Help! My Child Isn’t Talking. What Should I Do?

Perhaps you’ve noticed that your child isn’t using as many words or sentences as other children their age. Maybe a teacher has mentioned that your child is behind their peers in their language development. You may have even noticed that your child gets frustrated easily and can’t tell you what they need. These may be signs of an expressive language delay.




What is an Expressive Language?


Expressive language is the ability to express your wants and needs. Some children use sounds and then words which then progress to phrases and sentences to communicate their needs and thoughts. Other children will develop sign language and use visuals, sign or communication devices to communicate. Whichever way a child develops language, the ability to express one’s thoughts, needs, desires, and emotions is critical to communication, participation with others around them, and overall development.

What is an Expressive Language Delay/Disorder?


An Expressive Language Delay or Disorder means that your child demonstrates difficulty expressing themselves fully. This can show itself in speech, writing, sign language, or gesturing difficulties. More specifically, delays in expressive language can be characterized by difficulty learning and using vocabulary, labeling objects, generating comments and sentences, using an appropriate question, and using language to follow traditional rules of grammar. Sometimes children who show delays in using expressive language are referred to as “late talkers,” and many will catch up with their peers as they get older. Others need a bit more attention and support as they develop. If difficulties persist, your child’s diagnosis may change from Expressive Language Delay to Expressive Language Disorder, which means they may need more support with this area as they continue to develop.

What does an Expressive Language Delay/Disorder look like?


An expressive language delay can present at all ages of development, and you may notice one or a few of the following signs:

  • No babbling or vocal play as a baby

  • No words or limited vocabulary around the 12 month+ mark

  • Slow to acquire new words (uses the same few words but does not repeat new words and begin to use them independently)

  • Gesturing instead of using words (pointing, leading an adult’s hand to an object of interest, making facial expressions). These are all good indicators that a child is trying to communicate but may need help verbalizing.

  • Easily frustrated when an adult doesn’t know what they want. This can show itself in behavior such as crying, increased tantrums, headbanging, screaming, and frequent physical conflict with peers

  • Has an inventory of single words but does not put them together in word combinations (e.g., “mama eat,” “more cookie”) or simple phrases/sentences (“I want ball”, “daddy go bye-bye”)

  • Oversimplification of language or leaving key words out of a phrase or sentence, such as articles, pronouns, appropriate verb endings (e.g., “-ing”), or adjectives

  • In older children, they may have difficulty expanding on thoughts or using descriptive or precise language to express what they want to say. They may also have difficulty telling or retelling a story because they lack the language to describe or recall the parts of that story adequately.

  • Difficulty using language appropriately in social situations or making inferences from certain scenarios

  • Difficulty understanding or explaining higher-level language such as figures of speech, idioms, or metaphors



What causes an Expressive Language Delay or Disorder?


There is no known or specific cause for Expressive Language Delays or Disorders. Oftentimes it can be attributed to hearing loss or hearing impairments. An expressive language disorder can be genetic or related to other conditions, such as Autism Spectrum Disorders. Expressive Language Delays and Disorders can be first diagnosed in early childhood or can be identified later in a child’s development. The most important thing is to identify an Expressive Language Delay or Disorder in your child as early as possible and take the steps to help them as best you can.

What can I do to help my child?

First, it’s essential to rule out any hearing issues your child may be experiencing. If they have any difficulty hearing or discriminating specific sounds, this will be a significant barrier to language development. Bring any concerns you have to your child’s pediatrician and make sure you request a hearing screening or complete audiological evaluation if you notice any of the following signs:

  • Not turning toward a sound after around 6 months

  • Not attentive to or startled by loud sounds as a baby

  • Not responsive to their name being called

  • Delay in acquiring first words (none by 12-15 months)

  • Consistently needing to turn up the volume on the TV/tablet

  • In toddlers and young children, abnormal speech sounds or significant articulation deficits that reduce their ability to be understood by others

  • Trouble hearing over background noise

If you have ruled out hearing issues, it’s important to consult with a Speech-Language Pathologist if you have any concerns about your child’s language development. If your child is under 3, ask your pediatrician about Early Intervention which is a home-based service aimed at helping children with a range of developmental delays. An evaluation will help identify ways in which your child may need extra support and is a great opportunity for parent collaboration and getting your questions answered. Your local school system is also a wonderful resource. Talk to your child’s teacher about any concerns you have. You can request an official evaluation be completed through the Special Education department, and a school Speech Language Pathologist will be able to assess your child during their school day. If your child qualifies for services, you will be notified to discuss and sign off on an Individualized Education Plan, which is a document that outlines what kinds of services they will receive.


