Speech and language difficulties and disorders can have a significant impact on a child’s school experience. However, the earlier a child’s speech or language delay or disorder is identified, the better the outcome! Yes, you’ve heard it once, you’ve heard it twice; early intervention is the best intervention! Below are some warning signs that may suggest a speech or language impairment.
Warning signs that should trigger a referral to an SLP
Any age:
- Ability to be understood by family, friends, and/or caregivers in the expression of basic needs, preferences, and feelings is reduced
- Speech is slurred; difficulty controlling breathing for speech; abnormal loudness, rhythm, or vocal quality
- Produces no meaningful words, or sounds that are understood only by family
- Speaks loudly in high pitched voice with frequent distortion, omission, and substitution of sounds
- Sound errors are prevalent but variable (i.e., “dog” could be produced “dog,” “tog,” “gog,” “god” by same child)
- Varies from rarely being able to produce sounds to ongoing speech that is rarely understood, or speech that is usually understood with frequent sound errors
- Unaware of sound variations or exhibits varying degrees of frustration and/or anxiety regarding inability to “control speech”
- Cannot produce movements for sound production, or sounds are produced without voice (whispered speech)
- Exhibits frustration and/or avoids talking due to difficulties
By 12 months:
- Does not point to objects
- Does not use gestures such as waving or shaking head
By 15 months:
- Has not used first word
- Does not respond to “no” and “bye-bye” appropriately
By 18 months:
- Does not use at least six to ten words consistently
- Does not appear to hear well or discriminate between sounds
By 20 months
- Does not use at least six consonant sounds (especially /p, b, m, n, w, h/)
- Does not follow simple directions
By 24 months (2 years)
- Has a vocabulary of less than 50 words
- Is less interested in social interactions compared with previously
By 3 years:
- Cannot be understood by family and/or caregivers more than 50% of the time
- Cannot correctly produce vowels and/or the consonants p, b, m, w in words
- Cannot repeat when not understood without getting frustrated
By 4 years:
- Cannot be understood by family/strangers more than 75% of the time
- Cannot correctly produce t, d, k, g, f
- Cannot be asked to repeat without becoming sensitive
By 5 years:
- Cannot be understood in all situations by most listeners
- Cannot correctly produce most speech sounds
- Cannot be asked to repeat without exhibiting frustration