Does My Child Need Speech Therapy?! Answering Your Questions About Your Child’s Speech.

Heyyyy friends!!! You caught me in the middle of a two-part series on child development from the perspective of a Speech-Language Pathologist (that’s me)!

Welcome, welcome. I’m so glad you’ve joined me.

CLICK HERE to check out my language development post in part 1 in case you missed it! (There’s also an accompanying video that you should definitely hit up if you haven’t already)!!

In Part 1, we talked about WHAT your child is communicating, but now, we’re talking about how your child’s speech sounds. For those of you who are up on child development lingo, we’re talking about articulation and phonological disorders.

According to THIS article by the National Institute on Deafness and Other Communication Disorders, “The prevalence of speech sound disorders (namely, articulation disorders or phonological disorders) in young children is 8 to 9 percent.” So this is definitely a conversation worth having, friends!

Articulation issues were one of the most common reasons that I would evaluate and treat children as a Speech-Language Pathologist in the outpatient pediatric clinic where I worked.

And honestly, I KNOW the general population wants today’s information, because I get asked about speech from a lot of concerned parents in my community.

So in this post, I’m answering the three most common questions that parents have asked me regarding their child’s articulation:

Question 1: Is it normal for my child to say this word: _______ like this: ______?

Question 2: Does my child need speech therapy?

Question 3: How can I help my child speak so I (or others) can understand him/her better?

Do any of these questions sound like something you’ve been wondering?  Let’s take them one-by-one.

Question 1: Is it normal for my child to say this word: ________ like this: ______?

I will first encourage you by saying that almost all of the time when a friend or acquaintance asks me this question, my answer is that yes, the error they are making IS normal for the child’s age.

Often, the question goes a little something like this: “My child is saying “yight” instead of “light.” She’s almost 4. Should I be concerned?”

So to answer this question, I want to first give you some helpful background info!!

A Quick Overview of Speech Sounds!

Every word that we say involves the tongue, lips, teeth, lungs, etc, working together to produce one or more sounds. Some are easier than others. When you’re just a tiny little human, you generally start by mastering the easiest sounds, and then over the course of a few years, progress to master all of the sounds, even those that are difficult.

Sounds that are generally easier to say are:

p, m, h, n, w, b

Children can usually make these sounds by age 3.

Sounds that are at a medium level of difficulty:

d, t, ng, g, k, f, y

Children can usually make these sounds by age 4.

Sounds that are most difficult to say:

th, s, z, r, l, sh, ch, j, v, and consonant blends like st, fl, pl, thr, etc.

Children usually make these sounds between ages 3 and 7.

As you can see, overall, there is a wide, WIDE range of normal regarding the ability to say most sounds.

Quiz time!!!

Going back to that first question: “My child is saying “yight” instead of “light.” She’s almost 4. Should I be concerned?” My response would be that “l” is a later-developing sound, so nope, this mom shouldn’t be concerned at this age.

Now you try these:

My 3 and a half year old child still says “cool” instead of “school.”

Look back at the list. Should this mom be concerned? You got it – nope!

But what about if I had a mom ask me if it’s normal for her five year old to be saying “pood” instead of “food?”

Based on our list here, that would be a little more concerning and I would definitely want to ask more questions.

Hopefully that makes sense!

Question 2: Does my child need speech therapy to help with his/her speech sounds?

A chat with your pediatrician, as well as a thorough speech evaluation is best for determining the answer to this question (a physician referral is often necessary but not always required). There are many factors that go into determining the need for speech therapy to help with speech sounds.

But for those of you willing to dive in a little deeper, I’m going to pepper you here with some factors that weigh heavily in my decision to recommend treatment or not.

1. Speech Sounds

Whether or not the child can say the sounds they should be able to say at his/her age is something we consider in an evaluation. A standardized assessment is included in a proper evaluation, and gives us the ability to compare the child’s sound productions with other children the child’s age. The amount of errors, the way the errors are made, and the frequency of which they are made is also noted.

Now, if you don’t have a scheduled evaluation but are interested in getting a general idea of where your child stands, look over the different sounds and the general age ranges for when a child should use those sounds correctly. Listen to your child’s speech and make notes of which sounds are difficult and compare that to the list. This is a difficult task for the untrained ear, but it may help to give you an idea, remembering there is a wide range of average. And be sure to talk with your doc about it.

Because of the wide range in age of when is normal to say certain sounds, we cannot only look at individual sound errors to determine need for speech therapy. Let’s look at some other factors as well.

2. Intelligibility

How well the child is understood by others (intelligibility) is an important factor in determining whether a child needs speech therapy. Intelligibility estimates can be quite subjective, however, and will vary different depending on who is making the estimate and whether it is the parents (who hear the child speak frequently), or a stranger (or unfamiliar listener). I really appreciate THIS article* – by Caroline Bowen, an SLP who does incredible work on the subject of articulation and phonological disorders. She cites the work of several researchers that discuss intelligibility standards:

How well the parents should understand a child**:

18 months old —————-> 25% intelligible to a parent

2 years old ——————–> 50-75% intelligible to a parent

3 years old ——————–> 75-100% intelligible to a parent

**Lynch, Brookshire & Fox (1980), p. 102, cited in Bowen (1998).

How well a stranger should understand a child***:

2 years old ——————–> 50% intelligible to a stranger

3 years old ——————–> 75% intelligible to a stranger

4 years old ——————–> 95-100% intelligible to a stranger

***Flipsen, P., Jr. (2006). Measuring the intelligibility of conversational speech in children. Clinical Linguistics & Phonetics. 20(4), 202-312.

