom I had met 5 minutes ago!). The question usually sounds like this:
My son is 2.5 years old. He understands everything we say to him, he is very smart, very active. He loves playing with other children. He is persistent about getting his needs met. But, he is hardly talking. He can say "mama" and "dada", and "mo" for 'more' and a couple other words. I see other children his age talking in sentences and I wonder if I should be worried. My mother-in-law compares him to my niece who is about the same age and talking up a storm. Should I take my son for speech therapy? My husband thinks I'm crazy for worrying".

There is much research out there related to this particular topic. First, late talkers have to be differentiated from speech and language disorders such as apraxia and autism. While this might be difficult for a parent or even pediatrician to differentiate, a speech-language pathologist has the skills to do so very reliably within a single evaluation. Things to look for would include the child's ability to comprehend, ability to follow directions, ability to initiate, intent to communicate, ability to communicate in a variety of ways (request, comment, clarify etc.), stimulability of early developing sounds such as 'b', 'd', 'm','n' 'p', 't', 'h'; the ability to point (a VERY important skill), waving 'hi' and 'bye', clapping etc.

Research indicates that most late-talkers that belong to supportive and nurturing families, will eventually catch up.  While the 'wait and watch' approach and 'they'll outgrown it' does work for many children, it does not for all of them. Conflicting research says that late-talkers might be at a greater risk of language delays and later reading and spelling delays in elementary school.

So the first benefit of taking your child to a speech-language pathologist is to ease a parent's mind. But there is one thing to consider before you visit a speech therapist. A hearing test! While most babies get a hearing test as newborns, a lot can change within a short period of time. Sometimes children have mild-moderate hearing loss due to intermittent ear infections. Make sure hearing is not an issue.

Another benefit is knowing if there need to be any follow-up therapy sessions. If your child is, in fact, just a later-talker and all else is good, do they still need speech therapy? Many parents would say 'yes, I would prefer therapy to help them get started'. This is a common practice- to stimulate and encourage language within structured and predictable routines. The speech therapist can also suggest simple everyday activities to stimulate speech and language at home and in the community. Here is a list of just a few simple ideas to get you started:

• 1. Name Walk: walk around the house or playground. Name and touch things as you go, encouraging the child to repeat the words or to take the initiative in naming.
• 2. Photo Album:  make a photo album for the child with clear simple pictures of family members, pets, or the child engaged in familiar activities such as eating, sleeping, reading a book, or playing with a favorite toy.
• 3. Circle Rhymes:  Movement rhymes are fun to learn and perform. Favorites are “The Wheels on the Bus” and “Hokey Pokey.”
• 4. Words, Words, Words: The more words you use with young children, the more they will have an opportunity to learn. Talk about what you are doing when your child is watching you. “Oh, some milk spilled.” Point out the things you see or notice: “I hear an airplane. It makes a loud noise.” Be sure to use descriptive words and phrases as well as nouns and verbs.
• 5. Go Fetch: All kids love to be helpful. Take advantage of their new ability to move around and follow simple directions by asking them to get something for you. At first, make sure the item is visible. As their receptive language improves, they will be able to get things from familiar places even if they cannot see them.
• 6. Texture Fun: Give young children lots of opportunities to fell different textures, such as fur, cotton, corduroy, sandpaper, silk, stone, denim, and dough. Teach words like soft, hard, rough, smooth, sticky, damp, wet, dry, squishy, and bumpy as the child strokes the materials.
• 7. What’s Coming Up: Use words to prepare toddlers for transitions. “Play time is almost over. Daddy will be here after snack.”

So, in the end. DO talk to your pediatrician and discuss your concerns and evaluate options. DON'T dismiss any concerns that you have! YOU know your child best.