Helpful Reference Charts and Information 

Speech Sound Development Chart
Ninety percent of children are able to say the sounds listed below by the age noted on the 'ladder'. 
​For example, 90% of two year olds can say p, b, m, d, n, h, t, k, g, w, ng ,f and y. 

Phonological Patterns Development Chart
The rules that apply to speech sound use are known as phonological patterns.  Most children pick up on these rules on their own.  However, some children benefit from more direct treatment of a 'rule' system to help them acquire the patterns and use them more regularly in their everyday speech. 

The Speech Banana

We hear a wide spectrum of sounds in our daily environment.  To ensure that our children are hearing the whole scope of sounds, a pediatric hearing evaluation is recommended (especially if your child is prone to ear infections, not responding to environmental noises or not babbling/making a variety of sounds).  

Red Flags in Speech and Language Development

There are general milestones that most children reach within a typical timeframe.  If your child has not reached these expected targets, it may be beneficial to seek a referral. These are common Red Flags:
Picture
9 months
  • Little or no babbling as an infant (using both consonants and vowels)
  • Few sharing of sounds and facial expressions (no joy from vocal interactions)
12 months
  • Does not respond to common words or his/her name regularly.
  • No pointing or gesturing toward desired items
15 months
  • No first words 
  • ​Does not look at familiar objects when you name them
  • Does not follow simple directions when you use both words and gestures (ex. Give me the toy)
18 months
  • Does not have 10 words
  • Does not follow 1-step directions without any gestures provided
24 months
  • Does not use 2 word phrases
  • Does not have a vocabulary of at least 50 words 
  • Is not at least 25% intelligible (understandable) by adults (non-parents); by 2.5 years old children should be 60% intelligible. 
  • Does not follow simple directions 
  • Cannot point to body parts or pictures 
  • Does not point to pictures in a book (ex. where is the bear?) 
3 years
  • Is not speaking clearly (less than 75% intelligible by all adults) 
  • Cannot answer 'what',  'who', 'where' or 'why' questions
  • No interest in communicating with others (does not initiate conversation; repeats others).
  • Is not able to take at least two conversational back-and-forth exchanges with a conversation partner
4 years 
  • Is not putting together 4+ words in sentences 
  • Is not repeating words to commonly heard songs, stories or nursery rhymes
  • Is not able to talk about tat least one thing that happened in their day (ex. I played soccer). 
  • Puts words together in the wrong order in sentences
  • Cannot follow multi-step directions
  • Speech is hard to understand (many sound errors) 
5 years
  • Speaks in only short sentences (3-4 words)
  • Many sound errors, hard to understand
  • Persistant repetitions of sounds or syllables (stuttering) 
  • Difficulty staying on topic and maintaining a conversation 

Other Things to Watch For...

  • History of ear infections
  • Lack of response to verbal interactions
  • Excessive drooling
  • Difficulty with eating and drinking (choking, gagging, etc) 
  • Interrupted or disturbed sleeping (Is your child getting enough sleep?  Do they snore often?  Do they wake often throughout the night?) 

