TALKING! What’s it all about?

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It may surprise you to learn that talking is one of the most difficult things we ever do. For most of us, it seems so easy that we just take it for granted. But, when it doesn’t happen like we expect it to, mastering it can take a lot of time and patience. If it weren’t for the control it gives us and the relationships it helps us enjoy, maybe some of us wouldn’t bother at all!
  
Speech Language Pathologists spend a lot of time learning to put something very difficult within reach of the people struggling with it. In order to do that, we make a lot of distinctions that help us know where to start. Following are some answers to questions we’re often asked.

What’s the difference between a “Speech Language Pathologist” and a “Speech Therapist”?

Only the words are different, but Speech Language Pathologist is a better description of what we do. We are the medical professionals who are trained and qualified to distinguish between the various facets of speech and language, identify the areas of break-down, and create therapy programs to remediate them. Surprisingly, because the same body parts are involved, we’re also experts involved in treatment of disorders involving voice, swallowing, and chronic cough!

What’s the difference between “speech” and “language”?

In the simplest of terms, “speech” is the combination of sounds that come out of your mouth when you talk. “Language” is what gives you something to say – the words you use, the types of sentences you make, and the kinds of things you want to say. Without language, there won’t be any meaningful speech. While there may be a lot of meaningless sounds, there certainly won’t be any “communication.”

Real communication is a “two-way street.” How does language make that happen?

“Receptive language” is speech therapy lingo for “understanding” or “comprehension.” One of the things your speech therapist will want to know is how well your child is able to understand what people say to her or him. “Expressive language” refers to what your child is able to say. Both need to be in place for communication to be successful.

What other distinction do speech therapists make?

Speech therapists use assessments to determine what areas of speech and language are not working like they should be. Following are a few terms you may hear frequently.
 
  • Articulation refers to the child’s ability to produce age-appropriate speech sounds. Can the child say them in imitation but not spontaneously? Can he or she say them in single words but not in sentences?
  • Syntax or Sentence Structure refers to the type of sentence’s the child uses? What is the MLU (mean length of utterance) – or in simpler terms, how long are the sentences my child uses? What different word-combinations and sentence-types does my child use? Does he ask wh- questions (e.g., who-, what-, where-, when-, why-)?
  • Content or Meaning refers to the child’s ability to use sentences to convey meaningful thoughts and ideas. It includes “vocabulary” but it’s more complicated than just how many words the child knows. Even though we distinguish between syntax and content, the truth is that they influence each other and one really doesn’t exist in isolation from the other.
  • Pragmatics or Function or Use is all about what the child uses his or her speech and language skills for. Does he or she use greetings? ask questions? label favorite objects? call to get your attention? change conversational topics appropriately? These are just a few of the communication patterns your speech therapist will be looking at.

At what age should my child begin talking?

Below you’ll find what skills you can expect your child to be developing at various ages and stages. It’s important to remember that these are just guidelines. Every child is unique. If you have concerns, it’s a good idea to talk to a professional. Ask your doctor for a referral for a speech assessment. If there isn’t a problem, you’ll be able to stop worrying. If there is, the sooner it’s addressed, the easier it will be for your child to improve.
 

SPEECH SOUNDS

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What sounds can you hear me making when I talk?
         
  • Between birth and 3 months:  You should already hear me making small, throaty “cooing” noises. I may make noises to respond to someone who’s really friendly.
  • Between 3 and 6 months: I start playing with making sounds, babbling different consonants and vowels as I learn how to shape them with my mouth.
  • Between 6 and 9 months:  I start putting two sounds together when I’m babbling (e.g., “gagagaga; bibibibibi). If you’re paying close attention to me,  you may see that I make sounds to get your attention.
  • Between  9 and 12 months:  You should hear me chattering to myself and occasionally I may imitate something you say!
  • At 12 months:  You’ll still hear me doing a lot of babbling.
  • By 18 months: You should be hearing me say some words that you recognize, and you’ll hear me starting to make a lot of different consonant sounds like “b”, “p”, “d”, “g”, “m”, “n”, “h” and “w”.
  • By 2 years: I’m starting to put final consonant sounds on words.
  • By 3 years: I’m using lots more sounds consistently, and saying combinations of consonants like “sp” and “sn”.
  • By 4 years: I don’t leave out many sounds any more. In fact, I sound almost like an adult!
  • From 5-to-6 years: I’m finally saying “l” and “r” if I didn’t say them earlier!
  • By 7 years: I can even say “th” in sentences and I really do sound like an adult now!

COGNITION

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What kinds of things do I like to think about?
 
  • At 12 months: I like toys that make sounds and I like making them work. I know that a toy is still there even if you hide it under something. I understand how familiar objects are used and I might pretend to drink from a cup or “drive” a toy car. I might push an adult’s hand to continue a fun activity, and I anticipate certain events from familiar signs (e.g., crying when mom gets ready to go out).
  • Between 12 and 18 months: I link more objects in functional play activities (e.g., put a cup on a saucer and pretend to drink). I imitate more simple everyday actions (feeding a doll; reading a book). I like putting small objects in and out of containers. I like looking at simple picture books with you and I might point to familiar objects. I have favorite toys and I play more appropriately with them. I start experimenting with toys to see if I can use them in different ways.
  • Between 18 months and 24 months: I probably follow you around and imitate things you do (e.g., sweeping floors, talking on the phone. I’m happy playing near other children but I don’t really play with them. I play more with “make believe” activities like feeding my dolls or having my cars interact with each other.
  • Between 24 and 30 months: I play more meaningfully with toys like dolls and cars, and while I play with them I talk about what’s happening with them. I match “same” objects and pictures and I notice little details in picture books. I can do simple form boards.
  • Between 30 and 36 months: I love playing “make-believe” and even make up people and objects. I like floor-play with blocks, boxes, toy trains, dolls and doll furniture. I still like playing alone but I also play more with other children. I match colors, and shapes in puzzles and shape sorters. I count to three and maybe further and I hold up fingers to show how old I am.
  • Between 3 and 4 years: I understand concepts of big/little, fast/slow, and long/short. I can tell a simple story with beginning, middle, and end. I match more detailed pictures of “same” objects and complete a form board of 5 or more pieces
  • Between 4 and 5 years: I know how old I am! I can match and label 4 colors. I can count to 10 and answer “how many…” if you ask me. I can sequence pictures in order of occurrence and I can answer questions about a story that you read to me. I can classify objects into categories (e.g., food, toys, vehicles). I understand “yesterday”, “today”, and “tomorrow”. I can understand and complete simple analogies (e.g., “Ice is cold. Fire is “hot” and I can predict the outcome of a story.
  • At 5 years: I know my “right” from my “left” and I can tell you my home address. I can count up to 20 objects, identify some small words, say the alphabet and write some letters. I can add and subtract correctly within 5 objects. I can still be easily distracted but I like learning by doing things myself. I can make up long stories and I know the difference between telling the truth and lying.

INTELLIGIBILITY

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Can you understand me when I talk?
 
  • By 18 months: Parents should understand approximately 25% of what I say.
  • At 24 months: Unfamiliar listeners should understand 26% to 50% of what I say. Parents should understand me 50% to 75% of the time.
  • At 30 months: Unfamiliar listeners should understand 51% to 70% of what I say.
  • At 36 months: Unfamiliar listeners should understand 71% to 80% of what I say. Parents should understand me 75% to 100% of the time.
  • By 4 years: I may still have difficulty with some sounds but my speech should be 100% intelligible.

VOCABULARY

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How many words should I be saying?          
 
  • From 12 – 18 months: I should have a vocabulary of 5-to-50 words.
  • By 24 months: I have a vocab of over 150 to 300 words! And I use at least 2 pronouns (I, you, me). You might also hear me say “my” and “mine.”
  • By 30 months: I may be using 400 words!
  • By 36 months: I’m using over 1000 words!
  • By 4 years: I have a vocabulary of over 1500 words. I know the names of familiar animals and I use at least 4 prepositions. I can name common objects in picture books
  • By 5 years: I use descriptive words (adjectives and adverbs) and I know common opposites.

UNDERSTANDING (RECEPTIVE LANGUAGE)

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How much of what I hear do I understand? How well do I follow directions?
 
  • 6 months: I respond to human voices by turning my head. I may recognize to my name, and I may react appropriately to friendly and angry voices.
  • By 12 months: I like to listen to sounds. I respond to “no” – at least for a moment! I know the words for several familiar objects and I might tell them to you if you ask. I follow several simple action requests when you use gestures as well as words (e.g., “Give it to Daddy.” or “Clap hands.” or “Bring me your shoes.”)
  • Between 12 and 18 months: I understand lots of words, including clothing, body parts, toys, family member names, and action words (e.g., run, go, eat, drink, play…). I follow simple directions (e.g., :Kiss the baby.”; “Push the truck.”; “Get Mommy’s shoes.”).
  • Between 18 and 24 months: I can point to 5 body parts when you ask me to and I follow simple 2-step directions. I understand action-object relationships (e.g., “wash the baby”), early prepositions ( e.g., in, on), possessives (e.g., “teddy’s feet), and early descriptors (e.g., big, little).
  • Between 24 and 30 months: I like listening to simple, familiar stories being read to me from picture books and I can point to objects and actions when you name them. I understand prepositions “in”, “on”, and “under”, and pronouns “my” versus “your. I also understand “one” versus “many” and I can identify objects by use (e.g., “Which one do you wear?”; “Which one do you watch?”). I understand simple questions (e.g., “Can you see the ____?”; “Where is ____ ?”; "What’s your name?”) and answer them correctly.
  • By 4 years of age: I can follow 3 unrelated directions and answer questions about stories that you read to me.
  • By 5 years of age: I understand simple time concepts (morning, afternoon, night, day, later, after, while, tomorrow, yesterday, today).

