CONTACT: BECKY SOGLIN
Iowa City IA 52242
(319) 335-6660; fax (319) 384-4638
Release: Dec. 16, 2002
Many resources available to help children with delayed talking
In addition to photos or a lock of hair, a baby book typically includes
milestones such as first words and sentences. But sometimes these milestones
are delayed, and children don't talk "when they should," causing
concern for parents and caregivers.
Delayed talking or problems with fluency have many different causes, so it
is important for parents to seek out appropriate resources for diagnosis and
treatment, said Debora Downey, a speech pathologist with the Center for Disabilities
and Development at University of Iowa Hospitals and Clinics. Early intervention
is vital, as an undiagnosed language disorder can later be difficult to remediate
and contribute to other learning problems.
"If parents become concerned about their child's speech and language
development, the first thing they should do is discuss it with their pediatrician,"
Downey said. "Pediatricians are an excellent starting point for guiding
parents to the most appropriate resources. The key is to look at each child's
Downey said a general rule is that by age 2 a child should be able to put
two words together. By age 3, a child normally should be able to communicate
"That means being able to make him or herself understood without a parent
repeating or interpreting the comment for listeners," Downey said. "The
range of normal varies in terms of sound development. However, if your child
is not able to communicate by the age of 3, then you should seek assistance."
Downey and UI colleagues recently published an overview article in the journal
Infants and Young Children on the diagnosis and treatment of children who
are not talking. The article emphasized the usefulness of a multidisciplinary
approach to help children and their families get the services they need.
Health care professionals at the UI Center for Disabilities and Development
can help determine if language problems are related to hearing problems, brain
development or another condition such as autism. Some parents may already
be aware of an existing motor or cognitive disorder that, as the child ages,
impacts speech and language development.
Downey said that in other cases a family may need assistance identifying
a possible speech or language problem with a child, especially if the child
can be understood by the family but is unintelligible to everyone else at
age 3 or older. Then, it is a good idea for parents to consider having the
child evaluated at an early age.
"Children with underlying language disorders who go undiagnosed can
end up later in life with obvious learning disabilities. By then, the language
foundation cannot be remediated," Downey said. "Reading, writing
and math are other forms of language, so children need a solid language foundation.
Otherwise, no matter how much support you provide later on, the children cannot
reach their full potential. It would be like building a house and there's
no framework to support the walls."
Downey said it is important to recognize that language delay and speech delay
are different. "Language delay has to do with how a child responds to
and reacts to his or her environment, whereas speech delay has more to do
with the actual sound development and sequencing of sounds to make words,"
Sounds such as "r," "l" and "s" can be difficult
for children to say even up until age 7. Time and maturation often are all
that is needed for a child to learn to correctly pronounce certain sounds
or words, Downey said. However, there are instances where intervention is
"If a child named 'Sam' or 'Rita,' for example, cannot properly say
his or her own name and begins to withdraw socially, then it is important
to seek services because the problem, although normal for the child's age,
impacts the child's emotional status," Downey said.
For children and adults who cannot produce language because of motor problems
caused by conditions such as multiple sclerosis, head injury or stroke, several
electronic devices can help with communication at home, work and school.
"Our augmentative communication services at the Center for Disabilities
and Development allows us to evaluate individuals and match a low-tech, mid-tech
or high-tech device to the child's or adult's needs," Downey said.
The UI Center for Disabilities and Development (formerly the University Hospital
School) provides services to many people in the Midwest, including Iowa, Illinois,
Minnesota, Nebraska and Wisconsin. Visit the center online at www.uihealthcare.com/depts/disabilitiesanddevelopment.
Or contact the center toll-free at (877) 686-0031 (voice), (877) 686-0032
(TTY) or locally at 353-6900 (voice).
Downey added that the American Speech and Hearing Association, online at
www.asha.org, is also a useful resource for people who want to find speech
and language experts in their area.
University of Iowa Health Care describes the partnership between
the UI Roy J. and Lucille A. Carver College of Medicine and UI Hospitals and
Clinics and the patient care, medical education and research programs and
services they provide. Visit UI Health Care online at www.uihealthcare.com.