Is My Child a Late Talker?

Is your toddler 18 months old and unable to use single words to communicate with you?

The inability to use single words by the age of 18 months can be the first sign of language delay in children. Before this age, most children learn to speak single words, refer to the correct person/object using the word, and are able to say the word consistently at different times and in different situations. The first words children speak usually serve to get the attention of a caregiver.

Ms Goh Siew Li, Speech Language Therapist, Rehabilitation Department, KK Women’s and Children’s Hospital (KKH) says that while speech and language development varies from child to child, generally, by the age of 18 months, most children can request for an object by pointing and talking. She advises parents to consult an expert if their 18-month-old is not able to do this.

Tips to help your child learn to talk

You can help your child learn to talk by using the following strategies which can be used at any time of the day, and across a variety of daily activities:

• Use short phrases when talking to your child. You can repeat the use of new words and phrases to increase your child’s understanding and use of new vocabulary.
• Recite nursery rhymes and songs, especially those with actions.
• Point out different sounds (e.g. the doorbell, running water, the radio) and label them.
• Encourage your child to look at the object that you are talking about by holding it next to your face when you label it.
• If your child reaches for an object, pick it up and hand it to him/her while saying the word. Gradually, delay the time you take to respond and encourage your child to request for the object verbally.
• Give choices (e.g. “Do you want an orange or a banana?”).
• Talk about things as they happen (e.g. when you change your child, watch television, go to a shop).
• Praise your child for all attempts to communicate. You can say, “Good talking” and then give the item requested.

Speech sound errors at the age of three

By the age of three, you should be able to understand about 75 per cent of your child’s speech. There may be errors related to the letters ‘s’, ‘l’ and ‘r’ which are mastered at an older age .Errors in later developing sounds are considered normal at this age since children are still learning new words and therefore learning to make new sounds. If there are errors related to the sounds of the letters ‘m’, ‘k’, ‘t’, ‘f’, ‘b’ by this age, you should consult a speech therapist.

It is important not to associate any negative emotion with speech sound errors by over-correcting your child. Instead, when you hear your child make an error, you can gently repeat the word with the correct pronunciation by using it several times in your conversation.

For example: Your child might say, “Look at the tat (cat)”. You could respond by saying, “What a nice cat. The cat is black and white. Let’s go and stand close to the cat.”

“Do not ask your child to repeat the word multiple times since this can cause a negative association with the word. Communication is meant to be fun,” observes Ms Goh.

Other speech and language milestones

• By age two (24 months), monolingual children are expected to have a vocabulary size of over 200 words.
• By age three-and-a-half, children should be using short sentences of three to four words.
• By age five, children can tell you what happened in school in some detail like they are telling you a short story.
• By age five-and-a-half, speech should be 100 per cent understandable.
• By age seven-and-a-half, speech should have no sound errors.

Training for parents

If your child is lagging behind in any of these language milestones, you should consult a doctor, paediatrician or speech therapist, advises Ms Goh.

Parents who are keen to learn how to stimulate language development in their children can attend training programmes organised regularly at the KKH Rehabilitation Department. These programmes teach parents practical strategies that can be used in everyday situations to facilitate language development and use in their child.

Common talking disorders	Age to be concerned	Tell-tale signs
Language delay, including late talkers	18 months  42 months   66 months	No first words Lack of 3-4 word phrases and decreased ability to string words together Lack of the ability to tell a short story about things in school, or retell a story
Speech sound errors	42 months  66 months 90 months	Child's speech is less than 75% understandable Child's speech is less than 100% understandable Child still has speech sound errors.
Reduced socio-communication skills	18 months   42 months 66 months	Child is not able to request for items using either pointing or talking Does not engage in symbolic play Unable to tell stories with a plot. Stuttering at 42 months / stuttering for more than 6 months
Stuttering or not fluent in speech	At any age, if stuttering persists for more than 6 months from onset	Stuttering or not fluent in speech
Voice disorders	Any age	Hoarse voice

Ref. T12