Does My Child Need Speech Therapy?

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Does My Child Need Speech Language Therapy?

By Adrienne Frohlich, M.S., CCC-SLP

Your child may be a "late talker", is difficult to understand, or just seems to be developing speech and language differently than his peers or siblings. His speech and language milestones may seem to lag behind his other areas of development. 

There is a wide age range for appropriate development for speech and language milestones, and changes can happen rapidly at any point. Your toddler may experience a ‘language explosion’ seemingly overnight. 

However, if something about your child’s communication concerns you, the first step is to discuss them with your pediatrician. They may refer you to a speech pathologist or other specialist, and can refer you for a full audiologic evaluation. A complete hearing test (not a screening) is essential for any child with a possible communication delay. Even if you think your child has normal hearing, a mild hearing loss or difficulty caused by chronic ear infections can have a significant impact on the development of communication.

Referring to charts on typical ages for development can be helpful, but are not necessarily a cause for alarm if your child is not mastering every skill at exactly the right age.

There are some red flags that should be addressed at any age:

  • Difficulty with chewing or swallowing or excessive drooling
  • Shows little interest in communicating
  • Appears to have difficulty understanding basic language
  • Has delays in more than one area
  • Makes limited eye contact, does not use gestures

Ages listed with some Red Flags

6 months

>Does not laugh and squeal
>Does not look toward new sounds

9 months          

>Has limited or no babbling
>Does not indicate when happy or upset

12 months

>Does not point to objects
>Does not use gestures such waving or shaking head

15 months

>Has not used first word
>Does not respond to “no” and “bye-bye”
18 months       
>Does not use at least six to ten words consistently
>Does not hear well or discriminate between sounds

20 months

>Does not use at least six consonant sounds
>Does not follow simple directions


24 months   
>Has a vocabulary of less than 50 words
>Has decreased interest in social interactions
36 months
>Strangers have difficulty understanding what the child is saying
>Does not use simple sentences
From Linguisystems Guide to Communication Milestones1


You know your child best, and if you are concerned, do not wait to seek help from a professional. Evidence shows that early intervention can be very effective, and the sooner you seek help the better the outcome will be for your child. 

An evaluation will consist of observing your child, playing with developmentally appropriate toys, and asking questions to the parent or caregiver, and can even take place in the home environment where your child feels most comfortable.

Even if the SLP determines that your child does not need speech therapy, they will obtain a baseline measurement of your child’s communication development, which can be used as a comparison if your concerns persist after a period of time. The SLP can monitor your child’s progress and provide you with recommendations to stimulate your child’s language development at home.

Need help answering some more of your questions?  Try TherapyfindR concierge 

Adrienne Frohlich is a licensed bilingual speech-language pathologist. She has extenisve experience with children and works privately with clients in the New York City area.  Adrienne is also an entrepreneur, check out the nurse purse at www.nursepurse.com  To read more about Adrienne, check out her full profile. 

1Lanza, J.R., & Flahive, L.K. (2009).  Linguisystems Guide to Communication Milestones.   East Moline, IL: LinguiSystems, Inc.

16 April 2013 15:44
by Adrienne Frohlich, MS., CCC-SLP