Intelligibility can be a very important factor in determining need for speech therapy, because it can have enormous implications for a child – impacting the child’s social experiences, self-confidence, education, etc.

How is your child’s overall intelligibility? Estimate it as the parent, and maybe ask someone who is just meeting your child what they think as well. This may help you have a better idea of whether your child is in the average range for his/her age in regard to speech.

3. Error Patterns/Phonological Processes

Look, I totally geek out on this stuff, but I imagine that for some of you, this is probably starting to get confusing. I want to just do a quick review before we dive into this one. Earlier, we were talking about how a child can make mistakes on a specific sound, like saying a “w” instead of an “l” as in the example I gave for the substitution of “wight” for “light.”

Moving on to this next concept, kids can also make errors in patterns, for example, deleting one consonant when it’s next to another consonant, like saying “tar” for “star” or “pane” for “plane.” So we’re talking about these PATTERNS now, called “phonological processes.”

Much like individual speech sounds, some error patterns are very common and are developmentally appropriate. For example, it’s normal for small children to leave out the last sounds of words, like saying “uh” for “up” when they’re little, or “beh” for “bed.” It’s also normal for kids to shorten longer words, like saying “nana” for “banana.”

I really like this chart that tells all of the different patterns and the ages that they are usually eliminated, by Little Bee Speech: Phonological Processes.

Check out the chart. If your child is using these error patterns for longer than they should, or they are using one of the few error patterns that we don’t typically see, then that may be an indicator that the child will need an extra assist through speech therapy. These can be tricky to understand, so don’t be afraid to ask me more questions about these processes!

4. Genetics

We do often see a connection between genetics and articulation or phonological process disorders, but it is not fully understood at this time. In my personal experience, if a family member of a child has needed speech therapy to overcome their delay, and I’m seeing some struggles in the other areas mentioned, then it may be an indicator that the child would benefit from intervention as well. This is just one of the questions we ask to help give us more information about treatment decisions.

In summary, Speech-Language Pathologists do a thorough standardized test to look at speech sounds and phonological process patterns. But hopefully this little list here will help you concerned mamas learn a little more about your child’s speech and better inform the questions you ask your pediatrician!

Question 3: How can I help my child speak so I (or others) can understand him/her better?

If your child doesn’t qualify for or doesn’t need speech therapy, but you still want to help them with his or her speech sound development, there are a few non-intrusive approaches you can take to help accelerate the process of talking more clearly.

1. Make sure you are on your child’s level when you talk, as much as possible. Not only is this ideal for interaction, but this way, the child is able to see your tongue, lips, and teeth move when you are talking, which is giving them more information about the production of words.
2. Hold items close to your face or mouth when you are naming them to, as above, give your child more information.
3. Repeat your child’s errored words, but correctly. If they say, “doo” for “zoo,” then you say, “Zoo! It IS a zoo!” or something similar, where you highlight the correct production of the word.
4. Avoid repeating the child’s errors (even as cute as they can be)! For example, it doesn’t help your child to learn to say “bottle” if you are calling it a “baba.”
5. Create structured play situations that will target certain words or sounds. This strategy requires the parent to think a little bit like a Speech-Language Pathologist. But, for example, if your child is struggling with a sound or word that they should already have by their age, you can create a play scenario where you use that word or sound a lot. If a child is struggling to learn the “k” sound, as in “cup,” then maybe create a tea time where you and your child are frequently requesting each other’s cups. Or maybe you’re taking care of a cat in a pretend play game. Or perhaps passing each other different cards.

Try to repeat difficult words often, but without pressuring the child to say them. I would wait until a child is in speech therapy to start any true “drills” to help with articulation or phonological processes, because you would definitely want to make sure that you’re doing it correctly if taking this step.

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I am truly so excited to hear how this helps inform your understanding of your child’s speech. I LOVE the topic (clearly), and could talk about it for ages, so please feel free to ask me any questions and I’d love to help answer them.

And, if there are any other questions you’d like answered from a Speech-Language Pathologist, you just let me know and I’ll put it on my topic list for an upcoming post!

Thanks for being with me, friends! ❤️

Can’t wait to see you again so soon!

XO! ❤️❤️

Honestly,

AM 🙂

More About Me: Hi! I’m Ann Marie, a blogging mama of 3 tiny gals, and a wife to a busy Orthopedic Surgeon. You can find me right here for a weekly smattering of inspiration for your motherhood journey, home, marriage (I see you other medical wives!), style, and beauty. You’ll find me most active on Instagram or Facebook for life between blog posts. And I truly can’t wait to see you there, friend. ❤️💋

To connect, shoot me an email at honestlyannmarie@gmail.com ❤️

*Bowen, C. (2011). Table1: Intelligibility. Retrieved from http://www.speech-language-therapy.com/ on [September 10, 2019]