Should you worry if children are slow to talk? Intervention, if needed, should start early

Published: Saturday, Jan. 19 2013 7:10 p.m. MST

Speech-language pathologist Jayna Collingridge works with Colter in Herriman on Friday, Jan. 18, 2013. Legos are used as rewards when words are pronounced clearly.

Laura Seitz, Deseret News

Four-year-old Colter likes playing with trains, and he's good at it. Sitting on the floor in his speech therapist's studio in Herriman, Utah, Colter has no trouble figuring out how to assemble the track, link up the cars and flip the switches. A rough-and-ready kind of guy with a buzzed haircut, he bends his head to the task, then gives a whoop as the train starts chugging.

There was never any question about whether Colter was smart. But, until recently, he was a "silent child," — his mother's description. For him, language development came slowly and with difficulty. It was obvious that he could understand and act upon what was said to him. But by age 2½, Colter could say only a handful of words, and they were garbled. Instead of "dog," the family pet was a "bob."

Between the ages of 2 and 3, when Colter should have acquired several new words each day, he added only a few more words to his vocabulary, and no phrases. But he knew what he wanted to say. His mother and his speech therapist, Jayna Collingridge, agree on that. Colter's frustration at not being understood began boiling over in passionate tantrums. Between those, he grew ever more quiet and withdrawn. He was shutting down — about to give up on trying to talk.

Colter has childhood apraxia of speech, a messaging problem between the brain and the mouth. It is a severe form of speech delay that affects both vowels and consonants and is resistant to intervention. He is receiving intensive speech therapy and has a good chance of catching up with his peers during the next few years. His parents don't want their son to be defined by a disability they hope he'll conquer, though, and asked that his last name not be used for this story.

About 15 percent of 4-year-olds have problems with delayed speech. Of those, 3 to 5 percent of children with speech delays have apraxia of speech, and Colter is among that number. Many infants who don't meet language development milestones right on time are simply late bloomers and will likely catch up on their own, said speech-language pathologist Julie Masterson, co-author of the book "Beyond Baby Talk."

National Health Institute statistics show that speech disorders resolve by age 6 for 75 percent of children who have them. It's important for parents to discuss any concerns about speech development with their child's doctor, Masterson said. If intervention is needed, the earlier it starts, the better. And children with speech delays who receive intervention have better school and social success later than those who don't get help, she added.

To worry, or not

When a baby is behind in reaching speech milestones, it can be tricky to tell whether the problem is a mild delay that will resolve, or something more serious. But parents can spot signs of speech development long before a child says "ma-ma" for the first time, Mastersons said. Babies begin communicating soon after birth, and that first "real" smile signals that language development is under way.

"We all know when that happens," Masterson said. "It just melts you. It shows that the child is developing, and it's incredibly powerful. An adult will do almost any foolish thing to make that happen again."

Babies who don't produce a social smile by age 4 months need immediate evaluation, Masterson said, to ensure that the communication delay is not part of a broader cognitive disorder, such as Down syndrome or autism spectrum disorder. Being delayed in more than one area — speech and physical development for instance — is another sign that evaluation is needed, as is being significantly behind on reaching developmental milestones in any area.

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