The Speech & Language Therapist
The role of the Speech and Language therapist on the neonatal unit is primarily in assessing and supporting infants in safely and efficiently establishing oral feeding (that is breast or bottle feeds by mouth). This specialised input is given to babies who have been identified as requiring additional help in preparing for or starting to feed by mouth, ie very preterm infants, infants with chronic lung disease or infants with underlying medical conditions. The Speech and Language Therapist may start working with families and infants well before the infant is ready to have any feeds by mouth to support pre feeding development and experiences. Early input may focus on understanding how to make the infant as comfortable as possible with tube feeds, learning about and understanding how the infant communicates through their subtle behaviours and helping infants to have opportunities to suck and feel calm and comfortable in feeding positions. To be able to start breast or bottle feeding, infants need to have developed the ability to co-ordinate sucking, swallowing and breathing. Infants also need to have stable breathing and a gastrointestinal system that is able to cope with milk feeds. The SLT therefore works closely with other members of the neonatal team. Language is an important skill that allows a person to communicate. A child begins to develop language even before he/she can use words, as seen by a baby who cries to get his/her needs met. A delay in language skills can cause frustration for a child as well as miscommunication about what he/she may be trying to convey. Language development is important to a child in order to adequately exchange information with others in a meaningful way. Language is not the same as speech. Language consists of a set of social standards that shows comprehension of the meanings behind words, putting words together in a sentence in order to communicate and understanding commands, directions and information given by others. Children must develop language skills to relate with their parents and peers, as well as to grow into a person who can socially interact with others through life. The world of special education and speech/language delays/disorders can be very confusing and incredibly overwhelming. There is a multitude of information out there on many different topics but little of it is parent-friendly. Your educators or healthcare providers may be using terms that you’re not familiar with and expecting you to keep up. Every parent wants to help their child but they simply don’t have any idea where to start or what to do. Speech and language therapists (SLTs) work closely with babies, children and adults who have various levels of speech, language and communication problems, and with those who have swallowing, drinking or eating difficulties. 
- Doctors
- Nurses
- Psychologists
- Physiotherapists
- Occupational therapists
- identifying children’s developmental speech and communication difficulties/disorders;
- assessing and treating swallowing and communication difficulties arising from a range of causes, e.g. congenital problems (such as cleft palate) or acquired disorders after a stroke or injury;
- devising, implementing and revising relevant treatment programmes;
- advising carers on implementing treatment programmes and training other professionals in therapy delivery;
- assessing communication environments;
- monitoring and evaluating clients’ progress;
- working with clients on a one-to-one basis, and in groups, to deliver therapy;
Speech And Language Problems: Terms to Know
- Speech Vs. Language: This will often come up in discussions about a child’s difficulties. A problem with speech has to do with how the child is able to pronounce certain sounds. This has to do with how well he is understood. A problem with language deals with any other part of communication, such as understanding what other say, formulating sentences, using correct grammar, having a good vocabulary of words, interacting with others, etc.
- Fluency Disorders: When we talk about a child’s fluency, we are talking about stuttering or stammering. You can learn more about fluency disorders by clicking this link:
www.speechandlanguagekids.com/stuttering-cluttering-resource-page/
- Voice Disorders: If a child has a voice problem, that has to do with the quality of that child’s voice. Does he sound hoarse? Is his voice scratchy? Is his voice to quiet or too loud?
