Should you worry if children are slow to talk? Intervention, if needed, should start early
Most babies who are behind in developmental milestones will catch up, especially if they are only a little bit behind and are progressing steadily. If concerns about a child's development arise, a pediatrician can refer the child for evaluation, which is provided free of charge in all U.S. states under the federal Individuals with Disabilities Education Act (IDEA).
In Colter's case, evaluation revealed that his delay involves speech only, but his speech problem is severe. He scored above the 90th percentile for cognitive skills like comprehension and ability to follow multiple directions, but in only the third percentile for speech development.
Free early intervention services — usually weekly home visits from a speech-language pathologist — are available to all U.S. children under IDEA starting at age 2, though services may vary from state to state. The child’s pediatrician is the best source for connecting families with available services, Masterson said. Information can also be found through the National Dissemination Center for Children with Disabilities. For children with mild delays, such help will sometimes catch the child up to peers by age 3.
Colter received in-home visits from a speech-language pathologist (SLP) starting at age 2. “It was fine, but we weren’t seeing progress,” his mother said. When he turned 3, he began attending Canyons School District’s early intervention preschool for two hours and 15 minutes, twice a week. It's a free program, where he participates in group work with other children and receives a minimal amount of one-on-one time with an SLP.
U.S. children with disabilities ages 3 to 5 typically receive some services through their state school systems, but those services vary from state to state. Parents can contact their local school districts to learn about what is offered. In most states, some speech therapy will continue to be provided through the public school system after the child enters regular school, and for as long as problems persist.
Because Colter’s progress continued to be slow after he started the early intervention preschool, his mother decided to add weekly private sessions with Collingridge, a speech-language pathologist with national and state certifications. The American Speech-Language Hearing Association's website includes a national directory of SLPs to help families find providers in their area. Some insurance plans cover this service, and some of the listed providers charge their fees on a sliding scale based on income.
In the 14 months since Colter started private speech therapy sessions, his language skills have “exploded,” his mother said. During the first six months, Collingridge worked on vowel sounds with Colter — he wasn’t ready to take on consonants. Toys like the train set and a toy farm set are integral to her process — setting up situations that urge a child to communicate using the sounds being studied.
Colton says many words now, and links them into simple sentences. Some of his consonant sounds are still confused, though. On a recent morning, Collingridge worked to help him produce the initial “Y” sound correctly. She sat on the floor with him, her face bright, animated and encouraging as she modeled correct pronunciation.
“Do you want to add the red car?”
“Can you say eee-ess?” she asked, exaggerating the movements of her mouth and tongue to model the sound.
“Eeee-NESS,” said Colter, only partly right.
“Good!” said Collingridge, handing him the car. Perfection isn’t necessary, she explained, and good effort deserves a reward. The process of shaping words correctly is a gradual one.
“When you are working with a young child, it’s all about motivation and keeping him engaged,” Collingridge said. “That’s why I have so many toys and games. I have to find something he is willing to work for, but I have to be in charge. If I just let him have all the toys, he has nothing to work for.”