Human language is the most complex skill in the universe. Other intelligent mammals have trouble even learning rudimentary aspects of it; who hasn't tried to try to direct their dog's attention to something by pointing, only to have Fido stare intently at their finger? Diexis (reference by pointing) is only one of the cognitive breakthroughs that children make toward learning how to speak in their first few months of life. Often babies say their first words before they even learn to walk without the assistance of furniture.
So intertwined with being and thinking like a human being is language, in fact, that parents often look to certain milestones to make sure that their child is 'normal.' And it would seem natural that with such a complex skill as speaking - necessitating articulatory, grammatical and vocabulary proficiency of very young children - that not every child always meets every developmental deadline. And many time this doesn't mean there is anything to worry about. But there are several things to watch for when assessing your child's speech development, and in assessing whether the ways that they differ from the normal language trajectory are cause for alarm.
NORMAL COURSE OF CHILD LANGUAGE DEVELOPMENT
While all children learn language slightly differently, there is a certain developmental trajectory that most of them follow, with stages that are very consistent among language learners.
1. 0-12 months: The pre-word or babbling stage
By about six weeks your baby will be making eye contact with you and probably will be smiling. The result of this face-to-face communication, which babies obviously prioritize as one of their favorite waking and alert activities, is that eventually they make themselves heard with little cooing sounds. These will consist of mostly vowels, like "aahhh" and "oooh."
At about six months, the child will start combining a consonant sound with these cooing noises, usually producing something like "babababa" or "dadadada." Then the older babbler will mix it up a bit, producing strings like "babaGADAnanababa." The child in this stage is likely practicing intonation, meaning making strings of speech have the tune or contour of the adult speech spoken around him.
A few things the child does during this stage are preparatory to saying actual words. Unlike other animals, the child masters deixis or the fact that one thing refers to another relatively early in their lives. They will soon learn to track the direction of a pointing finger and then produce perfectly-stretched index fingers to indicate the object of their desired conversations.
Additionally, babies when they get ready to practice saying babbles will start to take a distinctly word-like speech contour. Something like "Da" is said with a falling intonation in the way that they would say a single word.
2. 12-18 months: One-word or "holophrastic stage."
The first word is the culmination of babies' honing of skills in the pre-word stage, to identify deictic reference as a function, to master the word/statement intonation, and to practice the articulatory system to be able to have control over the sounds that make up words. First words will likely be items in their immediate environment and concrete and tangible "mama" (mom), "dada" (dad) or "baba" (bottle). Some of them can be hard to recognize because they are idiosyncratic, such as "niny" or "ooh" for blanket, but the key will be that whatever the sounds they select they will begin to use them consistently to communicate the concept.
3. 18 Months - 5 years: The two-word stage and telegraphese.
After mastering using one word for a while, children go into a stage where they use two words together to form rudimentary sentences. These can have a lot of flexibility in meaning. For instance, a child might say 'daddy sock' to mean 'there's daddy's sock,' 'daddy is putting on his sock,' 'daddy needs to put on his sock,' or 'I'm putting daddy's sock in the dryer.' After exploring this stage to develop semantic relationships between words a child will move on to telegraphese, a rudimentary sentence structure where there are many adult components but not all of them. A child might say 'Put daddy sock dryer."
HOW TO ASSESS LANGUAGE DELAY OR ABNORMALITIES AS A POTENTIAL PROBLEM
Late certainly doesn't mean never, and with all the things children are learning in this age some will be put on the back burner every once in a while without it meaning anything to chances of normal speech development. But there are several main causes of potentially serious speech delay, and each has its own particular symptoms:
1. Hearing (input) problems.
This type of problem will manifest itself in the child learning to speak late, not using intonation during babbling, ceasing with babbling at a year old, and not responding to speech or understanding it. The good news is that many hearing problems can be corrected, and even when they can't a child needn't be without language in this day and age where so many resources are directed toward early intervention to teach young children sign language.
2. A general learning (processing) problem.
Once hearing difficulties are ruled out, this type of a problem can explain long speech delays and failure to understand or respond appropriately to speech. In some learning disabilities like autism, initial stages of language learning like babbling and even word learning are on schedule but then all language production ceases, and if this should happen to your child it is a sign that they need to be evaluated immediately. Options and prognoses are never excellent with serious learning disabilities, but getting language evaluation as well as help with the underlying learning or processing disorder will mean that problems with one will not exacerbate the other any more than would be naturally expected.
3. Language specific (output) disorders.
Sometimes exhausting all possible causes doesn't turn up an explanation for a child's speech abnormality or delay. Some of the problems that might persist are marked delay in language progression through the normal course of development, atypical phonetic expression of words by older children (i.e. a speech impediment) or persisting syntactic abnormalities later in life.
These can be evaluated to some extent to determine whether they represent a more serious problem that your child will likely need to see a specialist for or whether they will outgrow it. One key in assessing delays is whether one delay is followed by another. Meaning, if a child took two years to learn his first word, if he is normal he will likely progress very quickly to the two-word stage and beyond after passing this initial hurdle. If delay in producing one word is followed by a delay in other progression, it is likely more serious.
And language problems of older children are evaluated based on whether they are idiosyncratic, meaning very atypical, or they tend to be the kinds of problems that comprise speech disorders. If your child can't pronounce /r/'s, /s/'s or /l/'s by age ten, these are very common features of a speech disorder and it is likely that your child will need treatment. If your child just can't pronounce a certain sound in a certain word or says a word a bit funny, these are likely things that she will grow out of with time.
A similar rule of thumb is used to assess grammatic idiosyncrasies. If your child every once in a while says or writes something in an unusual way, or uses nonstandard grammar like his peers or even adults around him ('he don't got none'), this is normal. But if grammatical abnormalities represent mistakes of much younger children and are consistent: "Hers don't do that." "Her goed to school," the child should be evaluated.
HELP IS AVAILABLE
If you have determined that your child might have a more serious language delay, he or she should be evaluated both by a pediatrician and if the doctor thinks it is necessary, by a language professional. Speech-language therapy involves having a speech-language specialist work with a child on a one-to-one basis, in a small group or directly in a classroom, to overcome difficulties involved with a specific disorder. Speech-language therapy uses a variety of therapeutic strategies, including:
1. Language intervention activities. These exercises involve having a speech-language specialist interact with a child by playing and talking to him. The therapist may use pictures, books, objects, or ongoing events to stimulate language development. The therapist may also model correct pronunciation and use repetition exercises to build speech and language skills.
2. Articulation therapy. Articulation, or sound production, exercises involve having the therapist model correct sounds and syllables for a child, often during play activities. The level of play is age-appropriate and related to the child's specific needs. Articulation therapy involves physically showing a child how to make certain sounds, such as the "r" sound. A speech-language therapist may demonstrate how a child should move his tongue to produce specific sounds.
CONCLUSION
Language is an activity inextricably linked with human thought and human interaction. Being able to function at it proficiently will affect many things that your child will do in life. But identifying and treating underlying sources of language difficulty, separating out idiosyncratic anomalies from truly abnormal development and getting help from what are the many qualified professionals now in the field to help your child, you can make sure that every possible intervention can be made so that this part of your child's life will be as successful and satisfying as it can possibly be.