Early detection
When should I bring my child in?
Here are some information to help you decide if your child should receive a speech and language assessment.
Are my child’s language skills on track?
Language can be spoken or written. It includes the understanding of language (receptive language) and use of language (expressive language). If your child exhibits the following signs or if you are concerned about his or her language, he or she would benefit from a speech and language assessment.
- Does not smile or interact with others (by 3 months)
- Makes only a few sounds (by 12 months)
- Does not use gestures (e.g., waving, pointing) (by 12 months)
- Does not follow routine instructions (by 18 months)
- Does not have their first words (by 18 months)
- Does not put 2 words together to make phrases (by 2 years)
- Says fewer than 50 words (2 years)
- Has trouble playing and talking with other children (by 3 years)
- Has difficulties acquiring phonics and early literacy skills (by 5 years)
Ways to develop your child’s language
- Be at eye level when talking to your child. This helps your child to look at your face and also helps you to know what your child is looking at.
- Read with your child daily. This has been shown to improve their language and early literacy skills.
- Communicate with your child in the language that you are most competent in. By doing this, you are giving your child the best model of the language that you can.
- Narrate about what you are doing and what your child is doing.
- Use a variety of words when talking with your child. Other than names of objects (nouns), you should include action words (verbs), describing words (adjectives) and fun words (e.g. Wow! Splash!)
- Model language that is one level higher than what your child is currently doing. For example, if he is saying one word (e.g. car), you can model a 2-word phrase (e.g. blue car, car go). If she is saying a 3-words sentence (e.g. I eat banana), you can model a 4 word sentence or a more complex sentence (e.g. I am eating banana, I eat small banana).
- When possible, provide opportunities for your child to socialise with other children.
Is my child’s speech sound development on track?
Speech refers to the sounds that your child produces when he or she speaks. Speech sound development is on a continuum and children learn to produce different sounds at different ages.
Intelligibility refers to how well a child is understood by strangers or less familiar people. A child should be
- 25-50% intelligible by age 2
- 75% intelligible by age 3
- 90% intelligible by age 4
If you are concerned about your child’s speech clarity, a speech and language assessment by one of our speech therapists can help to determine if your child is developing on track.
Ways to support your child’s speech sound development
- Pronounce words correctly when speaking to your child. You can simplify your sentences but use the correct words. For example, instead of saying “wawa” for “water”, just say “water”. It is okay if your child mispronounces the word. It is important for them to hear the correct pronunciation.
- Don’t over-correct your child’s speech sound errors. For every 1 time you correct her, you should praise her or comment about other matters 4-5 times. Your child should feel that you are more concerned about what she has to say rather than how she says it.
Is my child stuttering?
Some children will go through a period of dysfluency when they are between 2 years 6 months old and 5 years old. During this period, they will experience phases of fluency and dysfluency. This can happen because your child is acquiring language at a rapid pace and making more complex sentences. 75% of toddlers will outgrow this dysfluency on their own.
If your child presents with the following characteristics or if you’re concerned about his or her fluency, please contact us for an assessment:
- Repeating sounds or syllables (e.g. Kick the b-b-b-ball)
- Prolonging sounds (e.g. I see a mmmmonkey)
- Blocking. Your child appears to be unable to get the word out and/or physically struggles to say the word)
- Has accompanying behaviour when he stutters (e.g. taps his hands, blinks quickly)
- Showing negative emotion or behaviour to speaking
- Has a family history of stuttering
Ways to support your child when experiencing dysfluencies
- Give your child time and your full attention when he is talking. Do not rush him or finish his sentences.
- Do not interrupt or stop your child while he or she is speaking.
Is my child’s voice normal?
You may be concerned about your child’s voice if he or she:
- Uses a hoarse or breathy voice
- Uses a nasal-sounding voice
- Sounds strained when speaking
- Has a pitch that is too high or too low
- Speaks at a low volume or is too loud
You should seek help from your child’s paediatrician if you are concerned about your child’s voice. The doctor may refer your child to be seen by an Ear, Nose and Throat (ENT) doctor for more investigations. If needed, your child may be referred to a speech and a language therapist to work on improving vocal hygiene and ways to improve his or her voice.
Ways to keep your child’s voice healthy
- Keep your child away from cigarette smoke.
- Ensure that he or she drinks an adequate amount of water daily.
- When appropriate, teach your child the appropriate times to use a loud voice and when to use a normal voice.
Can my child hear me?
You may be concerned about your child’s hearing if he or she shows the following signs
- Does not pay attention to environmental sounds (birth–1 year)
- Does not respond when you call his/her name (7 months–1 year)
- Does not follow simple directions (1–2 years)
- Shows delays in speech and language development (birth–3 years)
What to do if I am concerned about my child’s hearing
- See an audiologist if your child did not pass the newborn hearing screening.
- Go to an audiologist if you have any concerns about your child’s hearing. Some hearing losses can begin months or years after birth so your child may need to have a hearing test.
- Ask your audiologist about the need for hearing aids or cochlear implants.