This guest post is from Patricia A. Prelock, PhD, CCC-SLP, a speech pathologist who is the 2013 President of the American Speech-Language-Hearing Association (ASHA). She is also dean of the College of Nursing and Health Sciences, a professor of communication sciences and disorders and a professor of pediatrics at the College of Medicine at the University of Vermont. In other words, she really knows her stuff.
Knowing what is “typical” versus problematic when it comes to communication can be difficult for parents, especially when it’s a first child. Sometimes, well-intentioned friends, grandparents and even pediatricians may advise concerned parents not to worry—saying, for instance, that a child will speak when he or she “is ready.” Although they may be right, taking a wait-and-see approach is risky. If an issue does exist, parents may miss a critical treatment window. In their first years, children form foundational communication skills for a lifetime. During this period, children generally respond extremely well to treatment. And there’s a lot more to it than when a child says his or her first word.
Having spent many years as a speech-language pathologist, I know firsthand that treatment is much more successful when it begins before age 3—and key early indicators are frequently overlooked. Below are five that parents often miss. If a child is exhibiting any of these signs, a parent should consult the child’s pediatrician. Parents may also want to look into Early Intervention programs in their state, or seek an assessment with a certified speech-language pathologist or audiologist (find a searchable list of professionals here).
1. A child isn’t making eye contact or smiling.
Much of early speech and language development is actually non-verbal. One of the first ways an infant communicates with a parent is through eye contact. As early as at 6 to 8 weeks, a tot should be able to hold a gaze—particularly with a parent or other caregiver. Around that age, a child should also have a social smile in response to a parent or loved one.
2. A child isn’t using gestures.
Also in the category of non-verbal communication, an infant should begin using gestures by the time he or she is between 6 to 12 months. These include clapping, pointing and waving.
3. A child isn’t cooing or babbling.
Well before the long-anticipated first word is spoken, a child should be verbalizing in sounds. Cooing typically occurs by the time a child is 2 to 4 months old, and babbling by 6 months. I have heard parents say, “He was such a good baby, he was so quiet.” That is a red flag for me. By age 1, a child generally should say 1 or 2 words. By age 2, a child should be stringing 2 or more words together.
4. A child is not understood by others.
Parents are wonderfully attuned to their children’s needs. They can sense subtle differences in their cries of needing to be changed, or being hungry, tired or in pain. As the months progress, parents get even better at deciphering what their child wants. But even if they understand a child’s sounds or words, they should pay close attention to whether other people can understand what their child says. If others cannot understand a child by 18 months to 2 years, this is an indicator of a potential speech or language issue.
5. A child is not responding to his own name.
This can be a sign of hearing impairment. Parents may not realize the need for vigilance about hearing because most newborns undergo hearing screening before leaving the hospital. However, hearing problems can emerge weeks or months following birth. Ear infections can also lead to hearing problems. Hearing issues may not be obvious, especially given that a child with a hearing impairment will make similar sounds (including cries) to a non- hearing-impaired child through 9 months. If a child is not responding to his or her own name by 7 months to a year, a problem may exist.
For more information on learning the signs of communications disorders, visit ASHA’s recently launched Identify The Signs campaign.
Image: Courtesy of ASHA