To be a “good communicator” children need to have well developed skills in speech sounds, language, fluency, voice and pragmatics.
If the following difficulties are observed, the child should be referred for Speech Pathology services:
- Inability to use speech sounds clearly
- Frustration when communicating
- Speech that is not understood
- Inability to follow directions
- Incorrect grammatical structures
- Making age appropriate sentences
- Chronic hoarseness
- Stuttering: Repetition of sounds or words
- Limited vocabulary compared to same age peers
- Difficulty answering questions
- Sudden change in ability to communicate
- Difficulty with swallowing and/or eating
- Poor socialisation
- Not coping with school work such as reading, writing, spelling
If a child's speech and language skills (receptive and expressive language) deviate from the milestones listed here, a Speech Pathologist should be consulted.
By age 2
- Can say b, d, p, h, m, n, and w and vowel sounds in simple words.
- Makes appropriate eye contact.
- Reacts to others' moods and starts to show off to get attention.
- Demonstrates appropriate use of objects in play.
- Vocabulary is about 150- 300 words.
- Follows commands like "Show me your...(5 body parts) and understands simple "wh" questions.
- Uses noun+verb 2 word sentences consistently and can ask for "more".
- Uses prepositions: on, in, under and pronouns I, you, me.
- Speech is usually 50 -75% intelligible.
By age 3
- Can say ng, f, m, w, b, n, t and k in words.
- Matches colours, listens to longer stories and understands and responds to questions about immediate environment.
- Follows two step related instructions with cues.
- Has about 900 words, uses some plurals and past tense and tells about his experiences.
- Uses 3 -4 word sentences.
- Asks questions.
- Speech is 75-100% intelligible.
By Age 4
- Uses s, g, j, ch, sh, and l sounds.
- Understands shapes and colours, the concepts of time e.g. “dinner time”.
- Can repeat four digits when given slowly.
- Follows directions when object in not in sight.
- Vocabulary is 1000 or more words.
- Uses many grammatical forms (e.g. possessives – “mummy‛s keys”, past tense verbs “ I jumped”, additional pronouns he, she, we).
- Asks how", "why" and "when" questions.
- Uses 4-5 word sentences and tells simple stories.
By age 5
- Masters r, z and v sounds.
- Follow three stage commands without help.
- Uses sentences of 5+ words and some compound sentences with joing words such as 'and' and 'because'.
- Uses many adjectives and adverbs, knows opposites e.g. "heavy-light" and count to ten.
- Can tell how and why events happened and can repeat sentences as long as 9 words.
- The th sound is often only said accurately after 7 years of age.
A school age child 8 years and older should be referred for a Speech Pathology Assessment if he/she:
- Is stuttering.
- Is having difficulty with any sounds in his or her speech.
- Is having difficulty with grammar.
- Has a limited vocabulary compared to same-aged peers.
- Is having difficulty asking or answering questions (who, what, how, why, when, where).
- Can not participate in detailed conversations.
- Is reluctant to answer questions in the classroom.
- Has trouble thinking of the word he or she wants to say.
- Gets frustrated because he or she is having trouble understanding something or communicating something.
- Is not remembering and following instructions with 3-4 steps.
- Is not using language to give information, have conversations, entertain and persuade.
- Is having difficulty identifying and solving problems appropriately.
- Is not engaging in appropriate social interactions with other kids.
- Cannot read aloud fluently.
- Cannot analyse what has been read.
- Has trouble spelling.
- Has difficulty writing.
- Has trouble with reading comprehension tasks.
- Has trouble with auditory comprehension tasks.
- Has difficulty understanding jokes and figurative language.
- Has difficulty following conversations in a group.