When should my child be able to pronounce speech sounds?

When should my child be able to pronounce speech sounds?
Ashley Kippins While speech sounds develop across a wide range of ages, developmental norms provide guidelines regarding the typical age at which children pronounce each sound. Comprehensive research (McLeod & Crowe, 2018) indicates that the vast majority of children (75-85%) develop speech sounds according to the chart below. Using this chart, you can determine which sounds your child is expected to produce. For example, a 3-year, 2-month old child (age 3;2) would be expected to pronounce the “b” sound, as in “bye” and it would not be atypical for this child to have difficulty pronouncing “r”, as in “red”. 75-85% of children produce this sound by age: (years;months) English Consonant Sounds 3;0 m, n, h, p, w, d, b, f, k, g, “ng” (as in “ring”) 4;0 y, t, s, l, sh 5;0 ch, z, r, z, j, v 6;0 voiced “th” (as in “that”) 7;0 voiceless “th” (as in “think”) McLeod, S., & Crowe, K. (2018). Children's consonant acquisition in 27 languages: A cross-linguistic review. American Journal of Speech-Language Pathology, 27(4), 1546-1571.
https://doi.org/10.1044/2018_AJSLP-17-0100

How many words should my child be using at this age?
Ashley Kippins The number of words a child uses regularly is referred to as his or her “expressive vocabulary”. Since children’s vocabularies vary, the chart below can be used as a guideline for the approximate number of words your child should be using according to his or her age in the left column. Age Approximate Words in Expressive Vocabulary 12 months / 1 year 2-6 words other than mama and dada 15 months 10 18 months / 1.5 years 50 24 months / 2 years 200-300 30 months / 2.5 years 450 36 months / 3 years 1,000 42 months / 3.5 years 1,200 48 months / 4 years 1,600 54 months / 4.5 years 1,900 60 months / 5 years 2,200-2,500 6 years 2,600-7,000 12 years 50,000 Lanza, J., & Flahive, L. (2008). Guide to communication milestones. East Moline, IL: LinguiSystems. https://speechhearing.columbian.gwu.edu/sites/g/files/zaxdzs1996/f/downloads/Milestonesguide.pdf

What are the speech and language milestones and when should my child reach them?
Ashley Kippins Speech milestones are guidelines for when children should pronounce different sounds and for how clear their speech should be. Children typically pronounce the following English consonant sounds by age 3: m, n, h, p, w, d, b, f, k, g, “ng” (as in “ring”). They pronounce the following by age 4: y, t, s, l, sh. By age 5 they pronounce: ch, z, r, z, j, v. By the age of 7, children typically produce all English consonants. Intelligibility is a perceptual judgment that is based on how much of the individual’s speech the listener understands. It can vary from “intelligible”, meaning the message is completely understood, to “unintelligible”, meaning none of the message is understood. Children’s speech should be approximately 25% understandable to unfamiliar listeners by age 1 year, 50% by age 2 years, 75% by age 3 years, and 100% by age 4 years. Familiar listeners (e.g., parents, caregivers, siblings) can often understand a higher percentage of what the child says than unfamiliar listeners. Children also simplify their speech in a patterned nature, called “phonological processes”. For example, children often produce consonant clusters as a single consonant so that a word like “plane” becomes “pane”. These phonological processes typically disappear between the ages of 3 and 5. Language milestones are guidelines for development of understanding and use of language, including vocabulary, syntax, grammar, and social skills. The following chart details some of the language skills your child should demonstrate according to his or her age. Age Language Skills 6-11 months Respond to sounds by making sounds Turns head toward sound source String vowels together when babbling: “ah”, “eh”, “oh” Coos and squeals for attention Respond to own name Make sounds to show joy and displeasure Begin to say consonant sounds like “m” and “b” Understand “no” Copy sounds and gestures of others 1 year Respond to simple spoken requests Use simple gestures like shaking head “no” or waving “bye-bye” Say “mama” and “dada” and exclamations like “uh-oh!” Repeat actions that made someone laugh 2 years Say several single words and sentences with 2-4 words Say and shake head “no” Point to show what he/she wants Pair gestures with words Point to things/pictures when they are named Know names fo familiar people and body parts Follow simple instructions Repeat words overheard in conversation Engage in parallel play Imitate adult actions in play Engage in simple pretend play (e.g., talking on a toy telephone) Say social words like “bye”, “thank you” 3 years Follow instructions with 2-3 steps Name most familiar things Understand words like “in, “on”, and “under” Say first name, age Say words like “I”, “me”, “we”, and “you” and some plurals (cars, dogs, cats) Use wh- questions, like “where is the ball?” Engage in conversation using 2-3 sentences 4 years Know some basic rules of grammar, such as correctly using “he” and “she” Sing a song from memory, such as the “Itsy Bitsy Spider” Tell stories Say first and last name Use location words like “up” and “down” Follow 2-step related directions without gesture cues Take turns and play cooperatively Express feelings and ideas 5 years Tell a simple story using full sentences Use future tense, like “Grandma will be here” Follow 3-step directions without cues Use words to invite others to play American Speech-Language-Hearing Association (2020). Speech sound disorders-Articulation and phonology.
https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935321&section=Assessment

