Those first attempts at language are one of the most anticipated milestones of childhood, with parents eagerly awaiting that “mama” or “dada.”
When a child’s speech seems to lag behind others their age, or the child is difficult to understand, well-meaning friends and family members often assure parents the kid will outgrow it.
With 21 years of experience as a speech-language pathologist (SLP), Prentiss Stidham encourages families not to wait.
Communication difficulties can affect a child’s behavior, social interactions and academic life.
Think of the child who has a meltdown from the frustration of not being understood, who may be isolated in the lunchroom or playground because other kids can’t understand them, who is unable to participate fully at school.
“Well-meaning parents listen to others that tell them that your child will grow out of it, just wait. If you have concerns, seek out a certified SLP who can give you some guidance,” Stidham said. “They can really answer your questions, ‘Is this typical for a child?’ or do an evaluation to get more information.”
When a child does need help, she said, “early intervention is going to more effective, it’s going to be less costly and treatment is usually shorter. You really don’t want to take a wait-and-see approach.”
Stidham has been an SLP at John Sevier Elementary school for 18 years and now is working part time at the school in addition to launching a private practice, where she is able to work with younger children and have more time interacting with parents and other caregivers.
Difficulty with speech — producing sounds — and language — using and understanding words — can be difficult for the untrained to identify because signs can be subtle, such as not smiling or interacting with others, something family members may dismiss as the child being shy.
At different stages a child may not be babble, not have as many words as others their age or struggle to make sentences. Close family members may understand their speech, but others don’t.
An older child may utter only a single sentence when asked, “What did you do this summer?” instead of being able to tell a full story.
To help families, the American Speech-Language-Hearing Association has a website — identifythesigns.org — with what to look for at different stages and a link to find professional help. Schools, health care providers and early intervention systems also can guide families to help for evaluation and services.
Stidham particularly encourages families to seek help before children start school, so they are ready to succeed academically and socially in kindergarten.
“If they don’t have the communication skills, friends don’t interact with them, and if they don’t have good speech and language skills, that also affects the ability to learn to read and write,” she said.
Speech services are available from birth to age 21, she said, but early intervention services often start around age 2.
“The more we can set kids up for academic success the better,” Stidham said. “We don’t want to miss that opportunity.”
Working with a very young child on speech and language development can take the form of play, such as making motorboat sounds at bath time so children learn to use their lips and tongue, Stidham explained.
The natural give-and-take of conversation — I say something, you say something back, I respond — is part of developing a child’s language skills.
Children can learn to use pronouns like “I” and “you” and spatial words such as “in” and “out” through everyday activities, as they are eating, getting dressed and playing.
When a child who has struggled to communicate finally is understood by others, Stidham said, “You just see that light in their eyes.” Confidence blooms.
“I get a thrill out of seeing when children have the ability to be understood by others,” she said. When children can use words to explain what they want it’s wonderful for their caregivers, too.
For older children it can be a transition from hanging back and being isolated to fully participating in the classroom.
Recently a daycare worker told Stidham a child has begun saying “Hi” to her.
“That is a big moment,” the speech-language pathologist explained, “because when that door is open, that relationship is established, then it just blossoms from there. That’s all you need to begin a conversation.”
Jennifer Davis’ son, Brandon, was diagnosed with developmental delays in his first year. “His main way of communicating was grunting,” she said, and he wasn’t crawling. He began receiving occupational, physical and speech therapy early.
Later he was diagnosed with apraxia of speech. “The brain and the mouth don’t communicate,” she explained. He couldn’t get the words out.
In a developmental preschool program, he received speech services two or three times a week, and the family also worked with him, at first just praising sounds. By first grade he was talking. Now, she said, “he doesn’t stop talking.”
“It’s not going to happen overnight,” she said of the progress. In addition to working with an SLP, “parents need to practice those skills.”
“I don’t know what I would have done without Prentiss,” who has worked with Brandon for three years, Davis said. “She understands my kid,” and understands the difficulties parents experience.
“I don’t know what I would have done without any of the therapists,” the mom said.
Brandon still has some language difficulties. He may leave out words and has trouble understanding idioms, like when someone says something was “a piece of cake.”
Davis, who has worked as speech therapy and special education assistant in schools, said that when a parent senses something isn’t on track with a child, “You have to trust your momma gut” and find the right person who can help your child.
Have a conversation
One of the most important things parents and other caregivers can do, in addition to reading to children, is simply to talk with them.
“Anything a child is playing, you can be talking with them about,” Stidham said. “They will love it because you are giving them attention about something that is important to them.”
Even taking a walk together or pushing a child in a stroller and talking about what is going on around them helps. “It’s just the everyday interactions that allow you to have fun with communication,” she said.