Speech & Language Development: What can parents do and when should they seek help?

The playful psychologist podcast is hosted by me, Emily Hanlon, a clinical psychologist who primarily works with children and adolescents. This podcast has been designed to offer support to new psychologists who may feel as though they are drowning in uncertainty. It has also been designed to inform and educate parents and teachers on all things child development. Along with some special guests, I explored different aspects of child development, including developmental disorders and emotional regulation, while also advocating for those who may be falling through the cracks in our current system. Hey guys, welcome to this week's episode of the playful psychologist. Today is really cool. We're going to talk about speech and language development in young children. And I have a really awesome special guest for you guys. We actually used to work together when I lived on the Gold Coast and we became really good friends. So Sabina, would you like to introduce yourself to everyone? Sure. Hi everyone. My name is Sabina. I am a speech pathologist here on the Gold Coast. I work mainly with the pediatric population, so I'm probably focusing on kids from about zero to twelve. And I have a background in special education as well. That's what I did before. I became a speech therapist and I absolutely love working with kids and families. Yeah, so important, hey. Okay, so why don't you tell us like obviously kids that come to say a speech therapist. We assume that they have some sort of like speech delay or like an issue with expression and that sort of thing. But what kind of things do you say kids for primarily? So I guess I would say mostly I see kids who are quite young even under two years old and that's probably for kids who just aren't really talking as much as they I guess should be. So I get a lot of inquiries about that. I also see quite a few kids who stutter and when it comes to older kids, I see a lot of kids for literacy difficulties. So speech pathologists actually work on quite a wide range of difficulties for kids whether it be speech, language, stuttering, literacy, feeding. So I don't think a lot of people know that like speech pathologists not all about just like speech. Exactly. It's like reading and feeding and like moral mode of movement and all of that sort of stuff. And even when it comes just down to speech and language, a lot of people don't know the difference between speech and language. So you know your language is what you say. So for a little child, that's what we're more concerned about what they're saying. We want to know that they're developing a vocabulary where the speech is how you say things. So for little kids, you know, between one and two, if they're not pronouncing words properly, that wouldn't be the main focus. We'd want to know that they actually are just coming up with words. You have a vocabulary and then you can later on work on speech sounds and stuff like that. Yeah, absolutely. So you know, being able to decide at that first meeting whether a child isn't talking because of a language difficulty or a speech difficulty is something that you do have to, you know, diagnose and decide what kind of route you want to take. So do you get, the most of your referrals come from parents who are concerned and just bring their kids in? Or do you get lots of referrals from like GPS sites and that sort of thing? I would say I guess this is a bit of a mix, but recently probably more from GPs. Okay. One of the things that I've noticed is so for little kids who aren't talking in the past, there used to be more of a wait and see. Whereas nowadays, if your child is not meeting their speech and language milestones, it is important for them to get assessed actually immediately or as soon as possible because your speech and language is a gateway to so many other things for later on in life. Even like social skills. Social skills, literacy, everything. Yeah. So now I think doctors are kind of logging on to the idea like, oh, if your child isn't talking, even as young as 18 months, let's do something about that. Yeah. So you know, one thing we do love is if a child has had their hearing checked before you come for a speech pathology appointment, especially your right. Exactly. So we can rule it out, especially if they have had air infections and stuff in the past. And that's another tricky area too because you don't actually always know when your kids do have air infections because they don't necessarily tell you or they don't necessarily, you know, some kids aren't miserable about it, which I had an air infection at 19 and I have never cried so much. So I think you need to know that. So later she's like legitimately the most dramatic person I had in that come across. I don't know how kids are not saying my ears because I was, yeah, it was not good. But yeah, so, you know, usually a doctor will say, all right, get your hearing checked and then you can go and see speech therapist or either or we'd still assess you without having your hearing checked. But it's just good to know. It's just good to rule it out. Yeah, yeah, 100%. Okay, so like, when it comes to speech and language, you know, therapy, is there, does it always need to be done with a professional or is there a few activities or are there some things that parents