Two children in every typical classroom of up to 30 children have speech, language and communication needs, yet many of these children go unidentified. The impact of missed speech, language and communication needs on a child’s education attainment, social, emotional and mental health can be significant and long-term, yet the most common reason for referral to speech and language therapy, speech sound disorders, often has the least long-term impact. The problem for parents, speech and language therapists, teachers and educators is there is no failsafe way of telling which children will have ongoing and persistent problems. It can be the children with the most hidden and subtle difficulties who are struggling the most.
Over the next few months I will take you through what to expect of your child’s speech, language and communication development from birth until secondary school
Last month a report called the Bercow Review was published by the government. It is a 10-year review of how the needs of children’s speech, language and communication development are being met across the UK. There are many positive aspects to the report, but it also raises concerns about how many children and families are not receiving the support and intervention they need. By writing for My Baba about speech, language and communication development and the work that speech and language therapists do, I hope to increase awareness about the role of the profession and the invaluable work we do in enhancing children’s speech, language and communication skills.
Over the next few months I will take you through what to expect of your child’s speech, language and communication development from birth until secondary school age, as well as write about the lesser known area of expertise speech and language therapists have working with babies and children who have feeding difficulties. I will tell you about the diverse and hugely effective work my profession undertakes, so if you or anyone you know is concerned about a child you will understand how a speech and language therapist can help. But, for now, let us start at the beginning…
0 to 18 months
The first thing we are taught as speech and language therapists is communication is so much more than sounds and words. Speech, language and communication development is a multisensory process underpinned by preverbal skills including hearing, listening, attention, turn taking, eye contact, playing, crying and babbling. Babies’ speech, language and communication develops from birth as they explore the environment through all their senses. Hearing is key, as even newborn babies have been found to prefer the sounds they hear in their parents’ language than a foreign language. This shows your baby is hearing and listening to you even before he or she is born. All new born babies in the UK have a hearing screen so if any sensorineural hearing difficulty is identified a specialist speech and language therapist would be part of the multidisciplinary team supporting you and your family from the outset.
Antenatal screening and early diagnosis of underlying conditions that may cause a child to have speech, language and communication needs allow speech and language therapists to work with children and families even before birth. For example, by introducing baby signing like MAKATON (a language programme that supports understanding and speaking) to a family when they are expecting a baby who may have a global learning delay as a result of Down syndrome or other genetic diagnosis.
Many people are unaware of the extent speech and language therapists work with neonates. As well as advising and supporting families who have a baby with early communication needs, speech and language therapists also work with neonates, babies and children with feeding difficulties, for example babies with cleft lip and palate, or neonates on special care baby units who are tube fed and at risk of becoming hypersensitive. This work is very specialist, but demonstrates how the work of speech and language therapists is so much more than sounds and words.
As well as working with babies we know will have communication and/or feeding needs, speech and language therapists also work with populations who are at risk, for example children from disadvantaged backgrounds. This work may include training other professionals, such as midwives, health visitors, GPs and social workers; running specific, evidence based intervention programmes; or participating in informative community events to raise awareness about how to support speech, language and communication development.
What to expect and when
There is a huge variation in the age children progress through the stages of speech, language and communication development. In the first 18 months, your child will go from unfocussed eyes, to making eye contact, to babbling and first words.
By 0 to 6 months your baby will:
- Recognise your voice.
- Be startled by loud noises and turn towards sounds in his or her environment.
- Watch your face when you talk to him or her.
- Use different cries for different needs, e.g. pain, hunger, tiredness.
- Smile and laugh when other people smile and laugh.
- Coo, babble and gurgle, experimenting with the different sounds he or she can make.
- Vocalise to get your attention.
By 6 to 12 months your baby will:
- Listen carefully and turn towards people talking, even if they are at a distance.
- Recognise and respond to his or her name.
- Begin to understand ‘social’ words and phrases like ‘bye-bye’ and ‘up’.
- Begin to understand the names of familiar objects and people.
- Babble sequences of sounds, e.g. ‘ba ba ba’; ‘goo goo goo’; ‘ne ne ne’.
- Turn take babbling and cooing with an adult.
- Engage with nursery rhymes and nursery songs, watching the actions and responding enthusiastically.
By 12 to 18 months your baby, or toddler, will:
- Enjoy playing anticipation games, e.g. ‘peek-a-boo’ and ‘round and round the garden’.
- Begin to engage in simple pretend play, e.g. talking on a phone, cuddling a dolly.
- Enjoy playing with cause and effect toys and toys that make noises.
- Understand an increasing number of words, including nouns (object words) and verbs (action words) and be able to point to them in the environment or a book.
- Begin to understand simple instructions, e.g. ‘give me’; ‘kick the ball’; ‘hug teddy’.
- Copy adults’ words and gestures.
- Say up to 20 words labelling familiar objects, toys and people.
- Use gesture and pointing with his or her spoken words to communicate his or her wants and needs.
Babies and young children can have vast differences in their speech, language and communication development so try not to compare too much with your child’s siblings and friends. As a parent myself, I never tell parents not to worry, because that is what we do! If you are worried speak to your health visitor or GP and ask for a referral to speech and language therapy. Or if your child attends a crèche or nursery speak to the staff as early years educators will have knowledge of early speech, language and communication development. Parental concern is very often valid so listen to your instinct and seek help and advice.
Traditionally, speech and language therapists were employed by the NHS but an increasing number now work independently. You can find a speech and language therapist local to you by contacting the Association of Speech and Language Therapists in Independent Practice (ASLTIP). Early intervention is very important and research shows the earlier support and advice is given the better the outcome for your child.
Remember most children develop speech, language and communication skills without any difficulty and it is a magical and rewarding time for parents and the whole family.
For more information, useful links and resources visit: