As parents of infants and toddlers, it can be challenging to make sense of all the conflicting information on the internet regarding language development. When you don’t hear your child’s first word by 12 months, there are several questions that come to mind: Should I “wait and see” how my child develops over the next several months? Is there a way to predict whether my child is just a “late bloomer” and will naturally catch up? Is there anything I can do to improve outcomes for my child?
If you have had any of these thoughts regarding your late talking child, you are not alone. Our speech language pathology team is here to help!
Late language emergence, more commonly known as late talking, refers to a delay in spoken language onset with no other diagnosed disabilities or developmental delays. Late talkers may present with expressive language delays alone, meaning there is only a delay in what your child says. Late talkers may also present with mixed expressive and receptive language delays, meaning there is a delay in what your child says and understands. The following are expected expressive language milestones in the first two years of life:
2-5 months: Cooing and laughter
6-7 months: babbling (ba-ba, ma-ma, di-di)
12-15 months: 2-6 words
18 months: 50 words, use of a variety of gestures (pointing, nodding and shaking head, waving)
24 months: 200 words and spontaneous two word combinations
The current accepted definition of late talking by the American Speech Language and Hearing Association is fewer than 50 words and no two-word combinations by 24 months (Paul, 1991; Rescorla, 1989). However, if your child is not utilizing words by 15-18 months, early assessment by a speech language pathologist can help to determine whether language intervention is necessary to support your child’s development. In addition, during an initial assessment, the speech language pathologist will share recommendations for how you can best support your child’s communication at home.
Late talking is relatively common, with an estimated 10-20% of two year olds presenting with delayed expressive language abilities (Rescorla, 1989; Rescorla & Alley, 2001; Roulstone et al., 2002; Zubrick et al., 2007). Every child develops at a different rate, and it is true that late talking children may catch up to their peers in time. However, the following risk factors indicate that a late talking child is more likely to have continuing language difficulties in the absence of intervention (Olswang, 1998). These include:
A history of ear infections
Limited number of consonant sounds (eg. p, b, m, t, d, n, y, k, g, etc.)
No linking of pretend ideas and actions together while playing
No word imitation attempts
Use of mostly nouns (names of people, places, things), and few verbs (action words)
Difficulty playing with peers (social skills)
A family history of communication delay, learning, or academic difficulties
A language comprehension delay: Delayed language comprehension is a significant predictor of language outcomes in late talkers (Weismer, 2007; Thal et al., 1991).
Use of few gestures to communicate
Early identification and intervention can mitigate the impact of these risk factors (Guralnick, 1997, 1998; National Research Council, 2001; Thelin & Fussner, 2005). 50-70% of late talkers catch up to their peers and demonstrate typical language development by late preschool and school age (Dale et al., 2003, Paul et al., 1996). The following have been identified by the National Joint Committee on Learning Disabilities (NJCLD, 2007) as ways to improve your child’s outcomes:
Expose your child to rich and varied vocabulary, sentence structures, and patterns of discourse: Regularly talk to your child and vary the way in which you talk. Many parents will label nouns all day in an attempt to get their child to imitate. While labeling is an important strategy in helping your child learn to talk, it is not the only strategy. You want to expose your child to comments, exclamations, questions, descriptions, and all of the ways in which we communicate with others on a daily basis. If your child is playing with a toy ball, try varying your language as you join in their play: “Wow! A ball! Can you throw it to me? Ready, set, go! This ball is so big! Do you want a turn? Ok, here it comes!” You certainly don’t want to bombard your child with language all day. Research has shown that learning language is more about the quality, not the quantity, of communicative interactions. As you interact with your child, make sure to pause to give your child the opportunity to look, gesture, vocalize, and join in the communication interaction.
Provide your child to responsive learning environments: If your child is not yet using words, use whatever skills they are already demonstrating to start a conversation. Is your child looking at something outside? Follow their gaze, point, and say “Oh! I see the bird! Hi bird!” In this example, you can pair the word “hi” with a wave to model for your child multiple modes of communication. Is your child cooing or babbling? Respond to your child as if they are saying real words. It can be as simple as “I hear you” or “I love you, too” or even a question like “Do you think so?” This may feel silly at first, but helping your child understand the back-and-forth of conversation is a great place to start building communication skills. If your child is starting to use words, this same strategy applies. Imitate and expand on your child’s utterances as you interact. If your child is playing and says“car” you can push the car and say “Car! Car go! Vroom!” Linking your language with the objects, people, and actions in the immediate environment is the best way to help your child to learn.