can do at home? So just like maybe push kids in the right direction or just help them with their language development. So this is actually a really, I like the way you ask that question, if it has to be done with a professional, the way I look at it is, especially for young kids. So in terms of that, you need to get each other's sex. If you concern, definitely get each other's sex. Okay, so you need that. I would say that's a for sure thing. But in terms of activities at home, the way I look at it is, I teach parents how to give their kids therapy at home. So for instance, if you come and see me for a speech pathology assessment and your child is young, they're not really doing much talking. The first things I'm going to do is teach you what you need to be doing at home because in my opinion or, you know, in anybody's opinion, you're going to, you're only seeing me for 30 minutes, 45 minutes once a week. That's not going to make a change. Yeah, so true. It's the constant therapy. So I tell parents, listen, I'm teaching you how to therapist your child so you can be doing it around the clock without even noticing that you're doing it. Yeah, 100%. And you can always tell right the parents that do the homework, you see the changes, the ones that don't, they come in and they're like, nothing's changing. It's like we have nothing to do. And then it's not working or stuff like that. So I actually do quite a bit of video feedback with my parents. So I might video them in session playing with their child. Of course, at this age, it's all play. So we're not doing, you know, flash cards. We're not doing, you know, that route learning. It's kind of focusing on that whole children learn through play. Yeah, which is so important about that. Very important. And that's important for everything. It's not just for speech and language. That is, the play is kind of the window to learning. Absolutely. So I basically, and if you're not such a great player, that's fine because it's hard for, it is so hard for parents to play with kids. And they're exhausted. Like they're done. It's hard like, you know, for me, like I grew up, my mom was just straight up. She was like, I don't play with kids. You know, parents don't want to have to play. And the other thing is sometimes parents who do love to play with kids, they want to direct play. So that's another important element is kind of following your child's lead. So basically, what I do is at that, well, for younger kids working with parents, it's teaching you how to play, how to interact with the kids in order to kind of bring out your child's language. So yes, you might play with your child all the time, but are you doing it in a way that's going to help illicit language from them? So that's so important. So, you know, are you playing with your child, but you're directing their play and then they get, they lose interest. Or you say, I love to play with my son, but he never wants to play with me. And let's say I video you guys playing and he kind of doesn't want to play with you because you're constantly trying to tell him how to play with his car. Whereas, you know, you want him to push it down the ramp, but he just wants to push it over the bridge, or you know what I mean. And because of that breakdown in the play, you're losing exactly and you're losing moments for teaching language and learning language. So you have to like play, but let the child take the lead and follow them. So you follow their lead. So, you know, I always all like to maybe even say to parents, look, let's just sit back. We're not even going to get involved in his play right now. We're just going to observe. We're going to watch what he's doing. And these are kind of the principles from kind of gold star standard treatments like the Hanon program and stuff like that, where we observe, wait and listen. So we're going to watch what you want to play with. We'll take a minute. We'll step back. We'll look what you want to play with. Then we'll find a way to get in on that play with you. So it's just important to take that time to observe. And when that happens, you know, I find a lot of the time we realize, oh, he really likes that. Or he really wants to play with that. And then we find something that maybe a child is interested in. So, you know, they might come in and they're like, oh, he doesn't really like to play with anything. But when we just sit back and observe, we might realize he actually really likes to play with the food or the cooking or, you know, stuff like that. It's just never giving him the chance to explore it the way he wants to. And what I say to parents is once we figure out something that your child likes, even if it's one thing, we can use that. Absolutely. And I think it's so, like sometimes parents say, like he's not motivated by anything or nothing. She doesn't want a prize. Nothing motivates her. And it's like, no, everyone is motivated or everyone is driven by something. It's just really sometimes half the battle is taking five to six weeks to figure out what it is. And once you have that, it's like a light bulb moment. Yeah. And so once we find that one thing, even if it's one little thing, we can start using that to try and get some language. So basically, you're using the strength of whatever it is to build those weaknesses of language development, you know. And you just start with, you