Language development varies extensively among toddlers and preschoolers. Because of this, well-meaning friends and associates often assure worried parents that their child will catch up. However, a delayed diagnosis means missed opportunities for early intervention. True language impairment causes continued difficulties with communication as well as social and academic challenges once a child becomes school age. Early identification gives your child the best chance for effective and complete treatment.
Using Language
Language impairments are distinguished from speech disorders in that they refer to difficulties with language use instead of speech production. Most children progress quickly from combining words starting at about age 2 to the use of easily understandable sentences by age 4. Listen to your child speak and think about how she is using language. Expect shorter, simpler sentences than those used by more mature speakers, but word order generally should be correct. For example, "want cat eat" is not a typical developmental error and could signify an impairment. Your child should be using language to comment on the world, ask questions, tell stories and explore new ideas. Even shy children talk about colors and shapes, ask questions and play rhyming and singing games with familiar people. Impairments in any of these areas suggest a possible expressive language delay and should be investigated.
Understanding Language
Children learn to understand language before they attempt to speak it. One of the strategies for differentiating between children with actual language impairments and late-bloomers is to assess "receptive" language skills, or the ability to understand what is being said. Toddlers and preschool-age children may not always follow directions, but they should understand what is being asked. Similarly, they should be able to respond to gestures and questions. A nonverbal response, such as handing someone a requested toy or waving back, signifies receptive language ability. If your child ignores all questions or requests, he may not be being defiant; he truly may not understand you.
Late Bloomers
Unlike recognizing the importance of a rash or a fever, distinguishing between language impairment and normal delays can be tricky. Toddlers and preschool-age children grow at vastly different rates, and development frequently concentrates on one aspect, such as motor skills, for a period of time before switching to another, such as language. Although the rate may vary, it should not stop completely. Look for the addition of new language skills, including new words and concepts, at least monthly. Additionally, think about how your child responds to your language. By the time she is a toddler, she should understand a great deal of what you say to her, and, by preschool, she should understand the majority of it. Late bloomers typically understand what is said to them but take some extra time learning to comment on it.
How Family Members Can Help
If you suspect your child's language is delayed, your first step is to have his hearing checked. Assuming he can hear, there are several steps you can take at home in addition to having him evaluated by a speech-language pathologist. Talk to your child as much as possible. Use simple sentences that describe what he is doing and how he is feeling. Respond to his speech whether or not you understand him, and give him extra time to answer you. Many language impairments include a processing delay, so pausing for longer than usual between questions and answers may help. Reading provides additional opportunities to talk about the pictures and story line. If you sense your child is struggling, quiet down your house and reduce the pressure to speak. Too much television or other background noise makes it difficult for some children to focus on speech and language. Ask questions but give choices for answers instead of requiring him to find the words, and model good grammar but resist the impulse to correct him.