Read regularly to your child: Shared storybook reading is a great way to build language skills. You can point to the pictures and label what you see, ask your child questions, and describe what you see in the pictures. Early reading is also a way to promote pre-literacy skills that are important to later literacy development.
Involve your child in structured and unstructured individual and group play interactions: Play is a wonderful way to build communication skills. During play, verbal routines are a great strategy to provide your child with predictable language. Just a few examples are ready, set, go!; 1,2,3, whee!; and peak-a-boo! Combine gestures with your language in play, such as holding up your hands when you say “boo!” in peak-a-boo. When possible, involving peers in play with your child can further aid your child’s language development. Peers model language and gestures at a developmentally appropriate level, and children often learn from imitating their peers.
Seek out communication supports and services as needed: Speech language pathologists are experts when it comes to communication development. By assessing your child’s expressive language, gestural communication, receptive language, social communication skills, and play skills, speech language pathologists develop a plan to meet your child at their current skill level and use evidence based strategies to support your child’s learning. They can recommend strategies that are tailored to your child’s abilities that empower you to promote your child’s communication development.
Dale, P. S., Price, T. S., Bishop, D. V., & Plomin, R. (2003). Outcomes of early language delay: Part I. Predicting persistent and transient language difficulties at 3 and 4 years. Journal of Speech, Language, and Hearing Research, 46, 544-560.
Ellis, E. & Thal, D. (2008). Early Language Delay and Risk for Language Impairment. Perspectives on Language Learning and Education, 15: 93-100.
Guralnick, M. J. (1997). The effectiveness of early intervention. Baltimore, MD: Brookes.
Guralnick, M. J. (1998). Effectiveness of early intervention for vulnerable children: A developmental perspective. American Journal of Mental Retardation, 102, 319-345.
National Joint Committee on Learning Disabilities. (2007). Learning disabilities and young children: Identification and intervention [Technical report]. Available from www.asha.org/policy/.
Olswang, L. B., Rodriguez, B., & Timler, G. (1998). Recommending intervention for toddlers with specific language learning difficulties: We may not have all the answers, but we know a lot. American Journal of Speech-Language Pathology, 7(1), 23-32.
Paul, R. (1991). Profiles of toddlers with slow expressive language development. Topics in Language Disorders, 11(4), 1-13.
Paul, R., Hernandez, R., Taylor, L., & Johnson, K. (1996). Narrative development in late talkers: Early school age. Journal of Speech and Hearing Research, 39, 1295-1303.
Rescorla, L. A. (1989). The Language Development Survey: A screening tool for delayed language in toddlers. Journal of Speech and Hearing Disorders, 54, 587-599.
Rescorla, L. A., & Alley, A. (2001). Validation of the Language Development Survey (LDS): A parent report tool for identifying language delay in toddlers. Journal of Speech, Language, and Hearing Research, 44, 434-445.
Rice, M. L., Taylor, C. L., & Zubrick, S.R. (2008). Language outcomes of 7-year-old children with or without a history of late language emergence at 24 months. Journal of Speech, Language, and Hearing Research, 51, 394-407.
Roulstone, S., Loader, S., Northstone, K. Beveridge, M., & the ALSPAC team (2002). The speech and language of children aged 25 months: Descriptive data from the AVON Longitudinal Study of Parents and Children. Early Childhood Development and Care, 172, 259-268.
Telethon Institute for Child Health Research (2008, May 16). Mixed Results For Late-talking Toddlers. ScienceDaily. 16 May 2008. Web. 10 Jun. 2011.
Thal, D. J., Tobias, S., & Morrison, D. (1991). Language and gesture in late talkers: A one year follow-up. Journal of Speech, Language, and Hearing Research, 34(3), 604-612.
Weismer, S. (2007). Typical talkers, late talkers, and children with specific language impairment: A language endowment spectrum. In R. Paul (Ed.), The influence of developmental perspectives on research and practice in communication disorders: A festschrift for Robin S. Chapman (pp. 83-102). Mahwah, NJ: Erlbaum.
Zubrick, S. R., Taylor, C. L., Rice, M. L., & Slegers, D. W. (2007). Late language emergence at 24 months: An epidemiological study of prevalence, predictors, and covariates. Journal of Speech, Language, and Hearing Research, 50(6), 1562-1592.