Bowen, C. (2018). Table 1: Intelligibility. http://www.speech-language-therapy.com/ Centers for Disease Control and Prevention (2020). CDC’s developmental milestones. https://www.cdc.gov/ncbddd/actearly/milestones/index.html Lanza, J., & Flahive, L. (2008). Guide to communication milestones. East Moline, IL: LinguiSystems. https://speechhearing.columbian.gwu.edu/sites/g/files/zaxdzs1996/f/downloads/Milestonesguide.pdf
McLeod, S., & Crowe, K. (2018). Children's consonant acquisition in 27 languages: A cross-linguistic review. American Journal of Speech-Language Pathology, 27(4), 1546-1571. https://doi.org/10.1044/2018_AJSLP-17-0100 Activities to encourage speech and language development. Ashley Kippins Age Range Activities All Ages Talk to, sing, play with, and read to your child 0-5 months Cuddle, talk, and play during feeding, dressing, and bathing Play peek-a-boo Use short statements and clear language Copy your child’s sounds Give age-appropriate toys, like rattles and colorful picture books 6-8 months Play on the floor with your baby Use reciprocal play - copy his/her facial expressions, sounds Repeat your child’s sounds and say simple words with them. For example, if your baby says “bah”, say “bottle” or “book” When your child looks at something, point to it and talk about it 9-11 months Play games with “my turn, your turn”. For example: rolling balls back and forth, pushing cars and trucks, building with blocks Say what you think your baby is feeling. For example: “You are so sad, let’s see if we can make you feel better” Describe what your baby is looking at. For example: “big, red ball” Talk about what your child wants when he/she points at something 12-17 months Talk to your child during routines. For example: during bath time, “Mommy is washing your hands with a washcloth” Have your child turn the pages while you read together. Take turns labeling pictures Expand what your child says, tries to say, or points to. For example, if your child says “d” or “dog”, say “Yes, that’s a big, brown dog” Hide small toys and have your child find them Ask your child to label body parts or things you see as you’re driving in the car Sing songs with actions, like “The Itsy Bitsy Spider” or “Wheels on the Bus”. Help your child do the actions with you 18-23 months Encourage pretend play (e.g., play chef, doctor, dress-up, dolls) Read books and talk about the pictures using simple words and sentences Use words that describe feelings Ask simple questions Pause after speaking to give your child a chance to respond 2-4 years Encourage your child to say words in addition to pointing Help your chid do puzzles with shapes, colors, animals, vehicles, etc. Play with blocks by working together or taking turns building towers and knocking them down Read with your child and ask her/him to help turn the pages, point to things in the pictures and repeat words after you. Help your child tell you what happened in the story as you go Give instructions with 2-3 steps (e.g., Go to your room and get your shoes and jacket) Play matching games with objects in books, pictures, or around the house Play make-believe. Let your child lead and copy what he/she does Encourage your child to say words, share toys, and take turns playing games of someone else’s choice Use words like “first”, “second”, and “finally” when talking about everyday activities to help your child learn about a sequence of events Say colors in books, pictures, and things at home. Count common items, like number of crackers, stairs, or toy trains Play outdoor games like tag, follow the leader, and duck duck goose Play music, sing, and dance. Take turns copying each other’s dance moves 4-6 years Have your child guess what you describe. For example: “It is cold, sweet, and good for dessert. I like strawberry”. Your child can guess “ice cream” Talk about opposites like up and down, on and off Work on groups of items, or categories. Find the thing that does not belong in the group. For example: “A shoe does not go with an apple and orange because you can’t eat it! It is not round and it is not a fruit.” Encourage your child to “read” by looking at the pictures and telling the story Help your child follow 2-3 step instructions like “Pick up the ball, put it in the basket, and come sit down” Ask your child to give you directions for how to play a game or build with blocks Play games like “house”. Let him/her be the parent. Talk about different rooms and furniture in the house Talk about what you are reading or watching (TV, movies). Let your child guess what might happen next. Talk about the characters and how they feel. Act out different endings to the story Go grocery shopping together and have your child help remember the list. Talk about what you’re buying, how many you will need, what you will make. Talk about sizes, shapes, and weight American Speech-Language-Hearing Association (2020). Activities to encourage speech and language development. https://www.asha.org/public/speech/development/activities-to-Encourage-speech-and-Language-Development/ Centers for Disease Control and Prevention (2020). CDC’s developmental milestones. https://www.cdc.gov/ncbddd/actearly/milestones/index.html

