When to Worry About Your Child's Speech


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Speech-language development begins long before a child utters his first word. By knowing what is normal — and when to seek help — you can support a lifetime of effective communication for your child.

Although communication begins at birth, the earliest consistent signs of communication are evident around 6 months. Eye contact, smiling, laughing and cooing are important, as is reciprocity, according to Elizabeth Crais, Ph.D., professor and coordinator of graduate studies in the UNC-Chapel Hill Division of Speech and Hearing Sciences.

"Parents often tend to focus on their child's speech, but communication encompasses much more than saying words," Crais says. "Cues of your child's comprehension, how your child plays, socializes and imitates you, are all important skills that we look at as well."

Age-appropriate milestones

A child's rate of speech development is as unique as he is. Crais provides the following general guidelines:

In general, before 12 months, a child should progress from babbling to intentional sound-making (word approximations, early words, etc.), reaching for objects, giving things to you, and pushing other things away.

Between 12 to 15 months, you should hear your child's first words. By 15 months, gestures — like pointing to show you things or to capture someone's attention — are good markers that his speech development is progressing well. Once your child starts talking, his vocabulary will start to increase and he will start putting words together to mark possession (e.g., "my doggie," "daddy's sock") or negation (e.g., "no cookie," "no to eat).

By 18 to 24 months, your child should be putting words into short sentences: "Doggie eat," "Mommy go." He should also have the ability to follow a two-step command: "Go into your room and bring me a sock."

Warning signs

The causes of speech and language delays are often unknown. However, Diane Brinkerhoff, speech-language pathologist with Project Enlightenment in Raleigh, says parents should be especially diligent if their children are born prematurely, have early feeding problems or have had multiple ear infections, and/or do not exhibit a lot of eye contact — especially gazing into your face for smiles and feedback about loud noises, new people, etc.

Other causes for concern include little or no response from your child when you initiate communication (gestures, etc.), children who are not walking or using single words by 15 to 18 months, children who are not using two-word combinations by age 2, or children who seem to be behind their peers with regard to speech-sound development (unclear speech, struggles to form words, or can only produce a limited range of sounds).

Early intervention

North Carolina Early Intervention Services will provide access to speech-language development evaluations for children up to age 3. Evaluations are available through an interagency system called Together We Grow. If your child is recommended for additional therapy, EIS is obligated to provide these services to families without private health insurance.

Children 3 years and older can be evaluated through the public school system, even if the child attends private school. As part of the Wake County Public School System, Project Enlightenment offers free developmental screenings of speech, language and learning skills for Wake County children, 3 to 5 years old.

The criteria for receiving an evaluation in the school system depends on the degree of the speech or language delay, according to Crais. "There are many ways to address speech-language development in children. I prefer natural environments [home, school] and working with people who interact with the child [parents, teachers, caregivers], rather than in an isolated intervention," she says.

When to seek help

Experts agree that parents should seek professional advice about their child's speech-language development as soon as possible. "If a parent is concerned, there's a reason, so don't hesitate to ask for help," Brinkerhoff says. "A
child has so much learning to share with you — so many thoughts, feelings and ideas — you don't want to miss out because you are unable to communicate with him. Make the call and schedule an evaluation."

Mutual frustration was the tipping point for Raleigh parent Anne Meulink and her son. Shannon did not start talking until age 2, and then his older sister was the only one who understood him.
"She'd translate for him," Meulink says. "He wasn't old enough to grasp the concept of changing his words to clarify what he was saying, so when I asked him to repeat himself, he would repeat what he had said, which I could not decipher, and we both became increasingly frustrated. That's when I knew we needed help."

Shannon's preschool invited a Project Enlightenment counselor to observe him in his 3-year-old class, and he was recommended for speech therapy. He received services through Project Enlightenment, and then Wake County Schools, until the middle of first grade.

"We noticed small improvements early on and it was wonderful to finally be able to communicate with him," Meulink says. "Project Enlightenment's early intervention was key to Shannon's success. We are a middle-class family, and it would have been difficult to afford private services for him," she says.