- Pragmatic Disorders: Pragmatics is another way to say “social skills”. When the Speech and Language Therapist looks at pragmatics, he/she looks at how well a child can interact with others and maintain appropriate relationships with those around him. You can learn more about social skills by clicking this link:
www.speechandlanguagekids.com/social-skills-resource-page/
[/one_full]Speech and Language Diagnoses
Your child may have received a diagnosis that describes his or her speech/language problem. Please click the links to learn more about each disorder/topic.- Speech Sound Disorder (articulation/phonology): www.speechandlanguagekids.com/speech-sound-resource-page/
- Expressive Language Delay/Disorder: www.speechandlanguagekids.com/expressive-language-delay-resource-page/
- Receptive Language Delay/Disorder: www.speechandlanguagekids.com/receptive-language-delay/
- Childhood Apraxia of Speech: www.speechandlanguagekids.com/childhood-apraxia-speech-resource-page/
- Hearing Impairment: www.speechandlanguagekids.com/hearing-impairment/
- Reading Problems: www.speechandlanguagekids.com/literacy-resource-page/
- Sensory Processing Disorder: www.speechandlanguagekids.com/sensory-behavior-resource-page/
- Behavior Problems: www.speechandlanguagekids.com/sensory-behavior-resource-page/
MILESTONES
[/one_full]
6 MONTHS
[/one_fifth]
1 YEAR
[/one_fifth]
2 YEARS
[/one_fifth]
3 YEARS
[/one_fifth]
4 YEARS
[/one_fifth]
5 YEARS
[/one_fourth]
6 YEARS
[/one_fourth]
7 YEARS
[/one_fourth]
8 YEARS
[/one_fourth]
The following milestones referred to are based on research about typically-developing children but this information is not meant to diagnose a speech-language delay or disorder. There is a wide range of normal and even if your child is slightly delayed in a few of these areas, it doesn’t necessarily mean he or she has a speech or language delay. Please contact a speech-language pathologist for a screening if you are concerned about your child’s speech and language skills. [menu_anchor name=”6months”]6 month Old Baby Milestones: Communication
[/one_full] Speech Sound Development for a 6-Month-Old: At 6 months of age, children should be exploring their vocal systems. They should begin playing with sounds and making noises. According to the Liguisystems Guide to Communication Milestones, a 6-month old should do some of the following things:- Plays with voice and mouth by squealing, growling, yelling, and blowing raspberries
- Produces vocalizations that vary weekly and daily
- Produces a variety of vowel-sounds
- Begins doing some experimenting with putting a consonant and vowel together, like “buh” or “gah”
- Startles to loud sounds
- Responds to voices
- Turns head toward a sound source
- Watches a speaker’s face when spoken to
- Recognizes familiar people
- Stops crying when spoken to
- Smiles when spoken to
- Makes noises/sounds to attract attention
- Makes eye contact when interacting
- Likes to chew or pat books
- Can focus on large and bright pictures in a book
- Shares books with an adult as routine part of life
- Does not laugh or squeal
- Does not look toward new sounds
1 Year Old Speech and Language Skills
[/one_full] Speech Sound Development- Begins variegated babbling. This means the child is putting together different non-sense syllables (consonant-vowel) together, like “buh duh gah”.
- Has adult-like tone of voice. This means that although they aren’t using real words, their pitch rises and falls as if they are asking a question or making an exclamation.
- Uses a variety of vowels and consonants while babbling.
- Responds to no
- Responds to his/her own name
- Points at things as if to ask what it is called
- Coos, squeals, and shouts for attention
- Laughs at times
- Tries to communicate with others through actions and gestures
- Smiles at self in mirror
- Plays pat-a-cake and peek-a-boo type games
- Copies simple actions of others
- Likes to chew and pat books
- Can focus on large and bright pictures in a book
- Shares books with an adult as routine part of life
- Responds to sound when a source is not visible
- Responds physically to music (like dancing!)
- Stops an activity when his/her name is called
- Recognizes words for common items
- Begins to respond to simple requests, such as “sit here”
- Does not point to objects
- Does not use gestures such as waving or shaking head
2 Year Old Speech and Language Skills
[/one_full] Speech Sound Development: By 2-years of age, a stranger should be able to understand your child’s speech about 50% of the time. Your child should be using a variety of vowels and consonants but it isn’t a problem if he/she can’t produce them all yet. Sentence Development:- Produces sentences that are an average of 2-words long. That means, some utterances will be 1-word, some 2-words, and some 3-words long
- Uses intonation to ask yes/no questions
- Uses some “wh-” questions, like “what?”, “what that?”, or “where mommy?”
