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When to Consider Speech Therapy for a Toddler

by Sharon Perkins , studioD

It takes time to learn to talk, but if your kid is the last one in his playgroup to master the basics of communication, you're probably ready to hustle him off to speech therapy. The trend today is to start speech therapy as soon as you notice a problem, rather than waiting until he hits kindergarten. If this is your first rodeo, it's not always easy to recognize when your little conversationalist needs help. Delayed speech, garbled speech and disinterest in communicating can all be reasons to make an appointment.

Delayed Speech

Many people know Einstein was a late talker, so thinking that your budding genius is just taking after other exceptionally bright people is a comforting thought if you have a late talker. "Late" speech is a matter of degree, since not all kids start using recognizable words at the same age. But most toddlers appropriately use at least one or two common words, like mama or dada, by 15 months and use gestures such as pointing to objects or waving bye-bye. By age 2, most use around 50 words and start to combine two to three words into short sentences, according to Kids Health. At 3, your toddler should use between 250 and 500 words in three- to four-word sentences. If your little one is far off the mark or if you can't understand anything he says by age 2, talk to his pediatrician about speech therapy.

Lack of Speech

Not speaking at all, making very few sounds or not using gestures to communicate isn't the same thing as talking late. All toddlers should try to communicate in some way. Their early attempts at speech, called jargoning, usually sound so much like actual conversation you might have to listen closely to make sure he isn't reciting the Gettysburg address. If he doesn't make many sounds at all, only repeats words that you say, doesn't use gestures to communicate, speaks in a monotone or raspy voice or stops using words he previously used, bring it to his pediatrician's attention, since hearing loss or developmental disorders such as autism can cause absent or little speech.

Pronunciation Difficulties

Some mispronunciations are both common and cute in toddlers. Many have trouble with certain sounds, including l, s, th and r, even up until around ages 5 to 7. By age 3, your toddler should be able to pronounce vowels accurately, as well as the consonants p, b, m, t, d, n, w, y and h, speech language pathologist Shelley Hughes explains. Around 5 percent of kids stutter for a short time and in 1 percent, stuttering persists, according to PubMed Health. While it might drive you temporarily wild to hear him stutter, give him a few weeks to get past it before rushing to the speech therapist.

Garbled Speech

If your toddler's conversation sounds more like alphabet soup than understandable words at age 3, he might have childhood apraxia of speech. Kids with apraxia understand language and know what they want to say, but have difficulty making it come out of their mouths correctly. If your toddler has apraxia, his speech might be choppy or have an odd cadence, or he might put emphasis on the wrong syllables of words. He might also put words out of order. Childhood apraxia of speech needs specific speech therapy techniques, including evaluation of the muscles and coordination of the parts needed for speech, such as the lips, tongue and cheek muscles.

About the Author

A registered nurse with more than 25 years of experience in oncology, labor/delivery, neonatal intensive care, infertility and ophthalmology, Sharon Perkins has also coauthored and edited numerous health books for the Wiley "Dummies" series. Perkins also has extensive experience working in home health with medically fragile pediatric patients.

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