Common Concerns about Speech Development:

"Why is my child not talking?" "Is my child talking clearly enough for his age?" "Will my child have problems learning to talk if we speak more than one language in our home?" Parents who are concerned about their child's speech development often ask questions like these.

First Things First Some children are naturally late talkers, just as some are naturally early talkers. It's true that sometimes second- or third-born children start to talk later than their older siblings did. But, even so, they catch up with their peers by the time they are 5 years old.

Assess Hearing Not hearing is a major obstacle to learning to talk. Have your baby's hearing checked on each visit, especially if your child has had multiple ear infections. Talk with your baby to see whether he or she pays attention to your voice.

Compare Each Child to Norms-Not Other Children Comparing each child to the established norms for speech development is better than comparing him or her to other children. Most children follow a normal progression. They:

•Make sounds by 2 months.

•Respond to noises or voices by 4 months.

•Babble by 9 months.

•Say a few words by 1 year.

•Use short, simple sentences (2 or 3 words) by 2 ½ years.

•Say longer sentences (4 or 5 words) by 3 years.

•Tell a simple story by 4 years.

Reading to and Talking with Babies Encourages Them to Talk Many parents want to know how to encourage talking in their children. Talking and reading to babies and young children are the two most important ingredients for stimulating a child to talk. Use clear words and phrases while doing daily activities. For example, you can say, "Let's walk over to the sofa. I want to get your Teddy Bear," or "Look, here comes grandma." Playing games such as peek-a-boo, singing along with music, repeating sounds and words that the baby says all encourage talking. Set aside time for reading, even to very young babies. Doing this helps establish reading as part of their daily care for their child. (For recommended books go to KidsGrowth Child Health's Book Review section.)

Baby Talk or Not to Baby Talk Many parents wonder whether baby talk or "parentese" is OK to use. Research shows the higher pitch and slower rate of baby talk along with the emphasis placed on certain words actually gets the baby's attention. It's best to gradually stop baby talk and use normal tone and rhythm by the time a baby is 6 months old.

This article only touches on a portion of the concerns typically expressed by parents. In Part 2, we address additional speech development issues including common speech mistakes and the opportunities afforded by multi-lingual households.

Speech development is often a concern for parents. When you're asking questions such as "Is my child speaking clearly?" and "Is it OK that's he's exposed to two languages?" here are a few tips.

Concerns About Not Talking Some toddlers just don't talk. If your child isn't talking, here are a few suggestions:

•Don't force children to talk and don't talk for them. Expect children to talk for themselves.

•Get children's attention before you talk to them. Face a child, speak clearly, use simple words and repeat what you say.

•Use rewards (praise, hugs and stickers) when a late talking child begins to talk more.

•Mistakes Are Part of Learning to Talk

•All kids make mistakes when they start to talk. The most common mistakes include:

•Using incorrect letter sounds, such as a "d" for "t"

•Mispronouncing words, such as saying "blankie" for "blanket" and

•Having trouble saying certain letters, such as not being able to sound out "sh," "w" and "th."

•Through practice, most children get it right. Remind parents to always use proper words and phrases, repeat a child's mispronounced word correctly and avoid teasing.

Hearing More Than One Language Helps a Child Many people believe that babies who grow up in households where more than one language is spoken have difficulty learning to talk. Quite the contrary: instead they have the opportunity to learn the unique sounds (phonemes), rhythm and melodies of more than one language. This makes it easier for them to speak that language later in life, even if they haven't heard it for a long time. Babies who hear more than one language may combine the languages until about 3 years old. Afterward, they sort them out and speak the different languages well. Dispel Other Myths About Late Talking Some people think that late talking is a sign of laziness or a result of being one in a multiple birth. In addition, some people think that having tongue-tie, a condition in which the tissue that attaches the tongue to the bottom of the mouth is tighter and thicker than normal, causes speech delays. None of these cause speech problems.

Practice Makes Perfect and Then… When children start to talk they often like to practice. They talk to everyone and everything. They may seem to be quiet only when they sleep.

References: Hay WW Jr. et al., eds. (1999). Current Pediatric Diagnosis and Treatment, 14th ed. Norwalk, CT: Appleton and Lange.

Montgomery TR (1994). When "not talking" is the chief complaint. Contemporary Pediatrics, 11(September):49-70.

Shonkoff JP (1996). Language delay: Late talking to communication disorder. In Rudolph AM et al, eds., Rudolph's Pediatrics, pp. 124-128. Stamford, CT: Appleton & Lange.

Wang PP, Baron MA (1997) Language - A Code for Communicating. In Batshaw, ML,ed., Children With Disabilities pp. 275-292. 4th ed. Baltimore, Maryland: Paul H. Brooks Publishing Co.

Coplan J (1995). Normal speech and language development - An overview. Pediatrics in Review, 16(3):91-100.

Bashir AS, Stark RE, Graham JM (1992). Communication disorders. In MD Levine, WB Carey, AC Crocker, eds., pp. 557-561. Developmental-Behavioral Pediatrics, 2nd Edition. Philadelphia, PA: W.B.Saunders Company.

--Her royal jennyness 22:39, 26 July 2007 (CDT)