Tuesday, 24 July 2012

Talking and Speech Delays

My daughter is learning to talk.  It's a fascinating little process, which started a few months back with: "Ma-ma." 

These days her expressive vocabulary extends to: "Mama", "Bye-bye" (with sign), "Go!" (exclamation mark required), plus signs for "again" and "no".  Arguably, she also has a sign for "I don't want you to do that," but that's hitting, so I'm not counting it.  We also have a few environmental sounds popping up as she makes select animal and vehicle noises... "Ee" for "Cheese" when we take a photograph should probably be in this category.

This is not very impressive for a child of almost eighteen months, but it's a huge novelty for me, because at this age, her brother wasn't speaking at all.  He would very intermittently come up with a word, but a week or so later, it would be gone again.  His doctor gave him a pass at fifteen months, because he plainly understood what was being said to him, but at eighteen months we were referred to a speech therapist.

Speech Therapy

I should make it clear that my son falls more into the category of late-talkers who start speaking in whole sentences at the age of three.  He didn't; he started using single words at twenty-one months, but the point is that he started talking when he was ready rather than because of an underlying issue.  I have no intention of undermining the problems that speech-delayed children can have (I've dealt with a couple at school), so I want to put that disclaimer in.

In other words, my son didn't have any communication frustration or difficulties in comprehension. He wasn't being prevented from talking by a physical defect.  His expressive (i.e. spoken) vocabulary was non-existent but his receptive vocabulary (i.e. what he could understand) was good.  An eighteen month old should be able to understand 100-200 words, and at the very least, he was safely in that range. 

Although I doubted that there was a problem, I went ahead with the early intervention programme, because it seemed silly to assume that I was right.  As it turned out, I was... but what if I hadn't been?

The first assessment was of our circumstances, and a very pleasant woman assailed me with a long list of questions about my mental state and what resources I had for support, and anything else that might be a contributing factor.  I couldn't give her much until we got into the medication during pregnancy part since I'd gone through both IVF and Ovarian Hyperstimulation Syndrome.  We ended up with a long list of drugs, which unreasonably made me feel helpful.

The second assessment actually was of my son, and involved four people, two of them playing with him and two taking notes.  They evaluated him for everything, and he was on track for his age except for expressive speech.  The other thing that bothered them was that he wasn't doing environmental sounds.  He would mimic a lion's roar and a snake's hiss if asked, but although we had a cat, he wouldn't attempt a meow.

They asked me what targets I would like to set, which I'm sure some person has established as a way to make parents feel that they are being listened to... except it also makes us feel put on the spot.  If it wasn't for my teaching experience, I would have had no idea what should be normal for a year's time.  But we hashed out a few short-term and long-term goals, which more or less ended up moot as he 'graduated' therapy by the first of our deadlines.

His speech therapy consisted of a lovely woman coming over every Friday morning to spend an hour playing with us on the rug.  Her purpose was mostly to illustrate ways to incorporate language into play.  She gave me a few direct tips about encouraging mouth muscles (play games waving cheerios about on the end of your tongues), and I noticed that she discreetly checked my son for some of the early signs of autism, e.g. she invited him to do pretend play, which is something you don't find in autistic children; my son was happy to indulge.

We both adored her, and I was quite sorry when, after a few months, my son had caught up to the low end of 'normal'.  The only problem with speech therapy was the cost, but at least that was within our means.

Baby Signs

Our speech therapist also did some signing with my son, but this was something we were doing anyway.  I had been given the Baby Signs book when I was pregnant and had, in first-time-parent fervour, eagerly perused it and drank in every 'baby conversation' in its anecdotes.  Then I discovered that in practice, I never had both my hands free and my son's attention at the same time.  To this day, I have absolutely no idea how the really successful baby signers do it.

Even so, I signed when I could, and my son's lack of signs (and, potentially my daughter's, though I've signed much less to her) was a big tip-off to his lack of interest in communicating.  I had a friend whose son couldn't talk and was frustrated about it.  When they started signing with him, it was like a switch went on in his brain.  He couldn't get everything together for the spoken word, but he could sign.

In my son's case, he did at least use and retain a few signs: "More", "All done", waving and shaking his head.  It's possible that the availability of these signed words slowed his attempts to master the spoken words, although the general consensus with baby signing is that it's more likely to speed up speech acquisition than delay it.  I see no reason to disagree with that, and even if it did have the opposite effect on my son, I'd still think he was the exception rather than the norm.

Baby signing came into its own when he did start talking though.  He started picking up more signs first, and then one day he started saying "Up."  While not technically his first word, it was the first word he both spoke and signed.  The difference between that and the ones that had gone before ("yes" "go" and "cracker") was that he immediately started saying it in a variety of different contexts--though not for "pick me up" surprisingly.  He also kept on saying it.