- Follows simple directions, especially with a gestural cue
- Waves bye-bye
- Indicates wet pants
- Repeats actions that made someone laugh
- Plays next to other children
- Pairs gestures with words to get wants and needs met
- Imitates adult behaviors in play
- Refers to self by name
- Protests by saying “no”
- Does “pretend play”, such as talking on a phone or pretending to eat play food
- Talks to self during play
- Uses social words like “hi”, “bye”, “thanks”, “please”
- Recognizes certain books by their covers
- Listens to simple stories, songs, and rhymes
- Turns pages
- Points to and labels pictures by herself
- Pretends to read books
- Follows simple spatial directions, such as “in” and “on” (put it in the barn, put it on the barn)
- Can follow the direction “give me another one”
- Uses simple directional terms, such as “up” and “down”
- Looks in the appropriate place when asked a simple question like “where’s daddy?”
- Chooses an object purposefully when asked about a choice of two, such as “do you want milk or juice?”
- Has a vocabulary of fewer than 50 words
- Doesn’t have much interest in social interactions
3 Year Old Speech and Language Skills
[/one_full] Speech Sound Development: Your 3-year-old should be consistently and correctly using all vowels and the following consonants:- /p/, /m/, /h/, /n/, /w/
- Deleting syllables from multi-syllabic words (such as saying “brella” for “umbrella”)
- Deleting all sounds at the ends of words (such as “ca” for “cat”)
- Uses some pronouns (such as “I”, “it”, “me”, “my”, “mine”, “you”, “your”, “she”, “he”, “yours”, and “we”)
- Uses the “-ing” at the end of verbs (such as “running” and “jumping”)
- Is beginning to use these grammatical markers as well:
- Plural “-s” (like socks)
- Past tense “-ed” (like jumped)
- Possessive “’s” (like Mommy’s)
- Some helping verbs like “can”, “do”, “be”, “will”
- Produces sentences with an average length of 3 words
- Watches other children and briefly joins in their play
- Requests permission for items and activities
- Begins to make simple play schemes, like playing house
- Defends own possessions
- Holds up fingers to tell age
- Looks for missing toys
- Likes to listen to books/stories for longer periods of time
- Holds a book correctly
- Begins to recognize logos (like the McDonald’s Golden Arches or a favorite food logo at the grocery store)
- Is developing phonological awareness and pre-reading skills:
- Distinguishes between “in” and “under”
- Understands (can point to when requested) number concepts of “one” and “two”
- Understands size differences such as “big” and “little”
- Understands “in”, “off”, “on”, “under”, “out of”, “together”, “away from”
- Begins to understand the time concepts of “soon”, “later”, “wait”
- Selects three that are the same out of a set of four objects
- Begins to say adjectives for color and size
- Points to objects when described, such as “What do you wear on your head?”
- Answers questions such as “Where…?”, “What’s that?”, “What’s ___ doing?”, “Who is…?”, and “Can you…?”
- Asks simple questions about his/her wants and needs, such as “where cookie?”
- Asks “where…?”, “what…?” and “what ____ doing?” questions
- Responds to commands involving body parts, such as “show me your nose”
- Follows simple two-step directions, such as “get your cup and give it to me”
4 Year Old Speech and Language Development
[/one_full] Speech Sound Development By this age, your child should be able to consistently make the following sounds correctly:- /p/, /b/, /m/, /h/, /n/, /w/, /d/, /k/, /g/, /d/, /f/, “y”
- Pronouns: – I, me, you, he, she, him, her, we, us, they, them
- Possessive Pronouns: – My, mine, your, yours, his, her, hers, our, ours, their, theirs
- “-ing” on the end of verbs
- Plural -s (The apples)
- Possessive ‘s (Mommy‘s ball)
- Past tense verbs (jumped, ran, etc.)
