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Our Baby's First Two Years
by Robert M. Selig, M.D., FAAP & Joann C. Cozza, D.O., FAAP

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There are variations of normal speech and language development.  Some children will begin speaking sentences by 18 months of age, while other children may not begin until 3 years of age.  Your child should understand instructions by 18 months (receptive speech) even though he/she may not be talking yet (expressive speech).


Many children will repeat the first sound or syllable of a word when they first begin to speak in sentences.  An example is “bbbbbaby wants his ball.”  This is normal and will disappear in time.  Do not confuse this with stuttering.  Be patient and wait for your child to finish.  Do not draw attention to your child’s speech by asking him/her to slow down, take a deep breath, or begin the sentence again.


The following is only a guide.  If your child exhibits any of the following, please bring it to our attention:


1. Your child has difficulty in following directions when you have his/her undivided attention.


2.  Your child fails to respond consistently to everyday sounds (ringing bells, barking dogs, sirens).  Your child only responds when spoken to in a loud voice.


3.  After two years of age, your child responds more consistently to gestures than to spoken word.


4.  Your child is not talking at all by age two.


5.  Your child's speech is largely unintelligible after three years of age.


6.  Sentences of three or more words are absent by age three.


7.  Your child uses primarily vowel sounds in his/her speech.  These vowel sounds may be distorted, however there is a deficiency in the use of consonant sounds.  An example would be “I ant a cookie” for “I want a cookie.”


8.  Omission of initial consonant sounds are frequent after three years of age.  Examples are “og” for dog, “ilk” for milk, and “ookie” for cookie.


9.  Your child is difficult to understand after five years of age.


10.  Sentence structure is noticeably impaired at five years of age.  An example is “me do it.”


11.  Word endings are consistently omitted after five years of age.  An example is “My name is Jay” instead of “Jake” and “Pa the do” instead of “pat the dog.”


12.  Substitutions of easily produced sounds for more difficult ones after five years of age.  Examples are “wittle” for “little” and “tootie” for “cookie.”


13.  Omissions, distortions, or substitutions of sound after seven years of age.  Examples are “ar” for “car”, “boid” for “bird”, “wabbit” for “rabbit”, and “shtay” for “stay”.


14.  Voice quality may be poor, monotonous, exceedingly loud or frequently inaudible.


15.  Vocal pitch is inappropriate for your child's age and sex.


16.  Your child appears to talk as if his/her nasal passage is blocked, despite not having a cold.


17.  Your child is embarrassed or disturbed by his/her speech at any age.



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