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In my experience when a parent is worried about a speech delay there is usually a problem that warrants attention. One mother recently wrote asking me about a child who did not speak any words except “Ma Ma” at age two and her pediatrician said, “Don’t worry about it.”
Mom was right and the pediatrician was wrong. A child at 24 months should have a vocabulary of 200 words and speak three word sentences (“Ball all gone.”) with 70% intelligibility.
Early speech delay is what I call a Developmental Red Flag. These are warnings to parents and doctors that the child is not developing at the rate that would be expected.
Some mild developmental lags turn out to require nothing more than tincture of time. Each child has his or her own time table for reaching developmental milestones. But we also know that early intervention can greatly help young children with many more serious developmental delays reach their full potential.
Delayed speech or language development is the most common developmental disorder in children occurring in 5-10% of preschool children. Early evaluation and treatment can make a great difference in the life of a child with what we call a developmental language disorder.
It is very important to have hearing tested by an audiologist because children can have a partial hearing loss that prevents them from hearing certain speech sounds. Even if the parents think the child can hear perfectly they can be mistaken. The clinical examination (often using a whisper, watch tick, or crinkled paper) can even fool the doctor because these children can be very savvy and sneaky in the use of visual clues.
Another possible pitfall is when a parent says, “My child understands everything I say perfectly.” Often the child can understand (or uses visual clues) to carry out one-step commands like, “Put your shoes on.” when the parent holds out the shoes. But the child is lost with a complicated set of directions like, “Get your blue shoes out of the closet, take them to Daddy, and find your knapsack so he can pack the shoes.”
In the olden days, children who lagged behind in an area of development were assumed to be retarded. The prevailing notion was that nothing could be done. Children were housed in special classes or institutions. We came to learn that MUCH CAN BE DONE for children with developmental delays, so much that the federal government has mandated that every state have an EARLY INTERVENTION PROGRAM. And every school district must have preschool services for children with a developmental delay.
PARENTS: You know your child best and you spend the most time with your child. Use your instincts. If you feel there is something wrong, you are very likely to be correct. Call it to the attention of your doctor, familiarize yourself with community resources, and be a very squeaky wheel. Persistence can pay off big time for your kid.
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