Speech Therapy - does my toddler need it?

Monitoring their child’s development milestones is the favourite past time of most new parents. Children acquire and understand language at different rates too and watching your child develop his communication skills is one of the joys of parenthood. But some times children do have difficulties learning to speak or have below-average vocabulary. In such cases, it’s natural that you’ll be worried about speech problems in your toddler who seems to be taking time at it, especially if you know other children of the same age have already mastered their stage.

As a parent, your desire to help your child is normal and you may be considering taking your child for speech therapy. At the same time, parents of today are probably much more competitive and pushy than parents of a generation ago - a reflection of the times we live in. But before pressing panic buttons, you should also realise that while most children follow a general timeline, they cross speech and other developmental milestones at different rates. If your baby is premature he may lag slightly behind his full-term peers in both verbal, physical and social development

Speech and language therapy involves the management of disorders of speech, language, communication and swallowing in children and adults. The danger is when you think your developing toddler is speech-disordered, but in reality he is simply at a normal stage of speech development which does not yet include the full adult inventory of sounds.

Sometimes speech delay in children can simply be due to lack of communication with parents and other adults. Also, as with walking, learning to talk late may simply be a family trait. Twins who develop a special language between themselves may also talk later than other children. It's important for parents of bilingual children to know speech delay may also be sometimes caused by bilingualism. Recognising for sure whether your toddler has a genuine speech problem or it’s just overzeal on your part, will help you decide correctly, whether your child needs speech therapy or not.

As per The Royal College of Speech & Language Therapists, which is the professional body for speech and language therapists in the UK, the need for therapy becomes necessary in case of the following:

In babies
- Your baby has feeding or swallowing difficulties

In Children
- Mild, moderate or severe learning difficulties
- Physical disabilities
- Language delay
- Specific language impairment
- Specific difficulties in producing sounds
- Hearing impairment
- Cleft palate
- Stammering
- Autism/social interaction difficulties
- Dyslexia
- Voice disorders
- Selective mutism

It is a good practice to monitor your toddler’s growth and development but obsessively worrying about your child’s speech development and taking him to a speech therapist even though he is quite little and doesn’t really need it can be stressful for the little one.

What's normal for my toddler?

It is completely normal for toddler's to mispronounce words, toddlers find it hard to say 'TH' for example and often replace 'th' with an 'f', so 'Thank-you' becomes 'fankoo' and 'bath' becomes 'barf'.
Toddlers also blend words together so 'Baa baa black sheep' can become, 'baa-r-ack-eep' which is totally normal.
The main thing to look out for is that your toddler's speech is improving - if, for example, you have pointed out an owl in your child's picture book, it is normal for him not to be able to say 'owl' straight away. But if you point the owl out to him four or five times over a few weeks, he should start to make the word 'owl' with his mouth, even if it comes out as 'ow'. As long as he tries it and the sounds he is making improve over time his speech is normal.
It is also normal for toddler's to become frustrated when trying to explain something to you - this is actually a good sign because it means they are trying to form words and will probably search for new words to help themselves to be understood.
Your child speaking with a lisp is also normal for young children and most children grow out of it by the time they reach seven years old. To help your child, take away dummies and bottles and give him a sippy cup which helps to strenghen oral muscles and give your child a straw to drink his drinks; this can also help promote good oral strength.

What's not normal?

If your toddler doesn't react to sounds such as their name being called, or bangs and pops from the Television, you should take him to the GP to get his ears checked. It may not be bad hearing, but something like fluid in the ears which is preventing him from hearing properly.
If between about 20-24 months (approaching two years) your child is still using single words and is not trying to form sentences it might be worth taking him to the GP. The sentences don't have to long, three or four word sentences is normal for a toddler to try to attempt at this stage.
If you toddler uses one word for everything; 'da' for milk, mummy, car, bus.
Doesn't point to pictures in picture books and doesn't attempt at least to say what they are, 'cat' or 'duck' for example.
Doesn't get frustrated at all when trying to explain something and simply gives up when he is not understood.
Hasn't learnt words like, 'bye-bye', 'Hello', 'mummy' or 'daddy', or a similar toddler interpretation of these words.
Doesn't appear to be progressing from month to month. Even if you child starts to talk later than other children, you should still see progress being made from month to month. He should be forming new words, trying to string short sentences together 'me wan milk', for example and speaking more clearly as time progresses. If he isn't and you are concerned, take him to your GP and explain your worries. Your GP will probably check his ears to make sure there are no problems and you may be referred to a speech therapist if your GP thinks it necessary. More often than not, parents are sent home from the GP after being told that their child is completely normal! However for piece of mind it's always worth making an appointment if you are worried.

Do keep in mind that the normal timelines for language development is long and it’s normal for occasional bumps along the way. However, if you still feel something is amiss, bring it up with your child's health visitor or GP. He will assess what your child can both understand and say, and can identify if your child is attempting to communicate in other ways, such as with gestures. They can also check how your child’s mouth, tongue and palate may be impacting on her speech development.

There is a lot you can do to help your child develop and improve her speech. Read to her often, pointing to things she sees in her books and labelling them so that she associates the word sound with the image. Talk to her as much as you can, keeping up a running commentary of what you and she are doing throughout your day, asking her questions and pausing so that she can answer you and say what she wants to.

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.

Last Modified: 19/03/2010

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