speech therapy for toddlers with speech and language delay

Speech & Language Delay: Speech Therapy for Toddlers in Singapore

Find out more about speech and language delays in toddlers, and how speech therapy in Singapore can help.

by Grace Koh

Children, in their early years, develop rapidly in the blink of an eye. But how do we know if their speech and language skills are on track? Find out some of the signs of potential speech and language delay in a toddler, and how speech therapy can help. 

What Are Speech and Language Delays in Toddlers?

From birth to three years old, a toddler acquires the foundations for speech and language, making it a critical period in a child’s development. At this stage, speech and language development refers to the understanding of languages, such as in following instructions or answering questions, and the usage of language in expressing one’s self. Speech can also refer to the clarity of pronunciation. 

These foundations build up and support the child in the later stages of development as they mature, such as in thinking and problem solving, and the ability to develop relationships with others. Speech and language abilities are also a crucial first step in literacy development and are important in learning how to read and write.

Just like practice with any new skill, you may find that a child’s speech and language skills at this age needs practice. Often, a toddler has unclear pronunciation and understands more than he or she can say. However, it can be a concern when a child is not matching up to his or her peers of the same age.

Below are some general milestones of speech and language development from birth to three, and signs of speech and language delays. It is important to bear in mind that every child develops differently, and there is a range of expected and appropriate development. Do consider this when looking at the developmental stages of a child, and recognise that some children may take some more time, but some children may be more advanced at the same age.

General Speech and Language Milestones

At three to 12 months of age, a child should be:

  • Babbling or jargoning e.g. making sounds like ‘bababa’, ‘mamama’ or using long strings of sounds which sound like he or she is trying to have a ‘conversation’ with you
  • Expressing him or herself by laughing, crying and/or cooing
  • Using a range of gestures e.g. pointing to get your attention, reaching up towards you for a hug
  • Trying to copy some sounds you make e.g. oh oh!, animal sounds
  • Understanding some of what you say with some hints, e.g. when you say ‘give me that’ and show your hand, a child should be able to give it to you

Early first words may also appear at 12 months. A child at this age will continue to use babbling, jargoning, gestures and some words to communicate.

At 12 to 18 months of age, a child should be:

  • Using more single words, i.e. should be using at least 8-10 words by him or herself
  • Able to follow simple instructions, such as ‘let’s clean up’, ‘wear your shoes’
  • Able to understand ‘no’ — though he or she may not always obey
  • Using gestures alongside words e.g. pointing at a bird and saying ‘bird’

At 18 months to two years, a child should be:

  • Combining 2-word phrases together, e.g. ‘daddy hug’, ‘give me’
  • Starting to understand simple questions, e.g. ‘what is this?’, ‘where is the door?’
  • Somewhat comprehensible in his or her speech and should be understood by others about 25 to 50% of the time

From two to three years of age, a child should be:

  • Speaking in longer sentences, in about three to four-word phrases or sentences about a variety of things, e.g. ‘this is a train’, ‘give me red ball’, ‘dog under table’
  • Using a variety of sounds in his speech
  • Understood by strangers about 50 to 75% of the time

Signs of Speech and Language Delays in Toddlers

Below are some signs on when to be concerned if your child may be behind in their speech and language development.

At 12 to 18 months of age, some signs of a potential speech and language delay would be:

  • Little to no sound play or babbling
  • Not showing much interest when people play with them
  • Not responding to name
  • Not using gestures, particularly to ask for help or for what he or she wants

At 18 months to two years, some signs of a potential speech and language delay would be:

  • Not using words or saying only a few words, e.g. 3-5 words
  • Not able to follow simple instructions
  • Only copying words but not spontaneously using words

From two to three years of age, some signs of a potential speech and language delay would be:

  • Using single words or not using any words
  • Not asking questions (nearer to 3 years)
  • Does not understand longer instructions e.g. ‘go take your shoes and put them on’
  • Using few sounds in their speech
  • Being understood by a familiar person less than 50% of the time
  • Not being able to follow instructions or respond to simple questions like ‘what’s this?’

Do note that these are not definite signs of a speech and language delay and are not meant to be used to make a conclusion or diagnosis that the child has speech and language delays.

Causes and Risk Factors of Speech and Language Delays in Toddlers

In most cases, there is no known particular cause of speech and language delays. However, studies have shown that there is likely to be a genetic or a biological component that affects speech and language development. There are some factors that may put a child at risk of speech and language delays, such as:

  • Being male
  • A known family history of language or learning difficulties
  • Developmental disabilities or disorders like autism spectrum disorder, Down syndrome, other genetic conditions — quite often, these conditions imply likely language delays in the individual
  • Having recurrent ear infections
  • Environmental factors could influence speech and language development as well, such as excessive screen time

Sometimes, delays in speech and language can be signs of more serious developmental disorders including hearing impairment, developmental delay, intellectual disability and autism spectrum disorder. Parents and caregivers know their children better than anyone else. You should seek professional advice from a speech therapist or your paediatrician if unsure. 

