Is your child a late talker? Or does your child have other challenges with communication? Do you wonder whether your child might have a communication disorder? If so, you can contact your Pediatrician to discuss your concerns and in California you can also contact your local Regional Center or Family Resource Center. These agencies will help guide you to the right referrals for assessment and services.

If your concerns are mainly about speech and language development (“late talkers”), a speech-language pathologist (SLP) can help. A complete speech and language evaluation is usually the first step. It can spot communication disorders and help with design of an intervention plan.

A Speech and Language Evaluation

Can your child benefit from early intervention by a speech-language pathologist? The best way to tell is to have a complete developmental assessment, preferably in your family’s home language.

The assessment should consist of:

• Determining your concerns and priorities
• Identifying your child’s existing communication strengths and weaknesses
• Evaluating the effectiveness of your child’s attempts at communication
• Evaluating your child’s environments to find out what supports or interferes with effective communication

Reasons to Intervene Early

Speech-language pathologists recommend early intervention if there is atypical or delayed development of communication skills, or the potential for it. There are five reasons for implementing interventions. They include:

• Prevention of a disorder
• Elimination of a disorder
• Modification or remediation of a disorder
• Teaching strategies that help a child compensate for a disorder
• Modification of the environment to aid the child

Here are ways to better understand each of these types of intervention.

Prevention of a disorder. If prevention is stressed, there may be a means for delaying or avoiding the onset of a disorder. Federal legislation encourages prevention by stressing early identification and treatment of communication disorders. An example is the Early Hearing Detection and Intervention (EHDI) program. This is a national initiative to screen the hearing of all newborns by one month of age. The program has greatly enhanced early detection of hearing loss, allowing for earlier intervention and better outcomes.

Elimination of a disorder. A child may be able to develop normal speech or language, although this is difficult to predict for most young children. We often don’t know the cause of “late talking” and can’t predict the course of development. Many articulation disorders are the result of an error pattern that then becomes the habitually used incorrect sound. With intervention, these speech sound disorders are often quickly eliminated, especially for school-age children.

Modification or remediation of a disorder. This involves improving communication skills and functioning. It is the most common outcome expected from speech and language intervention for young children with communication delays. Becoming a more effective communicator helps a child to advance developmentally. It also can prevent other problems, such as behavior problems.

Teaching Strategies to help a child compensate for a disorder. These are strategies used to develop a functional means of communication for a child. Compensatory strategies can reduce a child’s frustration with communication difficulties. For example, a young child with Down Syndrome can learn and effectively use many signs (Baby Sign or American Sign Language signs) or gestures (pointing to a desired item) to express their needs while they are also working on developing their speech. A non-verbal child with autism may use Picture Exchange Communication System (PECS) as a strategy to help develop a functional means of communication. These strategies may also be used to give the child an immediate way to communicate while also working on more long-term strategies to develop other speech and language skills. For younger children, teaching simple attention-getting or cause-and-effect work best. For example, “When I hit the switch, the toy lights up and makes music.” Older children with greater cognitive maturity can benefit more often from these strategies. They are able to explore alternative communication strategies.

Modification of the environment to aid the child. This can mean many things and is usually combined with one of the other more direct strategies. These are all the factors outside of the child, including communication partners. If changed in some way, these may facilitate the child’s ability to communicate. For example, by reducing background noise and visual distractions, such as by turning off the television or music, a child with sensitivity to distraction might be better able to concentrate on communication. Or a speech-language pathologist and occupational therapist might work together to treat a child to deal with issues like sensory integration or body stability issues. By changing position, support, seating, or room lighting, for example, a child can become more comfortable and more able to take turns with communicating.

References:

McClean, L.K. & Cripe, J.W. (1997) The effectiveness of early intervention for children with communicative disorders. In Guralnik, M.J. (Ed.) The effectiveness of early intervention. Baltimore, MD: Paul Brooks Publishing.

California Speech-Language-Hearing Association. (2002) Preferred practice patterns for speech-language pathologists in service delivery to infants and toddlers and their families. Sacramento, CA: California Speech-Language-Hearing Association.