Although Shannon's speech therapy ended in first grade, he struggled in school. "He was bright, but his handwriting was poor and he wasn't on grade level in reading," Meulink says. Several years of private tutoring and additional support from teachers were needed to keep Shannon on track. Now, at age 12, "he is an A/B honor roll student and you would never know he ever had a speech delay," Meulink says.

The Meulink family's experience illustrates the importance of early intervention. "Some things are too important to 'wait and see,'" Brinkerhoff says. "Delays in speech and language development often affect other areas as your child grows. It's best to trust your instincts and seek professional advice sooner, rather than later."

Maria J. Mauriello is a freelance writer, communications professional and the mother of two children. She lives in Raleigh.

 

Resources
American Speech
Language-Hearing Association
www.asha.org

 

North Carolina Early Intervention Services www.ncei.org/ei

Project Enlightenment
www.projectenlightenment.wcpss.net

For information about stuttering:

National Stuttering Association
www.westutter.org

The Stuttering Foundation
www.stutteringhelp.org

Seeking assistance for stuttering

Caron Lye, a speech-language pathologist and Durham parent, took her own advice when her 3-year-old son started stuttering. "If a parent is concerned, I tell them to have their child screened, so that's what I did," she says. Six months later, after Lye consulted with a speech-language pathologist with stuttering expertise, her son is "doing great. He's very verbal and loves to talk," Lye says.

Most children go through some period of disfluency in their speech, usually between the ages of 2 and 6. However, approximately 5 percent of all children experience a sustained period of stuttering that lasts six months or longer, according to the Stuttering Foundation of America. Three-quarters of those children will recover by late childhood, but it will be a long-term problem for about 1 percent.

Lye encourages parents to seek skilled intervention early on. "Stuttering is a complicated, multifaceted communication disorder, so it's important to find someone who has extensive experience treating it," she says.

"Early intervention is important. If you wait for your child to outgrow stuttering, you could be missing critical therapy time."

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Sponsor: Wake County Public Libraries

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Join park staff for a fun, informal fishing experience. Bring your own poles or borrow one of ours through the Tackle Loaner Program. Bait and basic instruction are provided. Fishing is catch and...

Cost: FREE

Where:
Lake Crabtree County Park
1400 Aviation Pkwy.
Morrisville, NC  27560
View map »


Sponsor: Lake Crabtree County Park
Telephone: 919-460-3355
Contact Name: Carol Cunningham
Website »

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The Engage Art Contest is a juried competition for original Visual Art, Music Video, Film and Performing Arts. The topic is the Spiritual Battle described in Ephesians 6:10-20 and related...

Cost: Free

Where:
Online
PO Box 78951
Charlotte, NC  28271
View map »


Sponsor: Engage Art Contest
Telephone: 980-999-1447
Contact Name: Ranika Chaney
Website »

More information

Amongst the ancient oak trees is the heart of Raleigh. We'll help you see the forest for the trees and all its magic splendor. Tourist, local, or new to town, this is a lively small group activity...

Cost: $11

Where:
Downtown
500 S Salisbury St
Raleigh, NC  27601
View map »


Sponsor: Let's Roam
Telephone: 833-202-7626
Contact Name: Kelly
Website »

More information

Summer Garden Camps at the JCRA invite your child to investigate nature during half or full day camps.  Campers tend to the garden, harvest vegetables, catch insects, and create crafts from the...

Cost: Varies depending on week of camp

Where:
JC Raulston Arboretum
4415 Beryl Rd
Raleigh, NC  27606
View map »


Sponsor: JC Raulston Arboretum
Telephone: (919) 513-7011
Contact Name: Elizabeth Overcash
Website »

More information

Summer Garden Camps at the JCRA invite your child to investigate nature during half or full day camps.  Campers tend to the garden, harvest vegetables, catch insects, and create crafts from the...

Cost: Varies depending on camp week

Where:
JC Raulston Arboretum
4415 Beryl Rd
Raleigh, NC  27606
View map »


Sponsor: JC Raulston Arboretum
Telephone: (919) 513-7011
Contact Name: Elizabeth Overcash
Website »

More information

Kindermusik is a research-based early childhood curriculum that includes 45-minute classroom lessons with materials and resources that encourages parental involvement . Research has linked...

