Red flags in Speech and Language for a Child
We are going to address, what are the red flags in speech delay and language disorders for children. My name is Patricia Ruiz and I am a bilingual speech language pathologist, and I’m here just to educate parents a little bit on what they should look for.
So, babies, at 12 months, should be saying their first words, such as “Mama” and “Papa”. They should have been babbling and cooing since eight months on. First words are very important, because they are developmental milestones; they go together, such as walking, that should be in the first twelve months. Such as sitting, that should be in the first six months. Such as talking, which is important. If your baby starts walking, before he starts talking, that’s okay, because usually one milestone takes over the other milestone. But if he is not meeting any of the milestones at the correct time, then that could be a red flag for your baby.
Baby speech developmental milestones. When to worry?
So, what should you look for? A twelve-month-old baby should say at least one word, besides “Mama” and “Papa”, then the next word, such as animal names and things like that. What is an inappropriate sign, for example: Your baby should respond to his name when he is being called. He should be able to have eye-contact with a parent, for at least one minute. He should be able to engage in a play routine, with other children or with parents themselves. If you notice that your child has poor eye contact or poor eye gaze, he is not babbling as he should, he’s not saying “Mama” or “Papa” or “Tata” or any of those kind of words, that go with the vocal “a”. You should talk to your pediatrician about it because this could be a red flag.
So, once you’ve realized that your baby is twelve months, and he’s talking appropriately as he should, we should move on to one or two years old, which is when they start acquiring language, and then to two to three years old. Two to three-year old’s is the most important part of language communication. It’s when children acquire the most words – they can acquire from 50 to 500 words at the age of two. They learn how to add words, add nouns, add verbs, add proverbs. So, from two to three it is the most crucial time for children to develop language. If you notice, or you have concerns, you’re probably right. If you are concerned about your child’s speech, there probably is something wrong. So please don’t wait till they’re three or four, because somebody tells you that they started talking late. The most important part is from two to three.
Now, what are the red flags in speech delays from two to three, for children? If your child is not putting two words together, such as a verb and a noun, like “Mommy eats” “Mommy Sleep”, that is not appropriate. If they are putting two words together that are just nouns, it’s not appropriate. It has to be a verb and a noun, and then adding on from there. They should do two to three word utterances or phrases. They should have eye contact. They should be able to play with other kids. In such instances, such as autism, there are some very immediate red flags when it comes to language, for kids hat are about two years old.
Autistic children, for the most part, don’t have any eye contact. They do not respond to their name. They are compulsive about doing certain things. They have echolalia, which most parents think is okay, because you’re repeating words, but they are not being used functionally. Words need to be used functionally. They need to call their Mom “Mom”. They need to use words in a communication. No gestures, and no physical pointing. We want kids to use the words appropriately. So, autistic kids most of the time, repeat words, which is called echolalia. They will have physical directions, so they will take their parents to point to the things they want. They’ll use gestures. They won’t respond to their name. They’ll flip the light switches on and off. They might start walking on their tippy-toes. There are very interesting characteristics for kids with autism. So, if you see any of it, it doesn’t mean that he has, or she has, autism. It just means that it might be a red flag.
These are important things related to speech delays, that you should definitely talk to your pediatrician about, and get a referral for a speech and language evaluation, because we know that autism is, the majority is, a social pragmatic disorder. It’s a communication barrier. So, the most important person in that equation for autism, is a speech language pathologist. So, besides autism, that is a very common disorder now a days, it’s getting more prevalent, especially in boys.
There are other disorders, such as a language disorder. So, let me first explain, what is a language disorder? So, communication is separated into three areas. There’s speech. There’s language. There’s pragmatics.
Speech is your articulation. Are you intelligible? Your pronunciation. Are your sounds perfect when you say the “s” sound, the “r” sound. That, we talk about as being speech impediments. Speech impediments are pronunciation mistakes, so if you have a lisp, if you can’t say the letter “r”. Or you talk too fast. You talk too slow. You don’t pause in the right places. Those kinds of disorders are considered to be speech related. Now, language disorders, there are two kinds of language disorders. There’s receptive language disorders, which are; do you comprehend? Do you comprehend the language that is being spoken to you? Can you identify things? Are you receptively understanding and listening to what is being said to you? So, that is considered a receptive language delay, and then there is the expressive language delay, which is what you say. Not exactly if you are pronouncing those sounds correctly, but are you grammatically correct? Are your sentences correct? Is your verbal production, that you’re putting out, correct? So, there are many different aspects of different speech, language, receptive, expressive, disorders, delays, and then of course there’s pragmatic delays. Your social skills. Do you greet people when you walk through the door? Do you say “hi”? Are you socially acceptable? Do you give people personal space? Do you wait for people to answer questions? All these things are social language, which us as humans, separates us from animals, that we’re socially able to have a social language without words. So, speech language pathologists also take care of pragmatic skills. Are you socially, appropriate when you meet other people? Do you have good eye contact? Do you not look down? All these things are the things you have to take notice of when you have kids, and see if there’s a red flag.
When and how to look for a Referral to Speech Therapy
Once you’ve identified, or you’ve thought to yourself, okay, maybe there’s a red flag, maybe my son or daughter is not exactly on point, what should you do? My recommendation is that, you call your pediatrician, and you request a speech language pathology referral. So, most of us work with insurances. You need to make sure that your pediatrician gives you a referral, so you’re able to contact a speech language pathologist, so that they can evaluate your child. Most pediatricians would tell you that, they’ll ask you why, and you’ll just state your concerns and that should be enough. Your concerns should be enough for a referral. Once you have a referral in your hand, you should contact your insurance company, and make sure that your policy does cover speech therapy, and where, and have them provide you a provider that’s in their network, so it could be easier for you to contact somebody. Then once you contact the correct provider from your plan, a speech pathologist should be able to evaluate your son. They’re going to give them a formal assessment depending on what the prescription says, so it is important that you explain to the pediatrician, what your concern is. Is it a pronunciation concern, is it that he doesn’t listen, or is it that he doesn’t speak in many words? Like, you need to be specific, because we will conduct assessments based on what your prescription says, and then once you get to the therapist you should be in good hands.
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Patricia Ruiz, Executive Director at Miami Speech Institute, identifies the Red flags in Speech and Language for a Child. Speech delays, Autism and most common speech and language disorders are addressed.