Do “Late Talkers” Really Need Speech Therapy?
A common question we get during speech-language evaluations is if we feel a child will catch up with same-aged peers naturally (i.e., without therapeutic intervention). It is not completely understood why some children understand spoken language at an age-appropriate level yet are not communicating verbally at a level commensurate with their same-aged peers, despite typical motor and cognitive development. When a child is not speaking by 18 to 30 months, he or she is classified as a “late-talker.” The prevalence of “late talkers” for this age range is 13%.
Did you know that the norm for expressive vocabulary for an 18-month-old is 50 spoken words and 90% of children are combining two words on a consistent basis by this age? By 24 months, one would expect spoken language to have blossomed even more, and a child can have upward of 200-300 spoken words and is beginning to combine 3-word phrases. The longer we wait to see if a child will catch up, the more delayed the child’s expressive language may potentially become. See a chart on developmental speech, language, cognitive, hearing norms with the link below (4).
How does one decide if therapy is needed? If a child is not gesturing or using basic communication and really attempting to be understood, he or she may have gaps in development of non-verbal language, which is a precursor for spoken language. The child may have a genetic component to a speech or language impairment if older siblings also demonstrated delayed language acquisition. Males are three times more likely to be “late talkers” than girls. A child born earlier than 37 weeks gestation is at higher risk as well as children who are also delayed in motor development. There may also be underlying conditions such as chronic ear infections, autism, or global developmental delay, putting the child at greater risk for language impairment. Studies show 20-30% of “late-talkers” will not catch up by school age and even the ones who seemingly catch up, have been shown to have other delays in literacy and language learning down the road.
If you are concerned about your child who is potentially “late-talker,” consultation with a speech-language pathologist who specializes in the evaluation and treatment of babies and toddles may be warranted.
Capone Singleton, N. (2018). Late talkers: Why the wait-and-see approach is outdated. Pediatric Clinics of North America, 65(1), 13-29.
Electronically retrieved on 03/06/2019 from http://www.hanen.org/helpful-info/articles/how-to-tell-if-your-child-is-a-late-talker-%E2%80%93-and-w.aspx
Electronically retrieved on 03/06/2019 from https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935380§ion=Assessment
Electronically retrieved on 03/06/2019 from https://hearingfirst.org/-/media/files/downloadables/hf-milestones-09062017.pdf