Parent Tips for Late Talkers
Get your child’s hearing checked. 
  • Even with a mild hearing loss or fluid in the middle ear (infected or not), children can respond to sounds.  It is important to know that your child can hear all intensities at all frequencies.  If your child has frequent ear infections, or silent ear infections (no fevers or overt signs of infection), keep this in mind as you and your pediatrician monitor your child’s hearing.  I recommend ruling out hearing loss by visiting an ENT/Audiologist for a full hearing evaluation if there is any question of your child's hearing ability. 
  • Additionally, if your child snores at night (on a regular basis) this could be a sign of enlarged adenoids.  You can discuss this with the ENT as well.  Children should not snore. 
Talk, Talk, Talk
  • Narrate what you do.  Do this in simple sentences.  Include nouns, verbs, descriptors, feelings, etc.  Example:  “It’s time for lunch.  I’m hungry.  Let’s have peanut butter and jelly sandwiches.  I need to get out the bread.  It’s in the pantry.  Next I need to find the jelly.  I bet it would be in the fridge.  Brrr, the jelly jar is cold….”
  • Narrate what your child is doing as he/she plays.  Keep it simple.  Example: “Jack is zooming the car under the table.  Uh-oh now his car crashed into the wall.”
  • When talking with your child it is important to use slow, clear, simple speech, but NOT baby-talk.  If your child requests ‘wa-wa’ for water, simply give him the water while stating “You want water, here it is.”  We refer to this as acoustic highlighting when we place more emphasis on one key word.  We do this by stating that word slightly louder, more slowly and clearly than surrounding words. 
Don’t anticipate you child’s needs/wants
  • Let them tell you they are hungry.  If your child leads you by the hand into the kitchen, then provide your child with the words to express her wants/needs.  “Oh you must be hungry.  Let’s get a snack.”
  • Put toys up out of reach (on the mantle, on a dresser, etc) and have your child attempt to ask for them. 
Play dumb
  • If you know what your child wants but he is using a non-verbal method to communicate what he wants, simply play dumb.  Pretend you don’t know what he is gesturing/grunting for.  Do this for about 15 seconds.  It will feel like an eternity, but it will give your child a chance to use a verbal attempt at communication.  If that does not happen, give the child the item as you restate the items name (Example: Ohh, cup.  You want the cup.”)
Give choices
  • Provide your child with two choices. Example: “Do you want goldfish or an apple today?” If your child uses eye-gaze or reaches for the item, restate the name of the desired object.  Eventually you want to encourage your child to TRY to say the word of the desired item.  We are not looking for accuracy or perfection initially…just an attempt.
  • Choices in dressing, food selection, activity selection, book selection, how to walk/hop/run to the car, etc. 
Give lots of practice.  Repetition is hugely important.
  • If your child wants goldfish, give him two goldfish on his napkin.  Then encourage him to ask for more.  He will get multiple attempts at one word (be it ‘more’ or ‘fish’ in this particular activity) in one sitting.  This is great for repetition.   
Read, Read, Read
  • Look at short, age-appropriate books.  Colorful books with large, simple pictures are best. 
  • Choose 1-2 books that you read at the same time EVERY day.  This repetition will get tiresome for the adults involved, but children crave the repetition.  You can read other books throughout the day, but remember to read those select books daily.
  • As you read, remember that you don’t have to actually read all of the words on the page.  You can just summarize, describe pictures, make up stories, etc.  Remember it is good to point to pictures and label the object, but also throw in some verbs and descriptive words (he is jumping, the baby is sleeping, etc) 
Sing, Sing, Sing
  • Along the same line as the books, select 1-2 songs that you listen to regularly.  For example, put in a children’s CD with appropriate songs that all children learn (ABC, Twinkle Twinkle, etc).  Listen to these songs every time you get in the car.  You can listen to other songs after that, but make sure your child listens to the same songs regularly.  This will provide them with the opportunity to learn the song and then give them the opportunity to try to throw in key words or hum the tune. 
  • An ‘echo mike’ (plastic microphone) can help in the backseat as well.  No one is watching the child as he/she tries to sing.   The pressure is off and they can use vocal play while the music is on…
​Participate in language-based community activities
  • Library Time: City libraries have nice library times for children.  These are free events.  They do get crowded, so get there early if you want to participate. Participation on a regular basis helps children learn the routine, songs and activities so that they can participate physically as well as verbally.  
  • Music classes: Kindermuisic, Gymboree, etc provide music and action with age appropriate songs and activities.  These also help reinforce repetitive songs and language skills.  Additionally, most kids are motivated by music and enjoy these classes. 
  • Encourage playdates or social interactions where children get to navigate play with other children.  
Make sure your child is getting a solid foundation to start each day
  • A regular, healthy sleep routine is the foundation for a rested body and brain.  This helps our child start each day on the best footing, ready for the intake of another new day of learning and growth.
  • Make sure your child has access to a variety of foods (all food groups) in both play and during mealtime.  Experiential exposure helps children accept new textures, smells and tastes and helps prevent picky eaters.  A balanced diet helps create a solid foundation for good health and growth in our children.  

RESOURCES



Childhood Apraxia of Speech (website)
http://www.apraxia-kids.org

The Big Book of Exclamations (great for toddlers with possible apraxia)
http://thebigbookofexclamations.com

The Late Talker: What to do if your Child isn't Talking (book) 
http://us.macmillan.com/thelatetalker/drmarilyncagin

Stuttering Foundation of America (website)
http://www.stutteringhelp.org/faq

Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child With Sensory Processing Issues, by Linsdey Biel & Nancy Peske (book) 
http://www.amazon.com/Raising-Sensory-Smart-Child-SensoryProcessing/dp/0143115340

What's Eating Your Child? The Hidden Connection Between Food and Childhood Ailments, by Kelly Dorfman (YouTube video, book)
https://www.youtube.com/watch?v=vf5yfUUIQFA 

The Speech Banana with Familiar Sounds, Hearing and Dizziness Center (diagram) 
http://www.hearinganddizziness.com/images/faq_the-speech-banana-with-familiar-sounds.png

Melanie Potock, MA, CCC-SLP
Pediatric feeding expert with books, blog posts and an IG page dedicated to helpful feeding advice and strategies for picky eaters.
IG: mymunchbug_melaniepotock
Proudly powered by Weebly