Speech/language development concerns

My just-turned three year old is very difficult for others to understand. His vocabulary is huge, and he says new things everyday, but he doesn't seem to have improved on the old words. At his three year checkup, his doctor said that if he doesn't improve, we should look into speech therapy. I'm frustrated and wonder if there is something we can do to help him improve his speech.

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Robert Steele

Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

Speech and language development is one of the most important aspects of childhood development. It begins the building blocks for other learning as the child goes on to kindergarten and grade school.

Language development also allows for further socialization. Therefore, much emphasis must be placed in how this development is progressing.

For those that seem to be having trouble with speech and language, an evaluation by a licensed speech pathologist should be undertaken. But how do you know if your child might be having a problem with his speech and language? There are certain guidelines that pediatricians tend to follow:

  • No cooing or making noises by three months of age
  • No babbling by one year
  • No words by 18 months
  • Less than 50 percent of words spoken are understandable by strangers by age two
  • Less than 95 percent of words spoken are understandable by strangers by age three
  • Any difficulty with language at age four to five

These guidelines are by no means set in stone, in fact some would argue that the age limits above are too generous, however, they tend to be the ones many speech pathologists (including my wife) use to advise pediatricians on when to refer patients for evaluation.

It seems that your son may be having difficulties based upon these guidelines. But does that absolutely mean he has a speech and language problem? No, not necessarily. However, I agree with your doctor in that he should have an evaluation by a speech pathologist. You can expect that your son will have a hearing screen and then undergo some standardized testing typically done one-on-one with the speech pathologist. It is only until he has this evaluation can you be certain whether he has a specific problem or not.

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