If you’ve ever tried to learn a foreign language, you can appreciate how difficult it is to hear, understand, and speak. Over the first two years of life, babies are hearing, processing, and learning to create language and communicate with those in their environment.
Here are some things that you can do to help your baby communicate:
-Respond to your baby’s smiles and coos. Repeat their sounds. If babies don’t ever get any kind of response when they try to communicate they may lose communication skills. Loving parents are so vital to communication!
-As you care for your baby through the day, talk to him or her. “Mommy’s folding your shirt. Do you see the flowers on your shirt? Here is where you spit up. Look! It’s all clean now!”
–Read to your children. Find books that have colorful pictures and are easy for you to read. Rhyming books help them hear sounds. Try to read one or two short books before your child lies down for a nap or goes to bed. As you read, point out pictures in the book. Support your local library. Share books with friends.
–Ask your child questions. “Where’s the ball? What is that?”
-For global families: Children that grow up hearing and speaking multiple languages are thankful for the ease with which they learned these languages. A child growing up in these homes will still show early signs of healthy communication. They will smile, babble, try sounds, and say words. They may appear slightly delayed as they are learning what words or language to use with the specific people they are speaking to, but this is not a true delay if they don’t have any of the red flags as listed below.
Red Flags
While we don’t want to compare our child to other people’s kids, we must be on alert for red flags that our child may have a communication disorder. Early recognition, means that your child can get help sooner to reach their full potential.
Here are what we call red flags (a sign that this child needs to be further evaluated):
6 months- Not laughing, making sounds, or not copying or responding to sounds of others.
9 months- Not babbling; Not responding or turning toward their name being called.
12 months- Not saying “Mama” or “Dada” specifically; Not pointing to objects or actions; Not waving “bye”, playing “peek-a-boo”, or some other type of verbal routine.
18 months- Failing to follow your simple instruction without a gesture, such as “bring me your cup”, Speaking less than 5 words (not counting Mama or Dada)
2 years- Other adults can’t understand your child when he speaks more than 50% of the time; No 2 word combinations
3 years- Other adults can’t understand your child when he speaks more than 25 % of the time; No word combinations greater than 3 words.
At any age- Losing language skills that a child had previously (not saying words that they had said before) and failure to participate freely and frequently in social interactions.
What now?
For communication disorders,
watchful waiting is NOT the best strategy
First, share your concern with your child’s doctor:
-Try to give clear examples of your concerns. Make a list of your observations. (Sometimes it’s difficult to remember things to mention in an exam room when your kids are actively opening every drawer in the office.)
-Do you have a family history of communication disorders? It would be helpful to know if any family members required speech therapy.
-Any concerns with hearing? Has your child had a lot of ear infections? One of the first steps if we have any speech delays is to get a formal hearing evaluation.
-Some children may benefit from a more detailed developmental examination, especially if they are missing developmental milestones in other areas.
Take your child to the appropriate therapist:
-Most communication disorders will be referred to speech therapist who will do a complete evaluation and will develop a communication plan.
-Some children with communication disorders may benefit from seeing a developmental specialist and multiple therapists. (Since there is often a waiting list to get in with a specialist, I prefer that my patients start therapy right away before they get a formal diagnosis. How they respond to therapy is a helpful piece of information for the developmental specialist.)
-Some communication disorders may be related to a type of anxiety disorder and would best benefit from seeing a behavioral therapist.
–In the United States, all states have an early childhood intervention program that is free. Parents can call in themselves and report their concern. A therapist will come to the home, evaluate the child, and develop a plan.
-Pediatric developmental specialists are not as readily available internationally, but most countries should have access to speech and occupational therapy. If you live in a limited resource setting, then take advantage of the resources listed below and go ahead and begin therapy with what is available in your area.
Resources:
Here are some useful websites to assist with communication needs:
– CDC milestone tracker (this is a free app that you can download to track every stage of development and it provides tips for how to encourage your child’s growth in areas that need help.)
– Autismspeaks.org (Even if your child does not have an autism diagnosis, the resources to aid communication from this website can be very helpful.)
– First words project, 16 gestures by 16 months. Firstwordsproject.com/about-16by16
Here are some useful books as recommended by a developmental nurse practitioner:
– The Late Talker: What to do if your child isn’t talking yet
– A Parent’s Guide to Speech and Language Simulation Techniques for Children 1-3 years
– The Parent’s Guide to Speech and Language Problems
– Born to Talk: An Introduction to Speech and Language Development
This post was written based on a continuing education talk, “Communication Disorders” from NAPNAP PedsCE: Online for Pediatric-focused APRNs given by Daphna S. Zack DNP, APRN, CPNP-PC (retrieved October 7, 2023)
Healthy Global Kids 