Early Language: Warning Signs and What to Expect

Every handout, every pamphlet in the doctor’s waiting room, every app about development talks about language milestones that babies should meet. Don’t worry if your baby doesn’t have their first word by one, the articles say, look for signs of readiness instead. The checklists at every well-baby visit are meant to reassure you that there are wide ranges of normal when it comes to speech and language development. Is baby waving? Making eye contact? Babbling with different consonants? Congratulations, you’re within the realm of ‘typical.’

But what happens when you answer ‘no’ to some of those questions? What happens when baby doesn’t say 20 words by 18 months or understand simple directions by a year? What happens when your three year old mispronounces words so often that you are his interpreter? What are you supposed to do when ‘typical’ language development just isn’t a part of your story?

Warning Signs for Early Language Development (Under 2 Years):

*please note, these are just ‘warning’ signs. Not every child develops the same, so please don’t panic. Just ask your doctor at your next well-baby appointment*

– doesn’t follow simple directions (by 18 months)
– doesn’t wave or use social gestures
– doesn’t use four or more consonant sounds (by 18 months)
– doesn’t ask for attention by making sounds, making eye contact, or vocalizing
– stutters
– loses words they once used regularly
– has an ongoing hoarse voice
– has difficulty with chewing and swallowing

When the pediatrician recommends that your little one gets a speech evaluation, here’s what to expect:

1. Have a hearing test: is your two year old’s lack of consonants because she can’t pronounce them, or because she can’t hear them? A hearing test will rule out any possible hearing issues.

2. Find a speech language pathologist: I’d go by recommendation for this one, as opposed to a random Google search. If you know someone who has a well-spoken kid (and there was a great SLP involved), jot down a name and number. If you don’t know anyone, check with the doctor, local mom’s groups or a daycare provider- chances are, you’ll get rave reviews from somebody.

3. Go for an assessment. Typical first assessments range in length; expect to be there for about 1-2 hours, depending on the age of your child. They may be assessed in stages; it’s a lot of material to get through, and it’s hard for a little to sit still for that long. As a parent, you’ll answer all sorts of questions about your child and fill out paperwork. Your child will participate in a variety of activities. These are usually play-based depending on how old your child is; expect a lot of labeling, repeating, turn-taking, etc.

4. Review the assessment results and make a plan: after your initial visit(s) with an SLP, your child’s treatment plan will be developed. Is it a speech issue (articulation of words), a language issue, a processing issue, or a combination of the above? Is it worth treating at this time, or should you wait a little longer before diving into therapy? Your SLP will give their recommendations and advice on how to proceed. If your child needs to start speech therapy, you’ll book the next appointment (usually only 1/2 hour). If not, you may book a follow up appointment in 6-12 months.

Have you had experience with non-typical speech? What were your initial warning signs?

2 thoughts on “Early Language: Warning Signs and What to Expect

  1. As a speech therapist id also say if your child doesn’t have any words by 18 months it might be worth at least a screen. Also make sure they are beginning to understand appropriate play with toys, can attend to a book/toy for a couple minutes, and is starting to be able to identify some simple objects. By 2 they should be using at least 50 words, starting to combine words and should be using words more often than not to ask for things. 🙂

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