SPEECH AND LANGUAGE MILESTONES
BIRTH to 12 MONTHS
•turns to source of sounds
• startles in response to sudden, loud noises
• makes different cries for different needs - I'm hungry, I'm tired
• watches your face as you talk
• smiles and laughs in response to your smiles and laughs
• imitates coughs or other sounds - ah, eh, buh
• responds to his name
• responds to the telephone ringing or a knock at the door
• understands being told "no"
• gets what she wants through gestures, e.g. reaching to be picked up
• plays social games with you, e.g. peek-a-boo
By 12 months, your baby
• follows simple one-step directions - "sit down"
•looks across the room to something you point to
• consistently uses three to five words
• uses gestures to communicate - waves "bye bye", shakes head "no"
• gets your attention using sounds, gestures and pointing while looking at your eyes
• brings you toys to show you
• "performs" for attention and praise
• combines lots of sounds as though talking - abada baduh abee
• shows interest in simple picture books
Babies like it when you:
- Get down to their level so they can see your face. This tells them that you're interested in what they're doing and saying.
- It makes it easier to interact with them.
- Repeat the sounds they make. Babies enjoy making noises and they like it when you imitate them over and over.
- Sing and laugh, especially when you are feeding, bathing and changing them. Remember to talk to your baby throughout the day about things you do and see:
• Mommy's putting on her coat.
•That's a big truck.
- Tell them the names of the objects they are looking at and playing with. Babies are interested in exploring and learning about new things, and like to hear what things are called.
Articulation Disorder: An articulation disorder is a speech sound disorder in which a child has difficulty making certain sounds correctly. Sounds may be omitted or improperly altered during the course of speech. A child may substitute sounds (“wabbit” instead of “rabbit”) or add sounds improperly to words. Young children will typically display articulation issues as they learn to speak, but they are expected to “grow out of it” by a certain age. If the errors persist past a standard developmental age, which varies based on the sound, then that child has an articulation disorder.
The most common articulation disorders are in the form of a “lisp” – when a child does not pronounce the S sound correctly – or when a child cannot pronounce the R sound correctly. He may say “wabbit” instead of “rabbit” or “buhd” or instead of “bird.”
Apraxia of Speech is a communication disorder affecting the motor programming system for speech production. Speech production is difficult – specifically with sequencing and forming sounds. The person may know what he wants to say, but there is a disruption in the part of the brain that sends the signal to the muscle for the movement necessary to produce the sound. That leads to problems with articulation as well as intonation and speaking stress and rhythm errors. Apraxia of Speech can be discovered in childhood (CAS), or might be acquired (AOS) resulting from a brain injury or illness in both children and adults.
Fragile X Syndrome (FXS) is an inherited genetic disorder that is the most common cause of inherited intellectual disabilities in boys as well as autism (about 30% of children with FXS will have autism). It also affects girls, though their symptoms tend to be milder. It is greatly under-recognized and second only to Down syndrome in causing intellectual impairment.
FXS occurs when there is a mutation of FMRI gene and is an inherited disorder. If a child received a pre-mutated X chromosome from one of his parents (as a carrier), then he is at greater risk of developing FXS. Diagnosing Fragile X Syndrome is not easy for parents and doctors at the beginning of a child’s life. Few outward signs are noticeable within the first 9 months. These signs may include an elongated face and protruding eyes.
Intellectual disabilities, speech and language problems, and social anxiety occur most frequently in children with Fragile X. Speech symptoms include repetition of words and phrases, cluttered speech and difficulties with the pragmatics of speech. All of FXS’s symptoms can range from mild to very severe.
Stuttering occurs when speech is disrupted by involuntary repetitions, prolonging of sounds and hesitation or pausing before speech. Stuttering can be developmental, meaning it begins during early speech acquisition, or acquired due to brain trauma. No one knows the exact causes of stuttering in a child. It is considered to have a genetic basis, but the direct link has not yet been found. Children with relatives who stutter are 3 times as likely to develop stuttering. Stuttering is also more typical in children who have congenital disorders like cerebral palsy.
A child who stutters is typically not struggling with the actual production of the sounds—stress and a nervousness trigger many cases of stuttering. Stuttering is variable, meaning if the speaker does not feel anxious when speaking, the stuttering may not affect their speech.
Language disorders can be classified in three different ways: Expressive Language Disorder (ELD), Receptive Language Disorder (RLD) or Expressive-Receptive Language Disorder (ERLD). Children with Expressive Language Disorder do not have problems producing sounds or words, but have an inability to retrieve the right words and formulate proper sentences. Children with Receptive Language Disorder have difficulties comprehending spoken and written language. Finally, children with Expressive-Receptive Language Disorder will exhibit both kinds of symptoms. Grammar is a hard concept for them to understand and they may not use of articles (a, the), prepositions (of, with) and plurals. An early symptom is delay in the early stages of language, so if your child takes longer to formulate words or starting to babble, it can be a sign of ELD.
Children with Receptive Language Disorder may act like they are ignoring you or just repeat words that you say; this is known as “echolalia.” Even when repeating the words you say, they may not understand. An example of this is if you say, “Do you want to go to the park?” and they respond with the exact phrase and do not answer the question. They may not understand you or the fact that you asked them to do something.
Children with Expressive-Receptive Language Disorder can have a mix of these symptoms
These are some of the most common speech disorders in children. No child is the same and you know your child best. If you feel that your child has a speech disorder, contact your pediatrician to discuss treatment options.