Cost: $70/month

Where:
Hope Community Building
2080 E Williams St
Hope Community Building, Fuquay Varina Room
Apex/Holly Springs, NC  27539
View map »


Telephone: 191-990-25432
Contact Name: Leigh Hamm
Website »

More information

Sign up for a Raleigh scavenger hunt and put on your best Nick Cage impression as you seek out the national treasures hidden in Raleigh. Via an app, be guided through the cultural, historical,...

Cost: See website for fees

Where:
Downtown Raleigh
500 S. Salisbury St.
Raleigh, NC  27601
View map »


Sponsor: LetsRoam!
Telephone: 833-202-7626
Contact Name: LetsRoam!
Website »

More information

I am a mom and retired CPA who is passionate about teaching teens about the high cost of their choices. I teach a fun, interactive "Game of Life meets Dave Ramsey" class that has teens experience...

Cost: $225

Where:
Hope Community Church- Apex
2080 E Williams Street
Apex, NC  27539
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Sponsor: Beyond Personal Finance
Contact Name: Charla McKinley
Website »

More information

Short class advertising for local class   I am a mom and retired CPA who is passionate about teaching teens about the high cost of their choices. I teach a fun, interactive "Game of Life meets...

Cost: $225

Where:
Hope Community Church- Apex
2080 E Williams Street
Apex, NC  27539
View map »


Sponsor: Beyond Personal Finance
Contact Name: Charla McKinley
Website »

More information

Short class advertising for local class   I am a mom and retired CPA who is passionate about teaching teens about the high cost of their choices. I teach a fun, interactive "Game of Life meets...

Cost: $225

Where:
Hope Community Church- Apex
2080 E Williams Street
Apex, NC  27539
View map »


Sponsor: Beyond Personal Finance
Contact Name: Charla McKinley
Website »

More information

We invite all Triangle youth between the ages of 8 thru 17 with a sincere interest in the Performance Art of Magic to join Magic Youth Raleigh! This youth program teaches magic history and theory,...

Cost: $35 per Student

Where:
New Horizons Fellowship
820 E. Williams St.
Apex, NC  27502
View map »


Sponsor: The International Brotherhood of Magicians
Contact Name: Roger Way
Website »

More information

Young children and their families are invited to participate in an interactive program with books, songs, movement, and other early literacy-based activities, carefully selected to engage an...

Cost: Free

Where:
Cameron Village Regional Library
1930 Clark Avenue
Raleigh, NC  27605
View map »


Sponsor: Wake County Public Libraries

More information

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The Engage Art Contest is a juried competition for original Visual Art, Music Video, Film and Performing Arts. The topic is the Spiritual Battle described in Ephesians 6:10-20 and related...

Cost: Free

Where:
Online
PO Box 78951
Charlotte, NC  28271
View map »


Sponsor: Engage Art Contest
Telephone: 980-999-1447
Contact Name: Ranika Chaney
Website »

More information

Forget tourist-filled museums, make your own memories with a photo scavenger hunt tour in Raleigh! On a Let’s Roam scavenger hunt, you and your team will work together to wander throughout...

Cost: $11

Where:
500 S Salisbury St
raleigh, NC  27601
View map »


Sponsor: Let's Roam
Website »

More information

Summer Garden Camps at the JCRA invite your child to investigate nature during half or full day camps.  Campers tend to the garden, harvest vegetables, catch insects, and create crafts from the...

Cost: Varies depending on week of camp

Where:
JC Raulston Arboretum
4415 Beryl Rd
Raleigh, NC  27606
View map »


Sponsor: JC Raulston Arboretum
Telephone: (919) 513-7011
Contact Name: Elizabeth Overcash
Website »

More information

Summer Garden Camps at the JCRA invite your child to investigate nature during half or full day camps.  Campers tend to the garden, harvest vegetables, catch insects, and create crafts from the...

Cost: Varies depending on camp week

Where:
JC Raulston Arboretum
4415 Beryl Rd
Raleigh, NC  27606
View map »


Sponsor: JC Raulston Arboretum
Telephone: (919) 513-7011
Contact Name: Elizabeth Overcash
Website »

More information

Amongst the ancient oak trees is the heart of Raleigh. We'll help you see the forest for the trees and all its magic splendor. Tourist, local, or new to town, this is a lively small group activity...

