It’s a heartwarming experience to hear that first “mama” or “dada” from your baby. When gurgles, babbles and raspberries become recognizable speech, parents look forward to opening that door of verbal communication with their child.
But for some families, that day doesn’t happen — or it doesn’t happen when expected. Parents and their child’s pediatrician continually monitor developmental milestones, and talking is on that list. However, there’s a wide age range when children acquire language, according to Henry David, MD, a pediatric neurologist with the University of Chicago Medicine Comer Children’s.
“For all parents, we can’t help but compare our child’s language progress to their peers. In this specific domain, there are a lot of distressed parents,” says Dr. David, adding that it’s common to see a stall or delay in language in the year after a child’s first birthday. Developmentally, children typically have a single word by age 1, then three to five words by 18 months — though some children have many, many more at this stage.
“By the time they get to age 3, there’s an explosion of language and they’re picking up multiple words each day,” he says. Speech delay is “very common,” he adds, so parents should look for progression.
“The majority of developmental delays I see involve kids not speaking many or any words by age 2,” says Dr. David. “That’s a specific situation when I recommend that you should give us a call.”
Finding their voice
When children experience a speech delay, the cause could be an autism spectrum disorder, cerebral palsy or a motor disorder. Childhood apraxia of speech is another specific reason for a speech delay. Apraxia of speech is a speech sound disorder, according to the National Institute of Deafness and Other Communication Disorders.
“Someone with apraxia of speech has trouble saying what he or she wants to say correctly and consistently. Apraxia of speech is a neurological disorder that affects the brain pathways involved in planning the sequence of movements involved in producing speech,” according to information on the Institute’s website. Childhood apraxia of speech is present from birth and its causes are not well understood.
In many cases, children who are unable to speak or express themselves verbally can find effective ways to communicate through augmentative and alternative communication (AAC).
According to the American Speech-Language-Hearing Association (ASHA), the term AAC describes all the ways someone can communicate without talking. There are many types of AACs, including sign language, writing and drawing, even pointing to photos.
And, there are high-tech options, too. AAC devices can include an app on an iPad or tablet that is used as a speech-generating device. When children with apraxia of speech or other disorder can learn to use an AAC device, they’re often less frustrated because they are better able to communicate their wants and needs.
Sarah Sobotka, MD, a developmental and behavioral pediatric specialist at UChicago Medicine Comer Children’s, shares a story about working with Emmett, a 6-year-old boy with apraxia and his joy in finding his voice with an AAC. He and his family call the AAC “his talker” and through an app, Emmett has learned to express himself, ask for a snack, even recite the Pledge of Allegiance at school.
“For most of us, when we want to say something, that’s a very automatic process,” says Dr. Sobotka. “We’re able to tell our facial motor muscles to make a certain sound. For children with apraxia, it’s not that fluid. They have trouble telling their body and their muscles to move the way they want them to.”
A common worry parents have regarding the use of an AAC device is that their child will simply stop learning to use verbal communication. However, research shows that AAC actually helps individuals continue to develop language skills, according to ASHA.
The AAC device has made a world of difference for Emmett, according to the story, and that message is something his parents want to share.
“I’m so proud of Emmett’s progress and I’m proud of his parents who are really advocating for him,” says Dr. Sobotka. “This is a helpful next step for him. Do I expect him to keep improving? I do.”
Read the full story and learn more at UchicagoMedicine.org.
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