- Regular third person singular (he jumps, she runs)
- Articles (the ball, a banana)
- The conjunction “and”
- Your child should also be producing sentences with an average length of 2.75-4.5 words/morphemes.
- Follows two-step related directions without cues (such as “stand up and push in your chair)
- Takes turns and plays cooperatively
- Relates personal experiences through verbalization
- Separates from primary caregiver easily
- Frequently practices conversation skills by talking to self
- Begins dramatic play, acting out whole scenes
- Shows frustration if not understood
- Expresses ideas and feelings
- Begins to pay attention to specific print, such as the first letter of his name
- Recognizes logos and other environmental print and understand that print carries a message (knows that the golden arches mean “McDonalds”
- Identifies some letters and makes letter/sound matches (such as knows that “s” says “sssss”)
- Participates in rhyming games (such as recognizing that duck and buck rhyme although they may not be great at this yet)
- Talks about characters in a book
- Likes to “read” stories to herself and others
- Protests if an adult changes the story
- Produces some letter-like forms in scribbles that look like letters
- Is developing phonological awareness and pre-reading skills:
- Follows quantity directions of “empty” and “a lot” (such as “which one is empty” or “which one has a lot of candy?”
- Follows equality directions of “same” and “both” (such as “which two are the same?” or “give me both apples”)
- Understands “next to”, “beside”, and “between”
- Identifies colors (points to the correct color when you name it, like “show me blue”)
- Matches one-to-one (can match two items that are the same)
- Points to the object that is different than the others
- Uses position concepts such as “behind”, “in front”, and “around”
- Answers a variety of questions, including “yes/no”, “what”, “who”, “where”, “why”, “how”, “when”, and “how many” (as long as there are only a few things)
- Asks “what”, “where”, “when”, “how”, “whose” and one-word “why” questions
- Asks “is” questions (like “what is this?” and “is she crying?”)
- Attends to name being called from another room
- Understands most simple questions pertaining to his/her activities and environment
- Begins to learn from listening
5 Year Old Speech and Language Development
[/one_full] Speech Sound Development By this age, your child should be able to consistently make the following sounds correctly:- /p/, /b/, /m/, /h/, /n/, /w/, /d/, /k/, /g/, /d/, /f/, “y”
- Pronouns: – I, me, you, he, she, him, her, we, us, they, them
- Possessive Pronouns: – My, mine, your, yours, his, her, hers, our, ours, their, theirs
- Other pronouns like: – myself, yourself, herself, himself, itself, ourselves, yourselves, themselves
- “-ing” on the end of verbs
- Plural -s (The apples)
- Possessive -s (Mommy‘s ball)
- Past tense verbs (jumped, ran, etc.)
- Regular third person singular (he jumps, she runs)
- Articles (the ball, a banana)
- The conjunction “and”
- Helping verbs such as “to be”, “to do”, and “to have”, including contractions (such as “that‘s my ball”, “I’ll do that”, and “I have two”)
- Your child should also be producing sentences with an average length of 4.5 words/morphemes or more.
- Follows three-step directions without cues
- Uses direct requests with justification (“Stop that, you’re hurting me.”)
- Uses words to invite others to play
- Uses language to resolve disputes with peers
- Plays competitive exercise games (with help from adults)
- Can hold a basic conversation
- Speaks of imaginary conditions, such as “What if…” and “I hope…”
- Understands story sequence (what comes first, next, last)
- Understands the function and purpose of print
- Knows many letter names
- Uses more letter-like forms that scribbles
- Is developing phonological awareness and pre-reading skills:
- Understands comparative and superlative adjectives, such as “big”, “bigger”, and “biggest”
- Understands time concepts yesterday, today, tomorrow, first, then, next, days of the week, last week, next week
- Understands different, nearest, through, thin, whole
- Identifies positional concepts first, middle, last
- Answers a variety of questions, including “yes/no”, “what”, “who”, “where”, “why”, “how”, “when”, and “how many” (as long as there are only a few things)
- Asks “what”, “where”, “when”, “how”, “whose” and one-word “why” questions
- Asks “is” questions (like “what is this?” and “is she crying?”)
