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What You Need to Know About Your Child’s Speech Development

By Fraser Clinical Services Manager and Senior Speech-Language Pathologist Valerie Olheiser and Pam Dewey • speech development, speech milestones, kids and speech, children speech milestones, kids and talking, children speech, children speech development, kid speech development, kids speech milestones, learning to talk, speech language therapy, speech therapy, language therapy • April 07, 2022

Hearing your child’s first words is a moment parents look forward to with anticipation. Will they say, “Mama,” “Dada” or “doggy?”

But we know children develop at different rates. To make it easier for parents, the CDC recently released new developmental milestones for children. According to CNN, the changes are meant “to give parents and pediatricians clearer benchmarks that will make it easier to identify developmental delays early.” Clarifying developmental benchmarks for parents is a great idea.

However, some changes are causing concern among speech-language pathologists.

Milestone changes could delay treatment

According to The Informed SLP (Speech-Language Pathologist), “One of the big changes the CDC made was to adjust the milestones so that they represented what most children are doing by a certain age, rather than what is average at that age.” So instead of 50% of children starting to speak at 12 months, the CDC guidelines now indicate 75% of children should try “to say one or two words” by 15 months. On the surface, that doesn’t sound like a negative change.

What has speech-language pathologists concerned, says Fraser Clinical Services Manager and Senior Speech-Language Pathologist Valerie Olheiser, is the children in the 25% percentile who aren’t meeting this milestone. Rather than discouraging a wait-and-see approach, Olheiser fears some parents and healthcare providers might wait longer, even when they’re noticing red flags with a child’s speech. At a 12-month well-child check, if a child isn’t talking yet, Olheiser also worries that a parent’s concerns might be dismissed by a pediatrician.

Should you be worried if your baby isn’t talking at 12 months?

Olheiser says the answer to that question is complex. When we communicate, we use more than just our words. A baby who isn’t speaking, but is babbling and using gestures with their family is still communicating. But a baby who isn’t talking, doesn’t have a babbling repertoire and isn’t gesturing to express themselves is more concerning.

“The developmental trajectory will be different in both these situations. If a baby is babbling, they may need a little more time, or they may need an intervention. With the other baby, I would likely recommend an assessment,” says Olheiser. “The new guidelines miss these subtleties in development and may cause families to wait longer, which can cause further delays in a child’s development.”

Spending too much time with screens or a stressful home environment can impact speech development. When Olheiser meets with families, she asks these types of questions, and then they decide whether a child needs more exposure opportunities, more time or needs an assessment. 

Milestones aren’t culturally inclusive

Another concern is the CDC milestones aren’t culturally inclusive. Children who grow up in a bilingual home may take longer to speak. Neurodiverse children, like those with autism, may start speaking and then stop, may not develop speech or may take longer to speak. Not speaking doesn’t necessarily mean a child will never speak, but they may require interventions to help them develop their language. The Informed SLP (Speech-Language Pathologist) states, “If we overemphasize ‘normal’ development as best, we can pathologize other valid developmental paths such as those of autistic children…Falling below the 25th percentile doesn’t mean that is something ‘wrong’ with a child that needs to be fixed. It does, however, clue us in that they may need more support.” But the new CDC milestones don’t call out these types of situations, which again limits how helpful this information is for all families.

A child can communicate without speech

Your child can communicate, whether they start to speak or not. When your child wiggles when you sing to them, that means they’re enjoying it. Other early gestures, like pushing something away from their body, communicate that your child doesn’t want or like the item.

Olheiser says when she works with parents of children who aren’t speaking — known as non-speaking or minimally speaking, communicators — she teaches parents about these types of gestures and how they can coach their children to do these movements. There are words that Olheiser calls power words, like “No, stop, help, come here or go away,” that you can start to teach children who are developing language, so they feel some control over their lives.

“You can start using a picture communication system, as soon as it’s developmentally appropriate,” says Olheiser. “You don’t have to wait until a child is 5 and not talking to use these tools.”

Even giving your child a choice between objects builds communication skills. Something as simple as offering them the choice of goldfish crackers or graham crackers creates communication opportunities that help a child engage with others.

When should you reach out for help?

Olheiser says if your child is between 16-18 months old, and you’re concerned that they’re not communicating well, have a conversation with your pediatrician. Again, communication means more than just words, so look at whether your child is using gestures, bids for your attention and how many sounds they make when they’re babbling.

You can reach out to Fraser for an assessment and speech-language therapy for your child