TALKING (EXPRESSIVE LANGUAGE)

What should I be able to tell you?
 
  • By 12 months: I use 3 or more words (other than “mama” or “dada”). I make noises other than crying to let you know I want something. I shake my head for “no” and wave “bye-bye”. I vocalize a lot when I’m playing alone, and sometimes I “sing” along with music and songs. I ask for things I want!
  • Between 12 and 18 months: I use up to 20 words including object names, action words, (e.g., up, go) and descriptors (e.g., pretty, big).
  • Between 18 and 24 months: I talk to myself a lot while I’m playing with my toys and I practice words I’ve heard you say. I like trying to participate in nursery rhymes and songs and I use a lot of 2-word combinations to show negation (e.g., “no doggy”); recurrence (e.g., “more juice”); possession (e.g., “daddy shoes); attribution (e.g., “big doggy”); location (e.g., “sit chair”); agent-action ( e.g., “mommy go”); and action-object (e.g., “hit ball”). I’m starting to use simple wh-questions (e.g., “where mommy?”; “what that?”).
  • Between 24 and 30 months: You can understand most of what I’m saying when I talk to myself during play. I say a few nursery rhymes and I’m starting to use 3- and 4- word simple sentences. I start using “(verb)ing” and past tense “(verb)ed”. I mostly ask “what-?“, “where-?”, and “why-?” questions.
  • Between 30 and 36 months: I join more in songs and rhythm. I say my whole name. I use “no” appropriately. I use simple pronouns (e.g., I, you, he, she, his, her, my) and regular plurals (e.g., “dogs”).
  • Between 3 and 4 years: I start asking “who-?” questions. I use possessives correctly (e.g., “mommy’s car”). I use regular past-tense (“verb”-ed) consistently. I learn to whisper, and most of the time I talk in sentences.
  • At 4 years: I like playing with rhymes and nonsense words. I’m interested in the meanings of new words and I do a pretty good job at re-telling stories. I ask all kinds of questions. I can describe past events and I can also describe objects by shape, size, and color.
  • At 5 years: I should be able to repeat sentences as long as 9 words. I can tell you what common objects are used for. I should be using longer sentences, including some compound and complex sentences (e.g., “I went to school today and played with my friends.” “The boy who lives across the street is my friend”)
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SENTENCES 

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When should I start putting words together? How long should my sentences be?
 
  • By 12 months: It might sound like I’m using sentences even though you can’t understand any of the words
  • Between 12 to 18 months: I gradually start saying words spontaneously – without imitating you! By 18 months, my average “sentences” are 1.2 to 1.5 words long.
  • Between 18 to 24 months: I have names for my favorite objects and I’m even starting to put 2-words together!
  • Between 24 to 36 months: I probably say “no!” (even when I don’t always mean it!) and I start putting 3 words together!!!
  • Between 36 to 48 months: I can put 3-to-4 words (and sometimes more!) together in sentences and I like labeling pictures!  I use complete sentences more often than just single words and gestures to let people know what I want to say, and I start asking questions that begin with who-, what-, or where?
  • Between 48 to 60 months: I use pronouns and tenses (past & future) and I name attributes like color, size, and shape.
  • At 5 years and over: I can retell you a story by “reading” the pictures and I’m interested in learning lots of words – even the more abstract ones!

SOCIAL-EMOTIONAL DEVELOPMENT

When do I start making friends?
 
  • By 2 years old: I’m just beginning to develop a sense of personal identity and belonging. I can be very possessive and often show it in a negative way. I may need some adult guidance but I like playing by myself. I’m easily frustrated and I’m not yet very good at choosing between two alternatives. I’m becoming more independent and I don’t like changes very well. I respond better to humor and distraction than to discipline and reason.
  • By 3 years old: I play well next to my friends. I start to learn to take turns. I also like making new friends and trying to help my mom and dad.
  • By 4 years old: I can pay attention for longer periods of time even though I’m still easily distracted. I have favorite friends and I’d rather play with a friend than alone. I’m getting pretty good at sharing and taking turns! I talk about my feelings and I notice when you’re sad or upset. My “manners” are improving and I’m learning how to let you know I’m sad or upset without having a complete meltdown. I’m also noticing the differences between boys and girls.
  • By 5 years old: I love playing with my friends. I like simple table games with rules and “school”. I feel proud of myself when people compliment me and I like to be given special responsibilities.
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