Communication Concerns

Late talkers

A late talker is a toddler who has few words but is developing fairly well in other areas. Find out how to tell if your child is a late-talker (PDF).

Stuttering

As children develop speech and language and start to talk in sentences, they may repeat sounds at the beginning of words or repeat parts of words. This is normal dysfluency. It may appear between 2 ½ and 4 years of age and could last up to three months. However, some children continue to have difficulty with hesitating, repeating sounds and words, or getting stuck on words and these children may require help.

Articulation (speech sounds)

Speech sounds develop in a particular order from easier sounds at the beginning to more difficult sounds later. Knowing when sounds should be emerging will help you know if and when you should have your child seen by a speech-language pathologist.

Social communication

How children interact with adults and other children is just as important as what they say and how clearly they say their words. Social communication involves many different skills including how a child takes turns, uses gestures, uses eye contact, plays with others, pays attention to what others are doing and saying, and has conversations.

When we have a conversation there is a lot more to it than just saying words. We look each other in the eye, we take turns, we read facial expressions and body language, we pay attention to what our communication partner is paying attention to, and we stay on topic. We can read a lot from a person’s tone of voice as well.

When a child is having trouble learning about social communication, it is harder to learn language, to join in conversations, and to play with other children. Your Speech-Language Pathologist can work with you to help develop your child’s social communication skills.

Social communication difficulties can be associated with other developmental concerns. We recommend that you talk to your family doctor if your child loses social skills or language skills, or if your child does not:

  • smile at people when they smile at him or her,
  • respond consistently when you say his or her name
  • pretend and play “make believe”,
  • show an interest in other children,
  • enjoy playing with you,
  • make appropriate eye contact,
  • show, give, share, and try to get your attention,
  • ask for help when he or she needs it, or
  • greet familiar people.

Day to day interaction and play will develop children’s social skills naturally. It takes time to learn the rules of interaction, but there are activities parents and caregivers can do which will help children understand the rules.

Eye contact:

  • Get down to your child’s eye level.
  • Encourage your child to be in the same room and to face you when talking to you.
  • Stop what you are doing, look at your child, listen, and respond. Then wait for your child’s response. Don’t rush communication. Children need lots of time to understand what they hear, and to think about what they want to say.

Turn-taking:

  • Respond to your child’s noises and gestures and he will soon learn to make another noise or gesture for you.
  • Play lots of turn taking games. Say “John’s turn, mom’s turn…”.
  • Practice sharing by taking turns with a toy.

Games to help develop turn-taking skills:

  • Take turns putting the blocks on a tower until it collapses.
  • Take turns blowing bubbles.
  • Take turns choosing bedtime stories. Take turns turning the pages.
  • Play board games with older children.
  • Sing Nursery Rhymes. Leave out a word or two and wait for your child to fill it in.

Listening skills:

  • Encourage your child to pause and listen, and then talk about the sounds you both hear.
  • Turn off the television (e.g., iPad, phone, etc.) and talk and play with your child.
  • Follow your child’s lead and focus your attention on what interests him or her.

Shared attention:

  • Follow your child’s gaze and focus on the same thing. Talk about what you both see. Eventually your child will follow your gaze too.
  • Go for a walk and point to, look at, and talk about the things you see, hear, touch, and smell.

Body language and gestures:

  • Use body language, facial expressions, and gestures when you speak to your child. Your child will learn to “read” body language and to use it herself.

Voice

Sometimes children have an unusual voice quality. They may sound hoarse, husky, or stuffed up as if their nose is plugged. A speech-language pathologist will listen to your child’s voice quality. Talk with your doctor if you have concerns. A visit to an Ear, Nose, and Throat Specialist (ENT Doctor) may be recommended.

If you child’s voice sounds are:

  • louder or softer than other children.
  • hoarse (e.g., as if he has laryngitis or a cold).
  • breathy or airy.
  • squeaky.
  • nasal (e.g., as if he is speaking through his nose).
  • stuffed up (without an obvious cold).
  • higher or lower than other children.

If your child is:

  • yelling all the time.
  • whispering all the time.
  • running out of breath when speaking.
  • clearing his throat or coughing too much.
  • Talk to your family doctor about your concerns and ask for a referral to an Ear, Nose, and Throat doctor (ENT). Voice problems can sometimes be a symptom of a more severe problem. An ENT visit is highly recommended.
  • See a Speech-Language Pathologist: Refer your child to the Early Expressions Preschool Speech and Language Program
  • Consults with the ENT about his or her findings.
  • Talks to you about your concerns and about the ENT findings.
  • Evaluates your child’s voice.
  • Talks to you about how your child is using his or her voice on a daily basis.
  • Teaches you and your child about healthier ways to use your voice.
  • Works with you to help your child reduce unhealthy voice use.
  • Provides fun activities for home practice.
  • Evaluates your child’s progress.
  • May suggest you return to the ENT for a repeat assessment.

Bilingualism (children learning two or more languages)

Learning two languages can happen at any age. Babies are born ready to learn more than one language and there are many effective ways to help your child learn languages.

To make a referral to Early Expressions Preschool Speech and Language program, complete our online referral form.

Referrals can also be made by phone at 613-544-3400 or 1-800-544-3400 ext. 3175 and press 3.


Adapted with the permission from Language Express Preschool Speech and Language Program, KFL&A Public Health and Markham Souffville Hospital Child Development Program.