Cost: $11

Where:
Downtown
500 S Salisbury St
Raleigh, NC  27601
View map »


Sponsor: Let's Roam
Telephone: 833-202-7626
Contact Name: Kelly
Website »

More information

Kindermusik is a research-based early childhood curriculum that includes 45-minute classroom lessons with materials and resources that encourages parental involvement . Research has linked...

Cost: $70/month

Where:
Hope Community Building
2080 E Williams St
Hope Community Building, Fuquay Varina Room
Apex/Holly Springs, NC  27539
View map »


Telephone: 191-990-25432
Contact Name: Leigh Hamm
Website »

More information

The Community Farm at Chestnut Ridge + Growga are excited to offer outdoor yoga classes this spring!   The Little Sprouts Growga program is for ages 2-5. They learn basic mindfulness elements...

Cost: $150

Where:
The Community Farm at Chestnut Ridge
2902 Mt. Willing Road
Efland, NC  27243
View map »


Sponsor: The Community Farm at Chestnut Ridge
Telephone: 919-304-2178
Contact Name: Erica Romkema
Website »

More information

Sign up for a Raleigh scavenger hunt and put on your best Nick Cage impression as you seek out the national treasures hidden in Raleigh. Via an app, be guided through the cultural, historical,...

Cost: See website for fees

Where:
Downtown Raleigh
500 S. Salisbury St.
Raleigh, NC  27601
View map »


Sponsor: LetsRoam!
Telephone: 833-202-7626
Contact Name: LetsRoam!
Website »

More information

We invite all Triangle youth between the ages of 8 thru 17 with a sincere interest in the Performance Art of Magic to join Magic Youth Raleigh! This youth program teaches magic history and theory,...

Cost: $35 per Student

Where:
New Horizons Fellowship
820 E. Williams St.
Apex, NC  27502
View map »


Sponsor: The International Brotherhood of Magicians
Contact Name: Roger Way
Website »

More information

Young children and their families are invited to participate in an interactive program with books, songs, movement, and other early literacy-based activities, carefully selected to engage an...

Cost: Free

Where:
Cameron Village Regional Library
1930 Clark Avenue
Raleigh, NC  27605
View map »


Sponsor: Wake County Public Libraries

More information

The park comes alive after dark! Let the moon guide your way as we stroll around the pond in search of these night-time critters. Play fun games and try to catch some nocturnal bugs! Don't forget a...

Cost: FREE. Registration required for everyone; children must have adult accompaniment

Where:
Crowder County Park
4709 Ten-Ten Rd
Apex, NC  27529
View map »


Telephone: 919-662-2850
Website »

More information

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The Engage Art Contest is a juried competition for original Visual Art, Music Video, Film and Performing Arts. The topic is the Spiritual Battle described in Ephesians 6:10-20 and related...

Cost: Free

Where:
Online
PO Box 78951
Charlotte, NC  28271
View map »


Sponsor: Engage Art Contest
Telephone: 980-999-1447
Contact Name: Ranika Chaney
Website »

More information

Forget tourist-filled museums, make your own memories with a photo scavenger hunt tour in Raleigh! On a Let’s Roam scavenger hunt, you and your team will work together to wander throughout...

Cost: $11

Where:
500 S Salisbury St
raleigh, NC  27601
View map »


Sponsor: Let's Roam
Website »

More information

  Meet at the Waterwise Garden (first parking lot on right) Join our bird enthusiast, Vernon, for an easy walk while looking and listening for our feathered friends. Discover...

Cost: FREE

Where:
Lake Crabtree County Park
1400 Aviation Pkwy.
Morrisville, NC  27560
View map »


Sponsor: Lake Crabtree County Park
Telephone: 919-460-3355
Contact Name: Carol Cunningham
Website »

More information

Summer Garden Camps at the JCRA invite your child to investigate nature during half or full day camps.  Campers tend to the garden, harvest vegetables, catch insects, and create crafts from the...

