Monday, June 30th, 2014
Although toddlers reach language milestones at different ages, substantial delays can be associated with long term language problems. Given that, it’s worth giving careful consideration to benchmarks at different key ages. For example, a typical milestone is using 50 words by age two – though recent research suggests that a more telling indicator may be functional use of 25 words by that age. Perhaps less attention is typically given to language milestones at later ages – even though these can signal the need for evaluation and intervention.
To this end, Dr. Leslie Rescorla – a leading expert on language delay – has offered 3 speech benchmarks for 3-year-olds:
1) Using 3-4 word sentences with subject-verb-object (e.g., “I like ice cream”)
2) Can be understood consistently by most people – not just family members
3) Using the following: -ing (e.g., “crying”); in/on (e.g., “on the table”), plural forms (e.g., “two cars”), and possessives (e.g., “daddy’s car”)
This array of speech benchmarks provides a good indicator of a 3-year-old’s emerging language skills. Delays on one or more of these do not necessarily indicate the need for intervention. That said, there is utility to having your pediatrician determine if an evaluation by language experts is warranted – for one principle we have learned is that early intervention can be very beneficial for toddlers. It’s better to evaluate early and intervene if necessary rather than simply “wait and see.”
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Tuesday, August 23rd, 2011
Many parents of young children grew up during an era when the “wait and see” approach to developmental delay was the primary philosophy. Today, it is highly recommended that parents follow the principles of “Learn The Signs. Act Early.” As my fellow blogger Jill Cordes pointed out to me last month (in response to one of my blog posts on early screening for autism), this emphasis on developmental screening is not only important for detecting problems in the earliest stages – but also for determining when delay does not warrant intervention and “wait and see” is appropriate.
Take the case of two-year-olds who are “late talkers.” If a comprehensive developmental screening does not reveal any issues beyond the lag in expressive language (measured in terms of number of words spoken), it may indeed be the case that delay is just reflecting normal variation and intervention is not necessary. Furthermore, a new study suggests that, contrary to early speculations in the literature, “late talkers” – defined as being at or below the 15the percentile (gender referenced) in terms of expressive language at two years of age AND not showing any other signs of developmental delay – do not show evidence of behavioral and emotional problems through seventeen years of age (a longitudinal design was used to conduct follow-up evaluations at 5, 8, 10, 14, and 17 years of age).
This study is important because the toddlers with delay at age 2 did, at that time, demonstrate elevated levels of behavioral and emotional problems. These problems, however, were shown to decline over time, presumably in concert with catch-up in language skills. The researchers speculate that for these toddlers the behavioral and emotional issues were a reaction to the frustrations of the delay, and were not attributable to other underlying causes.
To be clear, the take-home message of this research is that developmental screening is an important tool for evaluating the big picture when babies and toddlers show delays. It can help resolve when specific isolated delays may not signal the need for intervention. And of course it can guide clinicians and parents to seek out further evaluation and if necessary early intervention when appropriate. It can bring some clarity to what used to be a much fuzzier issue (it’s not a perfect science, but it is continuously improving in accuracy). These are the reasons that “Learn the Signs. Act Early” is the philosophy of choice for parents.
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