know, simple things. So it goes, so, so it goes back to kind of just being like, okay, we found these bubbles. He's obsessed with bubbles. He loves bubbles. What are we going to do? We can work on some really nice core vocabulary, like words like more go stop. Yes, no, you know, little things like that, which are the most, you know, very important starting places, because ideally, what we want to do is give even just a few core words, whether it be they can vocalize them or sign them, that will help to bring down frustrations. And once we bring down a child's frustrations from not being able to communicate efficiently, then, you know, that kind of opens up a whole new door as well, because now they are, they realize they've linked like, oh, my signs work or my words. And someone's finally understanding what I'm trying, I've been trying so desperately to say. And I think it comes down to as well, like when it comes to behaviour, there can be so many reasons for behaviour. And a lot of the time in young kids, it's just lack of like acknowledgement of what they're trying to say or communicate to us in any way. Exactly. But and another thing I always say to parents is put yourself in those shoes. Imagine you basically trying to be like, they, I want this or trying to communicate and not getting it across. Of course, you're going to get frustrated, you know what I mean? But once you can communicate what you need to communicate, then it's almost like a wait-lifted off your shoulders. Absolutely. And another thing I try to also really pinpoint with parents as well is, it doesn't have to be verbalised to communicate. So important. My stance on it is we just need to give your child a voice, a quote-unquote voice, whether it be their actual voice or using signs or pictures. Whatever it is, is we're giving them a voice to communicate their wants and needs. And that in itself is just amazing. Exactly. You know what I mean? Because you're giving them that independence, you're giving them just the ability to really be a part of things and make their own choices without you having, you're taking the guesswork out of it. So, you know, I tried to tell people not to focus on words per say in the beginning, but let's just get each child communicating at first, if that's the way it, you know, kind of pans out. Yeah, I think that's really important because I think once you do give a child, like you said, a quote-unquote voice and whether that be like even a communication device, anything, it's all about that then being able to build that relationship. And then that's when you really see like any form of communication kind of flourish a little bit more. Because again, they understand that you're finally understanding them. Yeah. And it opens the door for them. Yeah, for sure. Yeah. To make choices and to, yeah, it just, to me, that's, yeah. Really important. Yeah. Love that. Beautiful. I should also mention that, like Sabaina Godblesser has just had her second child, so we're doing this like, you know, she's doing such an awesome job considering she's still on mat leave and she's putting all these words together because I absolutely was not putting words together. This point in my parenting journey. So that's off to you. Okay. So what are some ways then that parents can encourage those early communications like any form of communication with their child? So like I had mentioned before, that kind of following their lead, that's really important. Just talking, you know, one, and this is one of the amazing things about communication and, you know, even that early therapy in communication and stuff is it's free. Yeah. You don't need to rush out and buy the latest technology. You don't need to get the latest games. It just needs a little bit of time in the sense that, you know, observe your child, follow their lead, see what they want to play with, spend a lot of time describing things. I find that sometimes we forget that we need to teach kids things and I think sometimes we think they're just supposed to know things. Yeah. So true. But we need to spend that time repeating things over and over and over again. So you know, your morning routine, your bedtime routine, all those times are really good times to implement specific vocabulary and stuff. Even in the bath, like you have to be there engaging with them anywhere. They're in the bath. So use that time, you know. Yep. There, there any time of the day is a good time for it. In the car, while you're driving, you can be talking about cars, trees, trucks, colors, you know, there's multiple things. You can do some counting. You can do singing in the car. And just kind of repetition. So you might, you know, choose to sing a song every night at bath time. And over time, what might happen is you might start singing. So like, for instance, I sing to my baby. First we take a bath, then we drink some milk, then we go to sleep. Oh my God. So I would do that basically the entire time in the shower, you know, once or twice, all she's drinking her milk and right before she goes to sleep. Anyway, so the idea is that I've said that so much that eventually I might say first we take a, and she would eventually kind of fill in bath. Yeah, okay. Or, or, you know, if you're doing that with Ready Set Go, you might model Ready Set Go every day at the park when you go to the swings. And hopefully the hope