Cost: Varies depending on week of camp

Where:
JC Raulston Arboretum
4415 Beryl Rd
Raleigh, NC  27606
View map »


Sponsor: JC Raulston Arboretum
Telephone: (919) 513-7011
Contact Name: Elizabeth Overcash
Website »

More information

Summer Garden Camps at the JCRA invite your child to investigate nature during half or full day camps.  Campers tend to the garden, harvest vegetables, catch insects, and create crafts from the...

Cost: Varies depending on camp week

Where:
JC Raulston Arboretum
4415 Beryl Rd
Raleigh, NC  27606
View map »


Sponsor: JC Raulston Arboretum
Telephone: (919) 513-7011
Contact Name: Elizabeth Overcash
Website »

More information

PARENTS JOIN OUR DHHS APPROVEDCPR/AED & First Aid Certification ClassesFoster parents are required to be CPR & First Aid certified. Parents, bring your child to class with you. Children 10 years...

Cost: 50-80

Where:
Holly Springs, NC
1001 Silverstone Way
Holly Springs, NC  27540
View map »


Sponsor: Save A Life Now Training Center LLC
Telephone: 919-215-6942
Contact Name: Valentina Cordoba
Website »

More information

Amongst the ancient oak trees is the heart of Raleigh. We'll help you see the forest for the trees and all its magic splendor. Tourist, local, or new to town, this is a lively small group activity...

Cost: $11

Where:
Downtown
500 S Salisbury St
Raleigh, NC  27601
View map »


Sponsor: Let's Roam
Telephone: 833-202-7626
Contact Name: Kelly
Website »

More information

PARENTS JOIN OUR DHHS APPROVEDCPR/AED & First Aid Certification ClassesFoster parents are required to be CPR & First Aid certified. Must register in advance. Space is limited. Parents, bring your...

Cost: 50-80

Where:
Holly Springs, NC
1001 Silverstone Way
Holly Springs, NC  27540
View map »


Sponsor: Save A Life Now Training Center LLC
Telephone: 919-215-6942
Contact Name: Valentina Cordoba
Website »

More information

Enjoy a wonderful springtime Brunch with the Bunny and photo op on Saturday, April 4, 2020 at Patterson Farm Market & Tours. Our Brunch with the Bunny is always a popular event! Tickets must be...

Cost: Ages 2 – 6: $10.00 includes tax Ages 6 – 12: $12.00 includes tax Ages: 13 – 54

Where:
Patterson Farm Inc. Market and Tours
10390 Caldwell Road
Mount Ulla, NC  28125
View map »


Sponsor: Patterson Farm Inc. Market and Tours
Telephone: 704-636-4005
Contact Name: Megan Hedrick
Website »

More information

Opportunities to explore all 4 levels of the mill don’t happen often! Learn the history of milling in North Carolina, test your mill trivia, and discover what interesting machinery is preserved...

Cost: $10/Adult; $8/Senior (ages 60+); $6/Child (ages 10-16);Registration is required

Where:
Historic Yates Mill County Park
4620 Lake Wheeler Road
Raleigh, NC  27603
View map »


Telephone: 919-856-6675
Website »

More information

Beavers are such busy creatures and have many unique features that allow them to survive in their aquatic world. Learn about their special adaptations through our "Build a Beaver" program then walk...

Cost: Free

Where:
Harris Lake County Park
2112 County Park Dr.
New Hill, NC  27562
View map »


Sponsor: Harris Lake County Park
Telephone: 919-387-4342
Contact Name: Joanne St. Clair
Website »

More information

Join us for an egg-cellent time on the farm Saturday, April 4 & 11,  2020 from 10 a.m. – 5 p.m. Explore the farm while you hunt for eggs and enjoy spring farm fun activities. Search for 12...

Cost: $10.00 for Hunters $7.00 for Non-Egg Hunters $6.00 for Non-Egg Hunters Senior (A

Where:
Patterson Farm Inc. Market and Tours
10390 Caldwell Road
Mount Ulla, NC  28125
View map »


Sponsor: Patterson Farm Inc. Market and Tours
Telephone: 704-636-4005
Contact Name: Megan Hedrick
Website »

More information

Kindermusik is a research-based early childhood curriculum that includes 45-minute classroom lessons with materials and resources that encourages parental involvement . Research has linked...

