AboutSharon Rosen Lopez Expertise I am happy to answer questions about speech and language development in children.
Experience I have close to 30 years experience working as a pediatric speech/language pathologist, and have worked with infants and children through 18 years of age.
Organizations NY Speech/Language/Hearing Assocation
The American Speech/Language/Hearing Association
The Westchester Speech/Language/Hearing Association
Education/Credentials BA University of Wisconsin, Madison, Wisc
MA University of Washington, Seattle, Wa.
how fortuitous for me that you are available to answer my query...i have a very bright and loquacious 3 year old, and i have no problem understanding him. "strangers" usually can understand him after they have spoken with him for a little while. he has an extensive vocabulary [such as talking about how the flag has to be illuminated if you want to leave it up and that he is patriotic]
my question is in your opinion is the fact that others do not understand him all the time something to be concerned about or will this be addressed developmentally.
thank you for being there to offer some much needed information and advice.
ANSWER: Hi J,
When you write that your son's not understood all of the time, I don't feel concerned, as we don't expect 3-year olds to be 100% intelligible. Rather, it's around the age of 4 years that our expectations for speech intelligibility increase. That said, although it's possible that the speech errors that your son makes will spontaneously dissolute with time, when a child has the verbosity and precocious language skills that you describe, my feeling is that speech therapy might be important, even if the speech sound errors he makes are 'developmental' in nature. Unfortunately, there are only guidelines, and no hard and fast rules as to when speech therapy is needed. What we want more than anything is that a child's self confidence, academic and social skills not be impacted in any way by his/her difficulty being understood.
My recommendation to you would be to have your son's speech articulation skills assessed. It's usually around the age of 3-years that we tend to see some of the speech simplification errors that toddlers produce dissipate. The type of speech errors your son makes, the pervasiveness of these in his speech, his overall intelligibility, and the fact that his language skills are so advanced should all be considered in determining whether he might benefit from supportive speech instruction.
thank you for taking the time to respond to my query. i am acutely aware of self-esteem issues, and therein lies my concern. he is quite aware and will tell me that maybe his grandma might not be able to understand him. it does not concern him, though, at this point. [i have no problem understanding him, but of course, i guess it is because so much of it is in context.]
thus, at this point, it does not concern him at all, but to make an issue of it is something that may adversely affect him, and as i said, that is where my concern lies.
i guess my follow up question would be two-fold...is there any damage down to wait for 6 mos even a year or longer [when he would be 4 1/2 or so] and see if he begins to enunciate more clearly. secondly, and i know you can not specifically address this, but what would they do in therapy...if there are certain letters, he does not say clearly, would it be a repetition of the letters? are there specific letters that some children have more trouble with?
thank you for fielding my questions and providing me with some insight. i do appreciate it
ANSWER: Hi J,
Your concern that going to speech therapy could make an unself-conscious child become self-conscious is a concern that many parents express, and interestingly, my experience with kids has been that this is not the case! I think that the reality is that most kids really enjoy the individualized attention they get in speech therapy as well as the games they get to play...and speaking better has a pay off too, whether the child is self-conscious or not. Just imagine how it feels to have people frequently ask you to repeat yourself, or to wonder whether people are going to understand what you're saying.
As to what we do in speech therapy, your guess is right -- we pick a speech sound or a family of sounds and use varying drills that walk a child from learning to produce the sound .. to producing the sound quickly and easily ... to including the sound in short phrases ... and then in sentences...and then even in stories. It's a benign process...and quite amazing to see the success that a skilled clinician and a 'ready' child can make! Some children fly through this process, and others drag their feet, and there's no knowing how a child will respond until we get started with the child.
All this being said, it sounds like you're not, at this point, wanting speech therapy for your son, and I can only advise you then to hold off. Four and a half years old is maybe a bit late to get started for a child who is an avid communicator but with a variety of speech sound errors, but you'll have to do what you're comfortable with. I can only advise that you continue to monitor your son's behavior and feelings, and others' reactions to him, and when you ...or he...feel 'ready,' do have his speech evaluated.
Best of luck!
Sharon Rosen Lopez, MA, CCC-SLP
Speech/Language Pathologist
914.629.7043
---------- FOLLOW-UP ----------
QUESTION: hi sharon,
i hope you had an enjoyable fourth and a great vacation. now that you have rested, here i am imposing on you one last time.
i wanted to clarify that i was not suggesting that i would not take my son for an evaluation and, if needed, speech therapy. i was just seeking some guidelines from you, obviously, i am not adverse to doing whatever will benefit my precious son.
[as an aside though, your arguments were not compelling in his particular case, because he does get immeasurable individual attention, and he is not bothered at this point at all if he is sometimes not understood. he will give an example or a synonym, if he does not get his point across immediately. because he is so bright, [i know...spoken like a very unbiased mother], he is quick to pick things up. unfortunately, if he does not get it immediately, he has begun to show some impatience, which we are working on. needless to say, repetition is not his favorite thing. i am sorry to bore you with all this information, but i just wanted to explain to you why i had some concerns about looking into speech therapy [at age 3] and why i was wondering if i could wait a little longer]
i have been trying to take note of which speech sounds he does not clearly emit, and i have noticed the "s" and the "f". for instance, i noticed that he had trouble saying house [it comes out hou], and even when i prompt him, he can make two separate sounds of "hou" and then "ssss", but he has trouble putting them together i took note that he has trouble saying "small" ["sall"] but he can easily say "short". the reason i gave you these examples is i was wondering, if i do wait a little longer to have him assessed [maybe until the school year begins], is there something i could do in the meantime? is there any way you could share with me some things i could do to assist him? or is there any resource i could use to learn some techniques to help him? [i am quite cognizant of the fact that i am not, in any way, a speech pathologist, but i am a loving mother, an educator, and a psychologist.
sharon, thank you in advance for your time and energy in reading this communacae and hopefully for your helpful assistance. i do appreciate it, and so does my son. [he said to tell you that you he thinks you are a very, very nice lady, because you are willing to help him! his mother could not agree more!!]
Answer Hi J,
Thanks for clarifying that your son is not feeling self-conscious about his speech, and for including some examples of your son's speech errors.
As mentioned in the last note, I use a graded approach in speech therapy, always building on success and incorporating drill. You mention that your son leaves off the 's' in 'house.' Does he also leave off other word final consonants or does he omit the 's' at the beginning of words as well? Speech therapy would be based on the 'complete picture' that we find during an evaluation. Regardless, knowing that your son is able to say 's' in isolation, we'd work to have him either say 's' followed by a vowel sound -- s...ah, s..oo, s..ee, s..ay, s..igh, etc. -- or 's' after a vowel sound -- eye ...s, ih...s, a...ce, oo...s, eh...s, ee...s. We'd start by having a pause between the target sound and the vowel, and then diminish that pause to get fluency and ease in production. And from there we'd go to the single word stage -- sock, soon, see, say, sign, etc; ice, miss, face, loose, piece, etc. And once the child is easily able to produce the 's' in those single word environments, we'd carefully build lengthier utterances incorporating those words -- 2- or 3-word phrases, sentences, response to questions, narratives. We work at a pace that is comfortable for each individual child, we're careful to avoid frustrating the child, we're aware of which speech sound environments and whether word initial, medial or final position facilitate the child's target sound production, and we're always encouraging. My therapy sessions for speech articulation are 30 minutes in duration, once weekly, and I request that a parent work with their child for afew minutes daily using the precise speech drill we used during our session.
I hope this information is helpful to you in facilitating your son's improved speech skills! Best of luck!