is that after us, and this is for a child who's about one, you know, one, 12 to 18 months, you would be going Ready Set and waiting, waiting, waiting, giving them that time to see if they say go, which leads me into waiting. So it's really important that you also give your child time to respond. Yes. So a lot of us might be like, what do you want to eat or do you want this? Yes. No, do you want more? Are you finished? And, you know, sometimes you actually do need to wait up to 20 seconds to give a child time to respond. And 20 seconds is a very long time when you're waiting for a child to respond. You keep talking, I'm going to just jump in when it's been 20 seconds just to give people that. So it really is that that length of time that you do need to give a child to respond to what you've said. And you know, things are fast paced sometimes we don't have time to think about it, but it is important that we do give our children time to respond. That's a long time man. I don't do that. I've got to get better at that. It's a long time. The other thing that's really important to do is with kids. This is probably one of the first things I do with parents when they come in is we have to work on questions. We ask kids lots and lots and lots of questions and we need to turn it into comments. Oh, interesting. And what happens when we ask kids so many questions is this can actually turn them off of talking. So when you're like, what's this? What color is this? Who is that? Where are we? It's just too much. You know, you need to start turning it around and being like, oh, this is a cat. The cat says me out. My theory is if you don't feel like you're talking too much, then you're not talking enough. Like you need to be describing things and commenting on things. I like to say, look, forget questions. Don't ask any. Just start describing and commenting on things. So, you know, it can feel like a bit of an idiot doing it, but it's so easy. Yeah, and that's the other thing. If you feel, if you don't feel bored of the line, where do I sit? Like, straight. Then you're not doing it enough. Then you're not doing it. You know, I'm a very talkative person. So like talking to my baby and talking out loud to myself, you know, I've been doing that forever. I talked to my dog. Beautiful. It does. It's crazy. So, you know, for me to kind of describe my day, I'm naturally, I guess, do that. But those are things you can do. Like, mommy is making you breakfast. We're going to have oatmeal. And just keep talking. Keep the conversation going, even from your baby is very, very young. It's important to really kind of get any baby's face and do lots of talking and describing. And now that you know, right, you can pick up on those keys when you baby need to break or they've had a laugh. Of course. Of course. Of course. Of course. But it's just that important, those important kind of conversations and letting your baby know that you like when they make sounds. And even from that early, you know, that back and forth and turn taking can happen between you talking and your baby cooling. Yeah, absolutely. Giving them that time to respond with their coup and then you speak back and stuff like that. So, you know, and doing that helps them to learn that turn taking skill in conversation. So, you can start implementing kind of a variety of not only speech and language kind of things, but also social skills in that turn taking, you're waiting for them to finish things like the reciprocal conversation. Yeah, exactly. So, that's really important. So, we've done your following Charles lead that kind of, you know, questions, other things, book reading. Yeah. This is really important as well. And what's important about book reading in the early days is helping each child to build good relationships with books, I think. Okay. So, you're not focused on a story. You're not going to read a story. If your child is one of those kids who flicks through books really quickly, let them do that. Yeah. Let them kind of have any relationship they want with books at the beginning. Okay. And you take that time where, you know, if you're, if you want to read books before bed, if your child does not let you stay on one page quickly, that's all right. Name one thing on the page. Yeah. Luke is like that. And turning. Luke, it just is so interesting in flipping the page that sometimes we're like, grain catch. Yeah. The end. You just comment. Yeah. And flick. Yeah. And because what we don't want to do is force kids to sit down and listen to stories. Or force kids to read books because then the relationship with books can go sideways. Yeah. And we don't want that. So, because we can learn so much from books for language. And what's nice is books for little kids are very repetitive. You can read one book, you know, every day for even two weeks, I would say, that's really good repetition of simple words and just again, developing that relationship with books too. So, absolutely. Like, even so I only realized this the other day, but Josh, my husband, has read the same, every time he puts us under bed, he reads the same book and he's been doing that for 10 months now, which is super fun. But now, like he says, that Luca knows when the words on that page are finished and he knows to flip to the page because he's so used to that book. It's pretty cool. It's good. And so, like, that's a