Identifying speech delay in toddlers

Parents wait for their children's first words. Mama/dada are the usual first words of a child and it is uttered when they are between five and ten months of age. Speech and hearing are closely related to each other. Some children start to speak early and some children a little late depending upon certain factors. A child starts to speak early when there is always someone talking to him/her and not left alone. There is also old lady's tale that girls speak quicker than boys.

However, there is an age limit within which a child must talk, though it can vary slightly from child to child. The mile stones goes on like this:
* The newborn cries soon after birth with a loud screech which itself is a good sign.
* The newborn is able to hear loud voices or noises when he is completely awake and turn their eyes and head towards that side. They also give a social smile.
* The infant can recognize the voice of his parents or the care giver in 1 to 3 months and respond to them with a smile.
* By 3 to 6 months, the infant can laugh and imitate the sounds (not words) made by the parents.
* In 4 to 8 months, the baby can make cooing sounds like using one syllable like ga, ma, pa, goo, ba etc.
* Following that between 5 and 9 months, he start to use more syllables in the form of a tune. Eg: lalalala, babababa, gagagaga
* Now by 5 to 10 months, the child starts to grasp certain words used by the parents or immediate care givers like mummy, daddy, tata.
* In 6 to 10 months, the infant will use those words to meet his needs knowing somebody will attend to him. Eg: He will use the words mama/dada in a cry when he wants milk or wants the nappy to be changed.
* In 9 to 15 months, he may start calling the parents mama/dada and ask for something by pointing to that object.
* By 12 to 20 months, the toddler must speak at least 4 to 6 common words. They usually say mama, dada, no, milk, juice, pen, papa, come.
* The words become meaningful sentence now by using two or three words in 18 to 22 months. They usually say more milk, want ice cream.
* By 2 years, they can speak in sentence with two or three words and use wide range of vocabulary (50+).
* In 24 to 36 months, he should be able to converse 2 or 3 simple sentences which should be understood by unknown people.
* Between 2 and 3 years, he should be able to name at least four colors and pictures, use at least two objects appropriately and obey commands.
* By the end of 3 years, he should speak fluently with at least 200+ words and should be well understood by a stranger.

If your child has not met the above mentioned milestone as a toddler, it is important to seek treatment at the earliest. The earlier the treatment, the better the results. Parents can identify the problem of speech delay by 18 months in their child. You actually need not wait till 3 years to go for a particular treatment like speech therapy.

As a parent, you can assess your child for
* delayed milestones
* fine motor skills
* concentration and attention span
* grasping power and ability to understand a command
* stammering speech
* reaction to a particular stimuli
* act outs
* agitation and irritability
* tantrums
* mental retardation or autism
These are some of the factors that can be associated with speech delay in toddlers. Observing and notifying this will help the medical professional to collect proper history for diagnosis and treatment.

Assessment tools used by the professionals are;
* Language development survey (LDS)
* Communicative Development Inventories (CDI)
* Assessing Linguistic Behavior (ALB)
* Communication and Symbolic Behavior Scales (CSBS)
* Infant-Toddler Language Scale (infant)
* Assessment Evaluation and Programming System (AEPS)

LDS and CDI are taken by the parents of the affected child to screen them for the word use, sentence use, gesture and prelinguistic communication. ALB, CSBS and infant tools are used by the affected child with parents help. This is mainly used in evaluation of prelinguistic communication in depth. AEPS is a test done by the child independently and this is used to assess the child's language and developmental skills which helps in actual plan of action.

Parents play a major role in treatment of speech delay. Talking to them continuously (not letting them stay alone), asking simple questions, talking in one particular language, teaching through colorful pictorial books and not depriving them from their pleasurable activity when they don't do well are simple tips which can improve your child's health.