late speech development

Late talking in children is a perplexing subject. We know that when children talk late, it may be a sign of developmental problems on a more universal scale. Late talking and delayed motor development are often the early signs of developmental delay or retardation which herald significant problems in intellectual function and adapative ability. Thus, speech production (as well as understanding) is an important milestone in any child's development.

First, we must consider that children who are thought to begin intelligible speech production late fall into two basic groups:

Those who talk too late to please parents or relatives but are "within normal limits" for speech development
Those who are truly late in speech development

The first group takes care of itself. First priority for the second group is to be sure that the child does not suffer from hearing loss, either from past ear infections (rare), from currently existing middle ear fluid, or from other problems such as familial or sporadic nerve deafness.

Very rough rules of thumb I use for checking speech production:

Cooing and babbling socially (in response to your vocalizations) by 8 week checkup
Some "syllables" by the six month checkup
One word utterances by age one: "Ma-Ma," "Da-Da" are naturally the standard.
Two word or more sentences by age two: "Cookie allgone!" (remember that bye-bye, allgone and the like are really just one word utterances for the child)
Three or more word sentences by age three; most kids are pretty conversant by now.
Pretty much adult style speech by age four, even if certain letters still give trouble ("you wascally wabbit!")

Intelligibility guidlines:

25% intelligible to another person (not in your family) at age one
50% intelligible to another person by age two
75% intelligible to another person by age three
100% intelligible to another person by age four.

Any child who is not functioning at at least these levels should be evaluated, by a speech pathologist or possibly a developmental specialist or developmental specialty team if there is any suspicion of more pervasive developmental delay than just in speech/language skills.

I refer any child who is falling short of these guidelines but otherwise seems developmentally normal to a speech therapist for evaluation by age two to three years old. Cost is an issue, because most insurance plans do not cover speech therapy for children under these circumstances. Luckily, on the third birthday, children are eligible for speech evaluation and any necessary therapy through the public school system, under Federal mandate. I refer the mother to the counsellor at the public school where the child would normally enroll for kindergarten. In Alabama, and possibly in your state, early developmental intervention programs are available which provide these services before age three. Ask your pediatrician or call your county health department.

A remarkable book is available for parents of children who talk late. It is written by Thomas Sowell, a distinguished economist at Stanford University. He has a son who talked very late and yet is quite gifted. It turns out that the phenomenon of late talking in persons (especially boys) who turn out to be normal to gifted in ability is not that uncommon. A number of very famous and gifted persons - including Albert Einstein - were late talkers. Dr. Sowell studied everything he could find about late talking children, collected case histories from parents of similar children, and wrote a book chronicling his experiences and the experiences of other parents. If you or someone you know has a child who is a very late talker, but otherwise seems developmentally normal, this book is a must read. Late Talking Children, Thomas Sowell, Basic Books 1997 ISBN 0-465-03834-4

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