Who needs speech therapy?
Ashley Kippins Speech therapists work with people across the lifespan, from babies to seniors. Individuals need speech therapy for support with: Feeding and swallowing Language expression (speaking or writing) Language comprehension (listening or reading) Articulation/speech sound production Phonology Phonological awareness Auditory processing Voice Pragmatics/social skills Executive functions A person may need speech-language pathology services as a result of delayed development or secondary to other diagnoses that affect the skills listed above (e.g., Down Syndrome, traumatic brain injury, Autism Spectrum Disorder).

How does speech therapy work?
Ashley Kippins A speech-language pathologist (SLP) will conduct an initial evaluation, consisting of a case history, a range of standardized or informal assessments, and clinical observation. The SLP will use the information from this evaluation to determine a diagnosis and recommend an appropriate frequency and duration of speech therapy. The SLP will use evaluation findings, as well as your therapy priorities to create a treatment plan of measurable and achievable long-term and short-term goals. The patient will attend speech therapy according to the SLP’s recommended frequency and duration. During each therapy session, the patient will complete a variety of therapeutic tasks prepared by the SLP and data will be recorded in order to track progress. The SLP will also recommend ways to work toward achieving the patient’s goals outside of the therapy sessions by providing ways to practice those skills in other environments (e.g., home, school, in the community). The patient will receive progress reports at regular intervals (e.g., every six months). Once the patient has achieved all long-term goals, the patient will be discharged from speech therapy.

How do I know if my child needs speech therapy?
Ashley Kippins Developmental milestones provide guidelines for when children are expected to demonstrate certain skills. You can consult speech and language developmental milestones checklists through the Centers for Disease Control and Prevention (CDC) or American Speech-Language-Hearing Association (ASHA) websites in order to determine whether or not your child is demonstrating the skills that are expected for his/her age. If you are unsure of whether or not your child needs speech therapy, the best thing you can do is set up an evaluation with a speech-language pathologist (SLP). Consult with your pediatrician for a speech-language evaluation referral.

What does speech therapy look like for teens?
Ashley Kippins Teenagers work with speech-language pathologists (SLPs) for a variety of reasons, including but not limited to concerns regarding: social skills, understanding and using spoken language, understanding and using written language, voice (e.g., hoarseness, vocal hygiene), swallowing, executive functions (e.g., planning/organizing, working memory), and articulation. Therapy begins following a comprehensive evaluation with a certified SLP. The SLP works with the teen and his/her family to create meaningful, measurable, and achievable goals for the teen in the area that has been identified by the diagnosis. The teen attends therapy at the recommended frequency and duration and is provided with therapeutic exercises and activities to support growth in the area of concern. The SLP will record progress toward each therapy goal, based on the teen’s participation during therapy sessions. The teen will be discharged from speech therapy when all goals are achieved.

What does speech therapy look like for infants?
Ashley Kippins In many instances, infants attend speech therapy due to feeding concerns. In other instances, children born with disorders such as cerebral palsy may benefit from speech pathology by learning techniques on how to communicate. A certified speech-language pathologist (SLP) may work with a team including nutritionists, nurses, lactation consultants, physical therapists, and physicians. Speech pathology for feeding concerns can begin as early as birth, following an in-depth oral motor and swallowing evaluation. Infant speech pathology may include: Practice oral stimulation with infants who cannot yet bottle or breast feed. Utilize feeding interventions to help improve skills Individualized treatment plans Feeding and dysphagia therapy Parent and caregiver education. Feeding and dysphagia therapy Tube weening (for infants who are being fed through a tube) Specialized activities that help babies learn to bottle and/or breast feed Stimulation activities to promote the early development of speech Birth Injury Guide (2019, February 19). Speech pathology for infants.
https://www.birthinjuryguide.org/birth-injury/treatment/speech-pathology/