Can We Talk?
The cheerful babble of a baby learning to use his voice is music to a parent's ear. But it turns out that the ability to understand words (receptive language) and produce speech (expressive language) are two different concepts requiring a variety of skills. In order to speak, a child must coordinate cognitive, hearing, listening, and motor abilities. Expressive skills typically kick in at about 4 to 6 months, when babies begin to make one-syllable sounds, such as "ba."
Between 7 and 12 months, babies will babble strings of syllables ("ba-ba-da"). Most children say their first words around their first birthday; by 18 months, babies should say at least 10 words, and may understand 50 or more. "Eighteen months also marks the beginning of a 'language explosion,'" says Lydia Soifer, PhD, a speech pathologist in White Plains, New York. "They may acquire as many as eight words daily."
As for receptive language, from around 9 months to 1 year, babies start to follow simple commands (such as "Sit down") and begin to show that they understand the word "No," particularly when it's accompanied by a stern tone. Between 1 and 2 years, babies can point to their body parts when somebody names them.
Because language is so complex, there is a wide range of issues that can put the brakes on its development. Muscle coordination is one of them. According to Jan Turner, PhD, director of the Speech-Language and Assistive Technology Department at the Kennedy Krieger Institute, a Baltimore-based facility that helps children with developmental disabilities, talking involves several muscular tasks: making sounds and moving the lips, tongue, and jaw.
A child who's having difficulty controlling and coordinating these actions may have trouble sounding out intelligible words. And because speaking involves controlling the release of air from the lungs, kids with breathing troubles, such as asthma, may have speech problems. It's also true that severe ear infections can impair hearing and slow both expressive and receptive language skills.
Some speech and language delays require no treatment. For example, according to the American Speech-Language-Hearing Association, studies show that 18- to 30-month-old children who are late to speak but who understand language and make steady progress don't need intervention.
Other times, a course of speech therapy can help. For expressive language problems, therapists use games and exercises to strengthen muscles; for receptive language problems, they may speak commands ("Put the doll on the table") and model a response, until the child gradually learns connections between words and actions. Speech and language delays can also signal serious problems, such as mental retardation or autism. If your child isn't making steady language progress, consult your doctor.
Though delays in reaching milestones may seem like insurmountable obstacles at first, rest assured, the majority of kids walk, talk, and do just about everything else you can think of eventually -- just on their own timetable.