Speech specifically refers to verbal language expression while language is a broader concept that encompasses meaningful expression and reception of information. This includes verbal, nonverbal, and written communication. Your pediatrician is evaluating your child’s ability to both communicate with others and understand communication from others in various formats.
Even in early infancy, children begin to communicate with others with smiles, eye contact, and cooing. Smiling can occur spontaneously in newborns during sleep or at random times. However, the “social smile” is a reciprocal smile in response to something pleasant, like someone else’s smile or a familiar face or voice. The social smile is often accompanied by eye contact and cooing. These are some of my favorite milestones to observe at the 2 month well visit. I like to think of it as the baby’s way of saying, “Hello, doctor!”
As time moves on, infants begin to jabber sounds and look in the direction where sounds originate. They start to have “conversations” where they babble, allow someone else to talk, and then babble in response. They also begin to gesture by pointing or waving as a means of communication. These are important milestones that occur before the first word is uttered around 12 months. Delays in these milestones can raise concerns about speech and language development that could be the result of a general delay, hearing deficit, or delay in social development.
Speaking of hearing, assessment of hearing is a crucial part of evaluating a child for speech and language delay. A specialist, called an audiologist, typically performs an age-appropriate hearing test to determine if hearing loss is contributing to the delay. In addition to a hearing evaluation, any child who has a possible delay in speech and/or language development should be referred to a speech-language pathologist. These experts use standardized tests to evaluate speech and language skills, but also observe these skills as part of the child’s overall development. Some parents are a little reluctant to pursue an evaluation for speech or language delay or want to take a “wait and see” approach. It is important to intervene as early as possible so the child does not get further behind.
Parents should understand that they have not done anything wrong if their child has a speech and language delay. However, there are some things you can do as a parent or caregiver to promote development in this area.
- Read to your child often, even during infancy.
- Avoid “baby talk.”
- Use everyday situations to reinforce communication. For example, when giving your toddler a cup of milk, emphasize the words “cup” and “milk” while pointing at them. This repetition is a key part of speech and language development.
- Teach your child some sign language. Even in the absence of a hearing deficit, signing can help a child communicate with their hands who has difficulty communicating with their mouth. This works best for children 9 months and older because their motor skills are too immature prior to this age. It does not hinder speech development, but rather promotes their ability to speak. There are lots of toddler sign language videos available online.
- Avoid comparing your children to other children or siblings. Some children develop more quickly than others and can cause parents to perceive a delay that is not there. However, if you have concerns about your child’s development, discuss it with your pediatrician.
- 9Avoid handheld screen time in infants and toddlers. New research presented at a recent academic pediatric meeting suggests that handheld screen time in children less than 2 years old increases the risk of speech delay.
It is important to be consistent with scheduling your child’s well visits so their development can be assessed. Early diagnosis and intervention is imperative. Finally, on a personal note, 2 of my 3 children have been involved in speech therapy and they absolutely loved it! Much of the therapy is done through play so they enjoyed participating. As always, talk to your doctor about any specific concerns about your child.