- Hears and understands most of what is said at home and in school
- Repeats four digits when they are given slowly
- Readily follows simple commands involving remote objects (such as “go to your room and get your blue shoes and bring them here”)
6 Year Old Speech and Language Development
[/one_full] Speech Sound Development By this age, your child should be able to consistently make the following sounds correctly:- /p/, /b/, /m/, /h/, /n/, /w/, /d/, /k/, /g/, /d/, /f/, “y”, /t/, “ng”, /r/, /l/
- Pronouns: – I, me, you, he, she, him, her, we, us, they, them
- Possessive Pronouns: – My, mine, your, yours, his, her, hers, our, ours, their, theirs
- Other pronouns like: – myself, yourself, herself, himself, itself, ourselves, yourselves, themselves
- “-ing” on the end of verbs
- Plural -s (The apples)
- Possessive -s (Mommy‘s ball)
- Past tense verbs (jumped, ran, etc.)
- Regular third person singular (he jumps, she runs)
- Articles (the ball, a banana)
- The conjunction “and”
- Helping verbs such as “to be”, “to do”, and “to have”, including contractions (such as “that‘s my ball”, “I’ll do that”, and “I have two”)
- Your child should also be producing sentences with an average length of 4.5 words/morphemes or more.
- Uses threats and promises
- Asks for the meanings of words
- Likes to complete projects
- Makes purchases at store (with adult supervision)
- Asks questions for information
- Chooses own friends
- Takes more care in communicating with unfamiliar people
- Engages in cooperative play, such as making group decisions, assigning roles, and playing fairly
- Announces topic shifts
- Recognizes letters and letter-sound matches
- Understands that print is read left to right and top to bottom
- Retells simple stories
- Begins to write stories with some readable parts with assistance
- Tries to spell words when writing
- Understands that spoken words are made up of sounds
- Recognizes some words by sight
- Identifies and writes uppercase and lowercase letters
- “Reads” a few picture books from memory
- Prints own first and last name
- Has mastered phonological awareness and pre-reading skills:
- Understands comparative and superlative adjectives, such as “big”, “bigger”, and “biggest”
- Understands time concepts yesterday, today, tomorrow, first, then, next, days of the week, last week, next week
- Understands different, nearest, through, thin, whole
- Identifies positional concepts first, middle, last
- Understands opposite concepts, such as big/little, over/under
- Understands left/right
- Understands number concepts up to 20
- Answers “How are things different/same?”
- Uses adjectives for describing
- Uses comparative adjectives such as loud, louder
- Uses yesterday and tomorrow
- Uses adverb concepts of backward and forward
- Uses prepositions through, nearest, corner, middle
- Names ordinal numbers, such as first, second, third
- Answers a variety of questions, including “yes/no”, “what”, “who”, “where”, “why”, “how”, “when”, and “how many” (as long as there are only a few things)
- Asks “what”, “where”, “when”, “how”, “whose” and one-word “why” questions
- Asks “is” questions (like “what is this?” and “is she crying?”)
- Repeats sentences up to nine words in length
- Follows three-step directions
- Responds correctly to more types of sentences but still may be confused at times by more complex sentences
7 Year Old Speech and Language Development
[/one_full] Speech Sound Development By this age, your child should be able to consistently make the following sounds correctly:- /p/, /b/, /m/, /h/, /n/, /w/, /d/, /k/, /g/, /d/, /f/, “y”, /t/, “ng”, /r/, /l/, “ch”, “sh”, “j”, voiceless “th” (like in “thumb”)
- Pronouns: – I, me, you, he, she, him, her, we, us, they, them
- Possessive Pronouns: – My, mine, your, yours, his, her, hers, our, ours, their, theirs
- Other pronouns like: – myself, yourself, herself, himself, itself, ourselves, yourselves, themselves
- “-ing” on the end of verbs
- Plural -s (The apples)
- Possessive -s (Mommy‘s ball)
- Past tense verbs (jumped, ran, etc.)