How Are Speech and Language Delays Managed?

Deciding to seek help and advice on a child’s speech and language delay is the first step. You can find out more in our Speech Therapy 101 article.

A speech therapist will assess a child’s understanding and use of language. For young children, the speech therapist might use tests or play with the child to determine how the child uses words or responds to instructions and questions. The speech therapist may also collect information from parents and caregivers about how the child uses and understands language at home, and more about the child’s background — for example, any known family history of language delays.

If there is a suspected speech and language delay, the speech therapist may offer one-to-one therapy sessions or sessions in a group with other children. This may depend on you and your child’s preference and needs, as well as where you seek speech therapy from.

Encouraging Speech and Language Development at Home

To encourage a child with his or her speech and language development, the most effective thing you can do is to have many conversations with him or her.

Talk With Your Child

Talk to the child as though he or she could talk back to you, starting from infanthood. Assume your child is responding to you through his or her sounds and babbling, and wait for him or her to respond after you speak. When your baby starts babbling, copy them and do the same to start a back-and-forth exchange of babbling. This keeps the enjoyable conversation between your child and you going!

As your child becomes a toddler, keep talking about the things happening around you and him or her — what you are doing, what she or he is doing and the surroundings. Make sure to use a variety of words when talking with your child and remember to keep what you say short and sweet so that your child is able to catch what you are saying too.

Respond To Your Child

As your child grows and starts to use gestures and words, respond to his or her attempts at communication. For example, if your child shakes her head, act as though he or she is saying ‘No’. If he or she points to a toy, respond as though you think he or she wants the toy. Noticing and responding to your child’s actions encourages them to communicate more with you.

Following your child’s lead is also a way to encourage more back and forth communication. If your child starts a conversation using a gesture, a behaviour or sounds, respond to it and stick to the topic your child has chosen. You can stress and add more meaning to what your child says and does too. For example, if your child points to a bear toy and says, ‘ba’, you can respond by pointing at the same bear toy and saying, ‘Yes, that’s a bear! It goes grrrr.’

Read With Your Child

Read and share books with your child. Talk about the pictures and link the picture to what happens in real life. For infants and toddlers, they enjoy books with clear and colourful illustrations, and lots of different switches, materials, or flaps to explore. Children usually enjoy reading books over and over again. Let your child choose the book he or she wants to read. The public libraries have a variety of books suitable for infants and toddlers which you can look up.

Can a Child with Speech and Language Delays Catch Up?

Studies have been done on toddlers with speech and language delays observing how they eventually catch up (or not) with same-aged peers. The results have found that 70 to 80% of toddlers do catch up with their peers by the time they enter school. However, between 20 to 30% of the toddlers do not grow out of the language delay and have ongoing difficulties with their language and literacy skills.

A wait-and-see approach, hence, may not be advisable considering the possible long term effect. If the child shows some of the risk factors as mentioned above, you may consider bringing the child for further evaluation and checks.

At Homage, you can get speech therapy for speech and language delays in the comfort of home. A certified speech therapist will visit you at your home. Besides convenience, the comfort and familiarity of the home setting can also be beneficial for your loved one’s progress. 

Homage provides a range of services for individuals with different conditions, including speech therapy services for speech and language delays. You can contact our Care Advisors at 6100 0055 to learn more about our range of services and find out how Homage Care Professionals can help.

Disclaimer: The information is provided for general informational and educational purposes only, and is not a substitute for professional health advice. To seek further medical advice for your medical condition, do consult your doctor or go to the nearest health institution to get assistance.

References
  1. American Speech-Language-Hearing Association. (2021). Early Identification of Speech, Language, and Hearing Disorders. https://www.asha.org/public/early-identification-of-speech-language-and-hearing-disorders/
  2. Bowen, C. (2021, January 3). Table 1 – Intelligibility. Speech-Language Therapy Dot Com. https://www.speech-language-therapy.com/index.php?option=com_content&view=article&id=29:admin&catid=11:admin&Itemid=117#:%7E:text=Pascoe%20(2005)%20is%20in%20general,some%20articulation%20and%20phonological%20differences
  3. iPad = I Don’t Talk: The Effects of Young Children’s Screen Time. (2021). Hanen. http://www.hanen.org/helpful-info/articles/ipad-equals-dont-talk.aspx
  4. Lowry, L. (2021). Do Late Talkers “Grow Out of It?” Hanen. http://www.hanen.org/Helpful-Info/Articles/Do-Late-Talkers–Grow-Out-of-It.aspx
  5. Ministry of Social and Family Development. (2021). Language Development: An Amazing Journey. Baby Bonus. https://www.babybonus.msf.gov.sg/parentingresources/web/Toddlers/ToddlersDevelopment/ToddlersLanguage_Development/Toddlers_Language_Development

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About the Writer
Grace Koh
Apart from reading, singing, and plodding up muddy trails, Grace enjoys scribbling notes and thinking up a storm. Her day job as a speech therapist involves helping children communicate, educating parents, and playing with lots of bubbles.
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