Does My Child Need Speech Therapy?

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Does My Child Need Speech Therapy?

By Hallie Bulkin

Does your two-year-old struggle with his/her “B’s” and “P’s”? Do your husband and friends have a hard time understanding your three-year-olds speech? Are you the only one who truly understands what your child is saying? It is possible that your child is experiencing a speech and/or language delay. Studies show that around 10 percent of children in America suffer from speech disorders.

Most children have certain sounds they stumble on when they are under four years of age. But at what point is it no longer “cute” that your child calls a rabbit a wabbit and an animal an aminal. How do you know when to get help?

Rest assured that no child speaks perfectly when they start talking. That said, it can be tricky as a parent to identify if what your child is doing in their speech and language development is normal or “off track”. Before you hire a Speech-Language Pathologist (SLP), keep reading for a better understanding of normal development versus when it may be time to pick up the phone and make that call.


A few things to look for between the ages of 2-4…

Age 2

Children typically produce their first single words around their first birthday. It may be hard to understand the words they are using and their vocabulary may be limited, this is normal. By age two they should be starting to combine two-words into simple phrases to make requests, initiate, protest, respond, and comment. Sample phrases follow a specific format, for example:

  • Description word + Object (Big car)
  • Possessor + Object (My car)
  • More + Object (More car)
  • All done/gone + Object (All done car)
  • Negative + Object (No car)
  • Object + Location (Car out)
  • Person doing action + Action (Daddy go)
  • Action + Object (Go car)
  • Person doing action + Object (Daddy car)

Age 3

By three years of age, your child should be speaking clearly enough in 3-word-phrases so that familiar listeners (parents, teachers, day-care providers, etc) understand what your child is saying at least 75% of the time. Don’t expect unfamiliar listeners (e.g., strangers or even family members and friends who you don’t see too often) to understand your child’s speech yet. They might, but if they don’t, it’s okay.

At this age, children are not yet expected to have mastered all of their speech sounds. By this age your child should be able to pronounce: “b, p, t, d, m, n, w, h, k, g, f”. If they are struggling with any of these sounds, you should consider having your child’s speech evaluated. Sounds like “l, r, ch, s, z, sh” and sounds combinations “kw, tr, bl” to name a few, are not expected at this age.

Age 4

By 4 years of age, your child should be talking up a storm and his/her speech should be understood by familiar and unfamiliar listeners. By this age, many sounds, but not all, have been acquired. Keep in mind that during their fourth year and up into their 5th year they will be developing a majority of the additional speech sounds. Note: there are sounds that some children do not develop until 7 years of age; however, when their speech is understood mosts of the time, you don’t typically pick up on the sounds they have not yet mastered.

Furthermore, your child may need to be assessed by an SLP if he/she:

  • Appears to hear but does not appear to understand what you say.
  • Does not make eye contact with your or others.
  • Uses noticeably fewer words than other children of the same age.
  • Is very difficult to understand after age 3.
  • Stutters often and appears aware and/or frustrated by his/her stuttering.
  • Repeats syllables or sounds in a word and appears to be frustrated.
  • Does not combine words in new ways or at all after age 2.

Who should you call if you are concerned about your child’s development?

Often times the first call is to your child’s pediatrician. If your pediatrician says your child is fine but you are still worried, remember you are the parent and you know your child best. It can’t hurt to have your child screened or assessed by an SLP. You can find an SLP by contacting your local school system’s infant & toddler program or by going to the American Speech-Language-Hearing Association’s (ASHA’s) site to find a certified professional in your area.

The earlier you catch a speech and/or language delay, the better. Early intervention will affect your child in positive ways for years to come. If you have that gut feeling that you need to make the call, I urge you to do so.

Go ahead, make the call!

With Love,
Hallie Bulkin, MA, CCC-SLP

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