good example of Josh eventually going to be able to see the cat is and Luca filling in. Yeah. Yeah. Exactly. Because of that repetition. Okay. And that's the same thing that happens with my older daughter. We have one book, I mean, my partner thinks it's like the coolest, most incredible thing, but it's like a rhyming book and she fills in all the rhyming books. Oh my god. And, I mean, Caleb is just like, she can read a lot of your childhood games. No, she's just got a good memory. And we've read that book 35 times. So, like, she fills a tin, but it's just one of those things that when you start to see these things happening, you're like, oh, wow. Yeah. And these are the little things that really do help. So, repetitions, so don't feel like you need to have a million books. Don't feel like you need to have, you know, a million toys or an iPad with the latest apps. Yeah. You don't need that. That's a new stuff as well, right? Like, we learned to speak with all that sort of stuff. Exactly. And I mean, when it comes to, I see a lot of ads for all these apps to increase speech and language. I don't know the research and stuff on it. So, I don't recommend it to my clients because I don't know much about it. And I just kind of say, look, if it comes to that, then maybe we can look into it, but there's so many other things that we can try. It's like a loss before we would even think of doing that because the other side of things is we want kids to, I don't, we don't want kids just to be able to count or say their ABCs or name things. We want kids to be able to have conversations for sure and realize how important socializing is and having a conversation with someone. So, you know, if I meet a child and they can do their ABCs and their 123s, but they don't necessarily say hello and goodbye and things like that. That kind of shows me that we actually need to work on those skills as well. Absolutely. Not just vocabulary and all of that because those are very important skills to have. Yeah, 100%. So, if parents are like kind of sitting on the fence and they're like, oh, I'm sure I should not. When do you think they should seek help? Like, for you, is it when things are like, there's a huge difference between them and their peers? Or is it when you notice even the slightest maybe delay? I would say, look, it kind of goes like this. You expect a one-year-old to have a few words. If your child is between one and 18 months, this is keeping in mind that other things are developing well. They have really good icons. There's no other issues. Yeah, there's no other kind of red flag issues, I guess. Then between 12 and 18 months, you know, definitely by 18 months, you'd want to see, you know, coming on to 10 words, even by 20 months, 20 words. Yeah, okay. So, you'd want to be seeing developmental words. You'd want to see them adding to their vocabulary. And what do you mean like, do you mean just like, dad, dad, like stuff like that? Why don't you mean like, dad? Yeah, so not babbling when I'm babbling anymore, when I'm not doing dad that because, and I know this can be quite crushing news, but usually when kids start saying things like, "Dadda," and "Mama," it's not directed at the person. That's just their babbling. Yeah. What? It's when it's that nice moment when you realize that they have linked that that's "Dadda," and that's "Mama." Yeah. So, yeah, we are looking for, you know, "Dadda," meaning that's my dad, "Dadda," "Mama," that's my mom, even things like, "Yay!" Uh-oh! Yeah. Things like that is what you want to see kind of coming through, and you want to just see that your child is getting more. Okay. So, it's not kind of like a standstill. You don't want to get to two years old, and your child only has five words, or something like that. So, I mean, most, if you Google or look up, you know, kind of how many words should a child have by a certain age or whatever, most of the research is kind of all the same in terms of the number of words, and just take that into consideration. Yeah. So, you're more like of the, I think, we're on the same page in regards to, like, there's no harm in getting a second opinion. Like, worst case scenario, they're like, you know, you didn't need this appointment, everything's all good. Best case scenario, you've gotten in early and you've figured out that there's something you can do to help, right? Yeah. Early intervention, best thing ever. Yeah. I mean, chances are, if you go in at 18 months to see a speech therapist, you're not necessarily going to get booked in for weekly therapy. Yeah. I might say to you, you know, go away for two weeks and do this, come back, we'll see how, if there's any progress. And I mean, in that amount of time, it gives me a chance to kind of figure out, okay, we implemented some signs. Are they using the signs? Yeah. You know, if all these other kinds of things are happening and they're developing and excelling in these ways and we think, oh, okay, well, you do have a lot of communicative intent and stuff like that that lets us know that you're building on it. So it's just important, I think, to get that second opinion. Yeah. Like to get the assessment done. You speech therapist is going to give you some tips to do at home and, you know, they can kind of guide you in the right direction in terms of what you need to be doing, especially if they were to do like a