Do They Need an SLP? Red flags for speech & language development

Back-to-school time: when the  smell of new crayons, paper, and books fills the air, and parents and kids are counting down the days (for different reasons).  Back-to-school sales are in full swing and kids need the latest and trendiest school supplies. I have worked at least partly in schools for my entire career, so I have never had to miss the thrill of excitement I get from shopping for new pens, paper, and other school supplies. As each year gets in to gear, however, I have noticed that a lot of kiddos start the year thinking they have everything they need for school, but end up needing my speech services as the year progresses. According to ASHA, speech and language impairments can negatively affect child's school work in the following ways: 

Children with communication disorders frequently do not perform at grade level. They may struggle with reading, have difficulty understanding and expressing language, misunderstand social cues, avoid attending school, show poor judgment, and have difficulty with tests.

Difficulty in learning to listen, speak, read, or write can result from problems in language development. Problems can occur in the production, comprehension, and awareness of language sounds, syllables, words, sentences, and conversation. Individuals with reading and writing problems also may have trouble using language to communicate, think, and learn. 

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Speech and language disorders can have a huge effect on a child's school experience. But fear not! The earlier a child's speech or language impairment is identified, the better the outcome! Even if your child is not in school yet, there are many Early Intervention programs that will help you find the therapy your child may need. Here are some warning signs that might indicate a speech or language impairment; if your child shows any of these, talk to their teacher and/or a speech therapist right away! 

Warning Signs that should trigger a referral to an SLP

Any age:

• Ability to be understood by family, friends, and/or caregivers in the expression of basic needs, preferences, and feelings is reduced
• Speech is slurred; difficulty controlling breathing for speech; abnormal loudness, rhythm, or vocal quality
• Produces no meaningful words, or sounds that are understood only by family 
• Speaks loudly in high pitched voice with frequent distortion, omission, and substitution of sounds
• Sound errors are prevalent but variable (i.e., "dog" could be produced "dog," "tog," "gog," "god" by same child) 
• Varies from rarely being able to produce sounds to ongoing speech that is rarely understood, or speech that is usually understood with frequent sound errors 
• Unaware of sound variations or exhibits varying degrees of frustration and/or anxiety regarding inability to "control speech" 

• Cannot produce movements for sound production, or sounds are produced without voice (whispered speech) 
• Exhibits frustration and/or avoids talking due to difficulties 

By 12 months:

• Does not point to objects
• Does not use gestures such as waving or shaking head

By 15 months:

• has not used first word
• does not respond to “no” and “bye-bye” appropriately

By 18 months:

• does not use at least six to ten words consistently
• does not appear to hear well or discriminate between sounds

By 20 months

• does not use at least six consonant sounds (especially /p, b, m, n, w, h/)
• does not follow simple directions

By 24 months (2 years)

• Has a vocabulary of less than 50 words
• Is less interested in social interactions compared with previously 

By 3 years:

• Cannot be understood by family and/or caregivers more than 50% of the time
• Cannot correctly produce vowels and/or the consonants p, b, m, w in words 
• Cannot repeat when not understood without getting frustrated 

By 4 years:

• Cannot be understood by family/strangers more than 75% of the time 
• Cannot correctly produce t, d, k, g, f 
• Cannot be asked to repeat without becoming sensitive

By 5 years:

• Cannot be understood in all situations by most listeners 
• Cannot correctly produce most speech sounds 
• Cannot be asked to repeat without exhibiting frustration

If you have any questions about your child's speech and language development, give me a call! When a speech or language impairment is identified early, a child can have a much better school experience. Happy learning!

Related:

• Kindergarten, Ready or Not?
• My Child Failed  A Speech Screening- Now What?

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