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Expert Advice on Children's Hearing and Speech Development
Written by Megan Rozantes M.S., CCC-SLP, Pediatric Speech-Language Pathologist, Director & Lead Therapist of Chatterboxes, www.teamchatterboxes.com. Megan’s full contact details can be found at the conclusion of this article.

When does a parent need to see an expert on a child’s hearing and speech development?
The early months and years of your baby's life are a critical period during which the development of strong social & communication skills, emotional growth and intelligence takes place. These skills serve as the foundation for which all other learning will be built upon as they grow older. For this reason, early intervention is of utmost importance.

According to the American Speech and Hearing Association, if a child doesn’t talk by age 1, the speech is not clear or if speech or language is different from that of other children of the same age, there may be cause for concern. Parents should be urged to take action as soon as they feel that their child may be exhibiting signs of a developmental problem.

In addition, your child’s pediatrician, or other professional will also most likely recommend a hearing test. Oftentimes chronic ear infections may lead to hearing loss which in turn causes the child to miss portions of speech and language signals and may contribute to a language delay.

The following signs are of behaviors that often occur with hearing losses:

• Talks in a very loud or very soft voice
• Seems to have difficulty responding when called from across the room, even when it is for something interesting
• Turns body so that the same ear is always turned toward sound
• Has difficulty understanding what has been said or following directions after once she has turned 3 years of age
• Doesn't startle to loud noises
• Ears may appear small
• Fails to develop sounds or words that would be appropriate at her/his age

In terms of behavioral aspects, language delays may affect a child’s behavior both in the classroom and at school therefore, the following is a list of behavioral “red flags” or potential signs that may warrant further evaluation:

General Behavioral Warning Signs

• Does not pay attention or stay focused on an activity for as long a time as other children of the same age
• Focuses on unusual objects for long periods of time; enjoys this more than interacting with others
• Avoids or rarely makes eye contact with others
• Gets unusually frustrated when trying to do simple tasks that most children of the same age can do
• Shows aggressive behaviors and acting out and appears to be very stubborn compared with other children
• Displays violent behaviors on a daily basis
• Stares into space, rocks body, or talks to self more often than other children of the same age
• Does not seek love and approval from a caregiver or parent

To close, the lists below are some common developmental warning signs of speech, language delays/disorders according to age levels. Please note: this list is simply a general guideline and should not be used to diagnose, nor should it be construed as a comprehensive list.

Two to Three Year Olds

• Not combining words
• Unable to understand short instructions (ex: give me the ball)
• Must be told and retold to carry out simple directions (outside of non-compliance)
• Using only nouns
• Poor eye contact
• No rapid increase in number of words understood and used
• Does not tolerate sitting for listening activity/looking at books, etc.
• Cannot be understood by familiar people (teachers, friends, family, etc)
• Does not use any simple sentences
• Very little use of questions (what, when, why, where)
• Shows little interest in other children
• Extreme difficulty separating from a parent
• Failing to add final sounds to words (“dah” for “dog”)

Three to Four Year Olds

• Not speaking in full sentences
• Not using "I" to refer to self
• Cannot relate experiences, even in simple telegraph sentences
• Frequent fluency problems, such as stuttering.
• Isn’t fully understandable by familiar and non-familiar listeners.
• Unable to state first and last name
• Not able to sing along or say familiar nursery rhymes or songs
• Unable to understand and respond to “wh” questions
• Not able to sustain a conversation for 3-4 exchanges
• May not be able to describe attributes of objects when asked-
  Ex: “What color is your car?”
• Cannot follow a 3 step related command
• Is not showing inflection in their voice to ask a question

Four to Five Year Olds

• Not able to give simple meanings/definitions for words
• Unable to understand prepositions, such as on, under, next to, etc.
• Does not show simple reasoning skills-“What should you do if you’re cold?”
• Often times strays from the topic when telling a story
• Unable to answer simple questions about a story, or while reading a book.
• Poor memory skills
• Having difficulty learning colors, numbers, alphabet, shapes.
• Typical sentence length is less than 8 words
• Little use of his/her imagination

If your child is exhibiting any of the aforementioned “red flags” please do not hesitate to contact your child’s pediatrician, or a speech-pathologist. Children are very resilient during these early years; therefore, early intervention is essential to a child’s overall academic, language, play, cognitive and social development.

Author:
Megan Rozantes M.S., CCC-SLP
Pediatric Speech-Language Pathologist
Chatterboxes- Director & Lead Therapist
Phone: 617.723.TALK
www.teamchatterboxes.com

Chatterboxes can be reached at 617-723-TALK or feel free to visit us on the Web at www.teamchatterboxes.com where more pediatric developmental topics can be found.