Therapy Tips

Five Most Common Questions Parents Ask about their Child's Speech

Communication and speech is often a parent's number-one concern when a young child is diagnosed with autism. With so many interventions available, how can families be sure they're choosing the best option for their child? In My book Let’s Talk,  I provide practical knowledge that you need to evaluate communication therapies and treatments—and make sound decisions rooted in evidence-based practice. Many parents are unsure of what questions they should be asking their Speech Language Pathologist. To give you an idea of what many parents ask, I have compiled five of the most popular questions and their answers. Have any popular questions to add? Please share them in the comments below.

1.My toddler isn't talking, should I be worried? What can I do at home to improve my child's speech?

If your toddler has not yet started talking, there are many things you can do to help. It’s a good idea to get a referral from your pediatrician for a hearing test, and s/he may also recommend other professional evaluations if there are other questionable behaviors. At home, you can find lots of ways to support language development through everyday activities and routines. And you don’t have to set aside a special time to do it; use all the repetitive caretaking you do as language modeling opportunities. For example, during bathtime, you can name the toys in the tub, name the actions you see (splash, wash, kick) and comment on the ongoing activity with simple words such as up, down, hot, cold, and use routine language to create expectations by, for example, saying “ready, set, out” when the bath is over. It is also helpful to respond to any attempts your child makes to communicate, whether by pointing, making sounds or shifting gaze between you and objects s/he wants. You can look at the child as he or she communicates, repeating what is said, or giving the words for what the child is interested in. Late-talking is very common, over 15% of 2-year-olds show delays in learning to talk, but research has shown that 75% of these go on to develop normal language by the end of preschool. So late-talking should not be a big concern if you don’t see other worrisome behaviors and you know your child can hear. For the majority of late-talkers, some extra language stimulation, as we have described, will do the trick.

2. How do thumb sucking and pacifiers affect my child's speech?

Pacifiers and thumb-sucking are perfectly normal and adaptive for children under the age of two. For children under 2, they help develop the ability to soothe and regulate themselves and their emotions. Once a child begins talking, we do want to encourage him/her to have an empty mouth when talking, so s/he can be understood. If your child talks to you with a pacifier or thumb in the mouth, it is fine to say, “I can’t understand you. Please take it out and tell me again.” You don’t need to worry about sucking causing poor speech; there’s no evidence that it does. For most children learning to talk will reduce the need to regulate themselves with other means because they can say directly what they want and need. While some children do persist in sucking, and that can be an issue on its own, it generally does not result in language or speech difficulties.

3. Do you know of any toys that can help develop speech and language?

Any toy or activity can be used to develop language, but what really matters is interaction. No toy or electronic device by itself will teach a child to talk. We learn to talk from other human beings because talking is a social experience. So if there’s a toy your child likes to play with, join in! Talk about what you are doing and what the child is doing. Use short simple sentences and wait to give your child a turn to talk or communicate in his own way. There’s lot of scientific evidence to support the fact that this kind of experience is the best building block for words and sentences.

4. Should I "force" my child to use words?

It is usually not a good idea to “force” a child to communicate. But parents may want or need to encourage a child’s spoken language by offering choices or prompting by giving a model of what the child should say (“Say hello to Auntie Donia”). When you use these techniques, it’s important to give the child time to use your input, by waiting (a good 10 seconds), repeating the model, and giving lots of praise when s/he attempts to speak. Don’t expect a child’s production to be just like yours, but the more correct models are heard, and the more a child is successful in sending a message, the more speech improves. If the child refuses or fails to use the model, it is fine to accept a nonverbal answer, but give the spoken model again. They may use it next time.  This way the child will have positive associations and feelings about communicating.

5. My child with ASD talks just fine. Why does he need a speech-language pathologist?

Parents often wonder why children who either don’t talk at all or talk at high levels are referred to a speech-language pathologist (SLP). As we say in Chapter 3 of Let’s Talk, spoken language is just one type of communication. What SLPs do with children who don’t talk or those whose language is well-developed but who have trouble with social interaction, is work on the other elements of communication, beyond spoken language. These include how to talk politely, how to talk differently to different people, knowing what to say and when to say it. Communication is a term that means sending a message of any kind from a sender to a receiver. For example, if you and your friend are listening to a politician speak and he says something outrageous, you turn to your friend and roll your eyes and she knows exactly what you mean-all communicated without any words. SLPs work on all these kinds of communication, too, helping children who don’t talk at all to find other means of sending messages (signs, pictures, or electronic devices) and also helping children with ASD to use the language they have to communicate more effectively. They can help to guide children to choose the right words and topics for a particular situation, how to ask another to play or interact, and all the hidden social and conversational rules that other children pick up naturally.