Tips To Support Your Child At Home

  1. If your child is not yet using words, expose them to environmental noises, like the “vrroooom” of a toy car, “beep beep beep” of a garbage truck, “sssss” of a snake. Get close to their face to show them how you’re making the sounds and see if they will imitate you. Animal sounds are a great place to start because they use simple consonant-vowel constructions (mooooo, baaaaaa, neighhhh) and are typically easier for children to produce.

  2. When your child uses a single word, repeat it back to them to reinforce their talking. Be playful with your tone of voice. If they use a single word to request an item, celebrate their talking (“banana yayyy! Ok, here you go!”) to encourage them to do it again.

  3. If your child is gesturing for something they want, gently incorporate the label for that item and see if they will attempt to use the word (For example, if they’re reaching for a cookie, say, “Cookie? Yes, you want a cookie!” or if they are reaching to be picked up, encourage them to try saying “up!”).

  4. Slow and simplify your speech. It can be confusing for children if we use too many words altogether and at a rapid pace. Slow things down and use shorter phrases and sentences when talking to your child to give them time to process. For example, instead of “We need to get our shoes and jacket on so we can go to the store for some groceries,” try a “Get shoes on” (pause) “great! Now get a jacket on”.

  5. Use self-talk and parallel-talk throughout the day. Self-talk is when you describe what you are doing around your child (for example, “Mommy is driving,” “Daddy’s making some eggs”). Parallel talk is talking aloud about what your child is doing. This could be describing what your child is playing with, what they are eating, what they are pointing at, drawing – anything that is happening now and is interesting to your child. Emphasizing verbs and action words are also great for diversifying language. For example, “Wow, you’re building a tower!”, “Aw, you’re feeding the baby,” “Look at you drinking your milk- good drinking!”

  6. Give choices. For example, instead of “what do you want to play?” try offering more specific, concrete choices: “Do you want blocks or cars?”. This provides the child a direct model for the words they can use to request an item while giving them the power to choose for themselves.

  7. Wait for your child to respond. Sometimes children need a moment to figure out what they want to say and providing a slight wait time gives them some space to do that.

  8. Use the same language within daily routines. This makes it easier for your child to map your language, anticipate what you’re going to say, and attempt to use these constructions independently. Some examples are: “Ready set go!”, “Put socks on,” “tubby time!”.

  9. Create communication “temptations,” which are ways to elicit language from your child. One example is keeping your child’s preferred toys slightly out of reach, which means they will have to request your help in order to access them. Another way of setting up a communication temptation is giving an item to your child that they will need help opening (like a toy in a container or a pack of crackers). Another example is to start singing a song and then stop right before you get to the really fun part your child may love to hear. See how your child reacts and if they seem stuck, give them a model for what comes next.

  10. You can also use snacks to encourage additional communication attempts. For example, instead of giving your child a bowl of goldfish crackers, give them a couple at a time and hold the remainder in a container next to you. When they look interested or reach for more, model “more fish?” and see if they will imitate you. If your child is struggling to produce this or appears frustrated, give them a few more crackers and try the next time again.

  11. If your child is at the single word level (and at least 35-50 words) try adding 1 word as a way to up the challenge. For example, if your child says “baby” you could add another word to describe what the baby is doing: “baby crying.” Keep it playful and fun, and incorporate your modeling of language into play with your child.

  12. Songs are a fantastic way to incorporate language and the rhythm of language to your child. It exposes them to multiple repetitions of words which is how children learn to use language independently. Music and rhyming are also hugely beneficial for learning to use gestures, take turns, listen and anticipate a conversational turn, follow directions and engage in vocal play. You can build songs into your daily routine, like driving in the car, taking a bath, and bedtime.

  13. Read books and label people, animals, objects, and actions by pointing to them as you turn each page. Encourage your child to point to them too or if they’re not doing this yet, help them by placing your hand over theirs while you point together. Exposure to books is important for building word knowledge, auditory comprehension, asking and answering questions, vocabulary, and strengthening memory skills. Try to build books into your daily routine. Your child may develop favorites that they want you to read to them repeatedly.

  14. For older children, you can work on telling stories together. Ask them about their day – something they read, something funny that happened, which friends they had lunch with – and see if they can tell you a complete story about an event. Reading chapter books together is a great way to strengthen these skills too. During the story, ask your child questions to make sure they’re retaining the information, ask them to retell events in the story, and review vocabulary that they don’t understand.


Conclusion

For any additional questions about your child’s development, speak to your pediatrician, who will be able to tell you what to expect at each age and stage. You can also check out this post for more information about your child's developmental stages.


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