Late talkers are children who have a good understanding of language (Receptive Language) but are not using their language to speech (Expressive Language). This group typically has less than 20 words by the age of 18 months. By 24 months, they have less than 100 words and are not combining words into short phrases. They may lack variety in their vocabulary with only nouns and few verbs, adjectives, pronouns, or prepositions.
This group has no other concerns such as Autism, Down Syndrome, hearing loss, Cerebral Palsy, Childhood Apraxia of Speech, etc. It’s quite a puzzle since the child seems to have all the pieces needed to have speech, but does not use words to communicate as they should for their age.
Conventional wisdom at the pediatrician or from well-meaning family members is often to “wait and see.” The family may hear comments such as “boys talk later,” “children develop differently,” or “my uncle didn’t speak until he was 4.” This can be confusing and stressful for the family who wants their child to communicate with them. As a speech/language pathologist, I don’t recommend waiting to seek services if you are concerned.
Do Late Talkers Catch Up?
The answer to this question is not black and white. Some children do catch up, but a small percentage do not. See the research findings done by Roos and Weismer (2010) here. Late talkers generally catch up to their peers by school-age. Those that have difficulty catching up may have the following characteristics:
- Multiple ear infections and/or tubes in their ears from infections
- Difficulty imitating words
- Limited consonant sounds
- Vocabulary limited to mostly nouns
- Limited use of gesture to communicate
- Difficulty with play skills or social skills
- Family history of speech/language issues
- Being a male child
- Low birth weight or born before 37 weeks
The cause of “late talking” is not known. The characteristics above are some of the risk factors associated with being a late talker. As you can see from the list, none of the risk factors involve your parenting or anything you might have done wrong.
If your child is a “late talker” and demonstrates any of the risk factors mentioned, it is possible the “wait and see” approach will not work for the child. An evaluation by a speech/language pathologist would give you the information you need to help your child develop his communication skills. I talked about speech/language pathologists here and what to expect from speech therapy services here.
Why is Late Talking a Concern?
According to the American Speech/Language Hearing Association (ASHA), about “50%-70% of late talkers catch up to their peers by school-age.” See the article here. That is really good news! Why should we worry? Well, a study by Rice, Taylor, and Zubrick (2008) found that “1 in 5 late talkers had a language impairment at age 7.” That is why late talkers are a concern.
This possible language impairment that lingers into school-age could impact the child’s academic success. So my recommendation is always to see help from a trained speech/language pathologist.
What will Treatment Look Like?
Speech Therapy will different depending on your child’s needs. The Hanen Program is a good resource to find information about late talkers and strategies for parents to use at home. Many therapists have training in this program to use during therapy sessions with parents and the children. Possible strategies may be:
- Teaching the parents increase their self-talk. Self-talk is simply talking about what you are doing. “I am changing your diaper. Here’s a clean diaper.”
- Introducing Sign Language to your child. This will help give your child a way to communicate and decrease frustrations.
- Teach the parents parallel talking, which is talking about what your child is doing. “You are playing with cars. The car goes up the ramp.”
- Model short phrases for your child. This may seem weird, but is very beneficial for children having difficulty with speech. “Up car. My car.” Short phrases simplify things for your child even though they understand complete sentences.
- Teaching the child to imitate if necessary. Spend a few minutes imitating all your child’s sounds. This will delight your child, and it will help them catch on to imitating.
- Teaching the parents how to expand the child’s vocabulary. When your child says a simple work like “up,” you are able to then expand the phrase for your child. “Up now” gives your child another vocabulary word.
This is just a short list of possible strategies that may be discussed by the speech therapist. Once you settle into therapy, your speech/language pathologist will add to your list of strategies that work for your child in particular. Of course, when in doubt, read more to your child. You can never go wrong by reading more to your child. I discussed the importance of reading in this post here.