- Regular third person singular (he jumps, she runs)
- Articles (the ball, a banana)
- The conjunction “and”
- Helping verbs such as “to be”, “to do”, and “to have”, including contractions (such as “that‘s my ball”, “I’ll do that”, and “I have two”)
- Your child should also be producing sentences with an average length of 4.5 words/morphemes or more.
- Uses threats and promises
- Asks for the meanings of words
- Likes to complete projects
- Makes purchases at store (with adult supervision)
- Asks questions for information
- Chooses own friends
- Takes more care in communicating with unfamiliar people
- Engages in cooperative play, such as making group decisions, assigning roles, and playing fairly
- Announces topic shifts
- Identifies an increasing number of words by sight
- Begins to decode new words independently
- Uses a variety of reading strategies such as rereading, predicting what will happen next, asking questions, or using visual cues or pictures
- Reads and retells familiar stories
- Reads aloud with ease
- Decides independently to use reading and writing for different purposes
- Sounds out and represents major sounds in words when trying to spell
- Tries to use some punctuation and capitalization
- Understands comparative and superlative adjectives, such as “big”, “bigger”, and “biggest”
- Understands time concepts yesterday, today, tomorrow, first, then, next, days of the week, last week, next week
- Understands different, nearest, through, thin, whole
- Identifies positional concepts first, middle, last
- Understands opposite concepts, such as big/little, over/under
- Understands left/right
- Understands number concepts up to 20
- Answers “How are things different/same?”
- Uses adjectives for describing
- Uses comparative adjectives such as loud, louder
- Uses yesterday and tomorrow
- Uses adverb concepts of backward and forward
- Uses prepositions through, nearest, corner, middle
- Names ordinal numbers, such as first, second, third
- Answers a variety of questions, including “yes/no”, “what”, “who”, “where”, “why”, “how”, “when”, and “how many” (as long as there are only a few things)
- Asks “what”, “where”, “when”, “how”, “whose” and one-word “why” questions
- Asks “is” questions (like “what is this?” and “is she crying?”)
- Repeats sentences up to nine words in length
- Follows three-step directions
- Responds correctly to more types of sentences but still may be confused at times by more complex sentences
8 Year Old Speech and Language Development
Speech Sound Development By this age, your child should be able to consistently make all English speech sounds correctly:- /p/, /b/, /m/, /h/, /n/, /w/, /d/, /k/, /g/, /d/, /f/, “y”, /t/, “ng”, /r/, /l/, “ch”, “sh”, “j”, voiceless “th” (like in “thumb”), /s/, /z/, /v/, voiced “th” (like “the”), “zh” (like in “beige“)
- Pronouns: – I, me, you, he, she, him, her, we, us, they, them
- Possessive Pronouns: – My, mine, your, yours, his, her, hers, our, ours, their, theirs
- Other pronouns like: – myself, yourself, herself, himself, itself, ourselves, yourselves, themselves
- “-ing” on the end of verbs
- Plural -s (The apples)
- Possessive -s (Mommy‘s ball)
- Past tense verbs (jumped, ran, etc.)
- Regular third person singular (he jumps, she runs)
- Articles (the ball, a banana)
- The conjunction “and”
- Helping verbs such as “to be”, “to do”, and “to have”, including contractions (such as “that‘s my ball”, “I’ll do that”, and “I have two”)
- Identifies letters, words, and sentences
- Has a sight word vocabulary of 100 words
- Understands what is read
- Creates rhyming words
- Reads grade-level material fluently
- Expresses ideas through writing
- Prints clearly
- Spells frequently-used words correctly
- Begins sentences with capital letters and attempts to use punctuation
- Writes a variety of stories, journal entries, or notes