From that point, he surged forward picking up all kinds of words both spoken and signed, but he was more likely to say words that he could also sign.  I'm in no way trained in this, but I'd guess that the physical action helped code the speech into his brain.  Back in high school, I used to pace around a room while memorising a passage of text, which might be the same thing (or could be totally different... like I said, I'm not trained in this).

For our part, the signs were a lot easier to understand the speech, so for several months they were a comprehension aid, and I regularly referred to this website for new signs.  They phased out gradually, I'd guess by the time he was two and a half--certainly before my daughter was old enough to start observing them.

We never got the experience with signs that the book promised, but I was glad we had them as a resource.  I don't think they're essential, and as I've already admitted, I've done very little signing with my daughter.  Still, while I've not refreshed my memory on specifics like 'apple', I do try and attach gestures to certain words.  For me, it falls into the "It won't harm, and it might help," category.  But it's not something to stress over.  If you've made the decision not to sign, feel comfortable in that.  After all, every baby learns some signs, even if it's just 'bye bye' and 'shh', and finger-play songs probably provide the same mental stimulation.

But I absolutely recommend it for any speech delay... even of the "He'll talk when he's ready" variety.

Getting Used to Normal

I never really expected my daughter to have the same speech delays, since she's not nearly as laid back as my son, but I had no inkling of what normal speech acquisition is like.  After all, a twenty month old is much further advanced in mental development.  My son might not have leapt into full sentences, but he would apply the same word to different contexts comfortably--and was unlikely to say a word if he couldn't!

My daughter on the other hand, went from babbling "Mamamama" to saying "Mama."  I've never been called Mama before.  My son went straight to a Mummy/Mommy hybrid, though now he's picked up Mama from my daughter.  I can't say I had a particular interest in being called Mama, but when it actually started, when it became her first word, oh, I was an addict.  Over time, Mama has become a more general term for "I want attention," but it's still firmly attached to me.

"Bye bye" crept tentatively into her vocabulary while "Go!" I regret to say, was picked up from Go Diego Go, her brother's current favourite show, and was initially said only in reaction to seeing a picture of Diego or Dora the Explorer.  However, her brother has picked up on her exclamation with such enthusiasm, that it's getting used in many more situations--by all of us!

Beyond the words, she's been so much more focused on her babbling than my son, practicing anything she likes the sound of--including a wide variety of tongue-clicks--and when I make a sound, she'll watch my mouth closely to see what I'm doing.

On the receptive side, I think she might be a little behind where my son was, although I can't be sure of this just based on vague journal entries, but she's certainly at the level she should be.  Her favourite book right now is Bright Baby's First 100 Words which is hauled out several times a day.  Unlike her brother, she's a lot more attentive to those environmental sounds, and delights in pointing to animals or vehicles to hear the sound I attribute to them.  For some, she'll essay her own version, although it's somewhat random.  She'll say 'hoo' for owl and 'pfft' for camel but won't attempt 'moo'?

At any rate, I'm comfortable that she's coming along at the pace that's right for her, and she's showing no signs of frustration which is the important thing.  As for her brother?  He's got the typical three year old verbal diarrhoea these days, and we have no concerns about his linguistic future.


  1. I love your attitude--no signs of frustration = fine as far as we're concerned. One of the things that really stuck with me when I studied language development is that a HUGE variation in initial start up can result in absolutely no difference down the road. Those parents who are so proud of their precocious little talker can just stuff it. Ahem.

  2. Take a look at www.littletalkers.com. It is a free resource for parents designed by a speech and language pathologist. It has free videos to watch that promote speech and language development. Most of them are very simple and you can incorporate into play and your everyday activities.

  3. Thanks for such a detailed post about speech and delay and development in tots! In our Montessori 3-6 class, we never recommended speech therapy until after age 4/5, because we had experienced so many "late communicators" who had what we called "a speech lag" catch up during the three years in a preschool setting. So it's OK to wait, or get a head start if you are a concerned parent, or just want some "extra tools in your mommy tool kit"! What I also try to explain to concerned parents is that as far as development goes, large motor action is dominant in children under age three, mostly it means there is less interest in language activities and more interest in large motor activities (crawl, cruise, walk, run, as well as ball play, play at the part, and so forth). Of course, there is always an exception to the rule! (If you are interested in my speech delay thoughts and Montessori and the like, read my post here http://montessorispecialneeds.blogspot.com/search/label/Speech%20Delays and here http://montessorifortoddlers.blogspot.com/search/label/speech%20delays.) I wrote a post on baby signing but can't find it!

    1. Found it! http://montessoriconfessions.blogspot.com/2011/03/montessori-and-sign-language-question.html