Speech and Language Concerns

When and how to seek help for your child's development.

"I tawt I taw a puddy tat." Is this what comes to mind when you think of a person who needs speech therapy? If your answer is yes, you are not alone. There is a general misunderstanding about the field of speech and language pathology.

Here's some background: Speech therapy teaches structure and prepares children for the rigors of the classroom. It focuses on building confidence while providing compensatory strategies in order to help children in the classroom, as well as in all areas of their lives.

Speech-language pathologists work to improve the communication skills of individuals who exhibit a speech and language delay or disorder. What exactly qualifies as a speech and language delay or disorder, and what is the difference between the two? A speech and language delay is when a child is developing the appropriate skills in the correct order, yet there is a lag in development as compared to the child's peers. On the other hand, a language disorder is characterized as abnormal language development.

Delays and disorders include, but are not limited to, deficiencies in expressive language, receptive language, articulation skills, feeding skills, oral motor development, symbolic play skills and social pragmatic skills.

Every child develops differently and what is "normal" for one child may not be so for another. If by 12 months old your child has not produced his first word, but your neighbor's son says ten words, do not panic. There is a range of what is "normal" (see Facts at a Glance sidebar).

If your child does not meet the milestones outlined in the sidebar, look for the following warning signs, which can further indicate that a delay or disorder exists. Warning signs include, your child...

  • Does not babble or use a number of consonants or vowel sounds.
  • Lacks eye contact and social skills.
  • Has trouble following directions.
  • Has unintelligible speech.
  • Excessively drools and/or experiences trouble with feeding skills.
  • Falls behind in class.
  • Displays a reduced vocabulary.
  • Uses immature syntax (grammar).
  • Has difficulty processing information that was presented aloud.
  • Displays reduced long or short-term memory.
  • Has trouble recalling information that was previously learned.
  • Has difficulty with reading and writing skills.

If you notice any of these warning signs, it may be time to get an evaluation.

Parents have many options when it comes to finding a speech-language pathologist. If your child is between 1 month to 3 years old, you can receive an evaluation through Early Intervention, a national government-funded program that provides services for babies from birth until age 3. Early Intervention agencies in each state match parents with a local service provider to perform a thorough evaluation. Medicaid covers an initial evaluation for all children whose parents or healthcare providers request one. In order to find a local Early Intervention agency and learn more about the program, visit www.health.state.ny.us/community/infants_children/early_intervention (for New York) and www.njeis.org (for New Jersey).

Assessments should consist of a parent interview, formal testing, an informal observation of your child at play and an examination of the oral mechanism. The pathologist may suggest that evaluations in different disciplines, such as occupational therapy, physical therapy and special instruction, are necessary to identify other areas of delay.

Although Medicaid covers the initial evaluation, not all children qualify for continuing services through Early Intervention. To be eligible, a child must score two standard deviations below the mean on a standardized test administered during the initial evaluation.

After the age of 3, when Medicaid coverage ceases for qualified children, options remain for your child. For children between 3 and 5 years, the Department of Education may provide assessments and services. Call the Department of Education to see if your child qualifies. Of course, you can also contact a private speech-language pathologist in your area. For school-aged children, many private and public schools throughout the state employ on-site speech-language pathologists.

The right speech-language pathologist comforts your family and instills hope that your child will live a "normal" life and function independently in this competitive world. Additionally, the therapist may form a close relationship with your child and become an integral part of his or her academic upbringing.

In a world of acronyms - PDD, ADD, LD, ADHD - we can all feel a little puzzled and lost. Now that you have some background information on what to look for and what to do if you suspect a speech and language problem with your child, breathe a little easier and know that everything is going to be A-OK.