video feedback session to say, okay, look, this is how you guys played this game. These are the things I want you to change when you're playing this game and you're going to play this game every night. And once you get, once you kind of have a routine around this game, we're going to add something new to it. Cool. It's, it's very dependent obviously on each child and yeah. But if there's nothing else going on and it's just language that you're concerned about, I would say definitely by 18 months if you don't think that your child is where there should be, you should get them assessed. Okay. So you've put together a couple of books that you think that parents should read if they want more further information. And instead of reading them out, I'll just link them in the podcast notes for this episode so that parents could do to that. But if people want to like learn a little bit more about you or if they're on the Gold Coast and they're interested in you a little bit, what should they do? I have a very inactive Facebook page. So my actual private practice which I run out of home is called Spill the Bean Speech Therapy. I'm located in Mudraba and I have a website which is I think Spill the Bean's Therapy Doc. When you confirm that, I'll link it in the episode, no? Like Emily said, I've just had a baby so I haven't really even been on it. And I do have a Facebook page which is, I think it's quite inactive. Emily can probably verify that I'm not very good with social media. Absolutely not. She messages me today being like, hey I'm not going to add to my phone so just walk into the house. I'll be there. I'm like, oh okay no worries. So um but I am really good at returning phone calls. Yeah she is. So and very early in the morning as well. So the best way to contact me is probably via telephone and I usually like to do that because I like to really get an idea of what's going on with each child. And even from that first conversation, you will go away with having an idea of something you can start doing before I even meet you. Awesome. I think that helps to give parents a bit of peace of mind. Rather I'm a very anxious person. So if I was to call a doctor and be like you can't get in for a month, see you and not have any information, I just find it really important to give that to parents to say, you know, something. What are you doing right now? Okay do this, don't do that. Yeah. And then when you when we meet we'll talk more in depth about it. In terms of books and stuff for parents to read, I have to really say that I, this might sound, I don't know. So I kind of, I really like to take each case on an individual basis because some of the books that I might recommend to parents to read might be more geared towards a child who has an actual diagnosis of ASD. And sometimes I can see that people get quite off-put by that. Even though their child does not have a diagnosis of ASD. So it's like when I try and introduce sign to some parents, they're a little off-put by that as well because it's like, but why are we doing sign? What we don't know is that a lot of these things that we do implement for some of these kids can be good for all kids. So it's like sign, you know, when I used to be a teacher, I may, I introduce sign to my entire class. So whether you had a diagnosis, didn't have a diagnosis, had language difficulties, didn't have language difficulties, I felt like it was really important for all kids to kind of have that backup of communication because kids have tantrums, I don't want to talk. Kids are busy, they're all over the place, they might not hear when you say sit down, but they might have seen when you signed it or something like that. So those things are all really important. So back to the books, sorry. In terms of that, I just kind of think it's, it's important that, I guess what I'm saying is, I don't really recommend heaps of books to people. One of the books that I do tend to recommend quite a bit is it takes two to talk, which is the hand-in book. And I find that really useful because it kind of sums up everything. It's a really easy to use, really easy to read book. It has lots of nice colorful pictures for parents and stuff. And it kind of goes through that whole thing of, you know, observing waiting, listening, commenting, playing with your kids, book reading, all that stuff kind of gets put in there. So that would be my number one book that I would kind of recommend to parents to read if they were really inclined to do so. Okay. Okay. Well, like I said, I will link all of Sabaynas, socials and website and everything, and that book as well in the episode notes, so that you can check it out if you want. And if you have any questions that you need to direct to Sabayne, you can always just DM me on my Instagram pages, or at the Paveau Psychologist. But thank you so much. Thank you. For being on today, and how good that the baby slept for the whole thing didn't make eye contact. Yeah, we're all boring, gonna keep you down. Maybe we need some things therapy as I'll say. Good times. But how good the dog didn't buy the baby's status life. I thought about a big success. I would say so too. So yes, thank you very much, M's. All right, no worries. Well, I hope you guys enjoyed that. And like I said, check the episode notes for any of the details or links from today's episode. See you later. Bye! (gentle music)