Cost: $70/month

Where:
Hope Community Building
2080 E Williams St
Hope Community Building, Fuquay Varina Room
Apex/Holly Springs, NC  27539
View map »


Telephone: 191-990-25432
Contact Name: Leigh Hamm
Website »

More information

The Town of Holly Spring's annual spring event, Spring Fling, is taking on a new location that has a nice ring to it. This year’s Spring Fling at Ting! will take place on Saturday, April 4 from...

Cost: FREE

Where:
Ting Park Baseball Stadium
1151 N. Main St.
Holly Springs, NC  27540
View map »


Sponsor: Town of Holly Springs
Contact Name: Rachel Downey

More information

Many wildflowers bloom in spring.  Join us for a leisurely hike through our fields and woods as we learn to recognize some blooming beauties and appreciate their stories. Age: 5yrs. and up;...

Cost: $2

Where:
Annie Louis Wilkerson. MD Nature Preserve Park
5229 Awls Haven Dr
Raleigh, NC  27614
View map »


Telephone: 919-996-6764
Contact Name: Bryan England
Website »

More information

Sign up for a Raleigh scavenger hunt and put on your best Nick Cage impression as you seek out the national treasures hidden in Raleigh. Via an app, be guided through the cultural, historical,...

Cost: See website for fees

Where:
Downtown Raleigh
500 S. Salisbury St.
Raleigh, NC  27601
View map »


Sponsor: LetsRoam!
Telephone: 833-202-7626
Contact Name: LetsRoam!
Website »

More information

Want to get inside Historic Yates Mill? Join us for a half-hour tour (starting at 1, 1:30, 2, 2:30 or 3 p.m.) to view the main power drive and milling machinery while exploring the mill's history...

Cost: $5/Adult, $4/Senior (60+ yrs), $3/Child (7-16yrs), Free/Child (6yrs & younger)

Where:
Historic Yates Mill County Park
4620 Lake Wheeler Road
Raleigh, NC  27603
View map »


Telephone: 919-856-6675
Website »

More information

Bring the whole family for this fun interactive Growga family class. Siblings and parents come together for a fun Growga hour, combining elements of our Little Sprouts and Growga Kids programs...

Cost: $150

Where:
The Community Farm at Chestnut Ridge
2902 Mt. Willing Road
Efland, NC  27243
View map »


Sponsor: Chestnut Ridge Camp & Retreat Center
Telephone: 919-304-2178
Contact Name: Erica Romkema
Website »

More information

We invite all Triangle youth between the ages of 8 thru 17 with a sincere interest in the Performance Art of Magic to join Magic Youth Raleigh! This youth program teaches magic history and theory,...

Cost: $35 per Student

Where:
New Horizons Fellowship
820 E. Williams St.
Apex, NC  27502
View map »


Sponsor: The International Brotherhood of Magicians
Contact Name: Roger Way
Website »

More information

Young children and their families are invited to participate in an interactive program with books, songs, movement, and other early literacy-based activities, carefully selected to engage an...

Cost: Free

Where:
Cameron Village Regional Library
1930 Clark Avenue
Raleigh, NC  27605
View map »


Sponsor: Wake County Public Libraries

More information

Garner Sports League Opening Day Ceremony will be held at South Garner Park at 9am on Saturday April 4, 2020.  Come join us as we kick off the Spring season for recreational baseball, fast-pitch...

Cost: 0.00

Where:
South Garner Park
1210 Poole Drive
Garner, NC  27529
View map »

More information

Topper the Bunny can’t wait to see you at the 5th Annual Egg-ceptional Egg Hunt at Hubb’s Farm in Clinton, NC, features age-appropriate egg hunts with a grand finale airplane egg drop at 3pm...

Cost: 10

Where:
Hubb's Farm
10276 US HWY 421 N
Clinton, NC  28328
View map »


Sponsor: Hubb's Farm
Telephone: 910-564-6709
Contact Name: Tammy Peterson
Website »

More information

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