Oral language predicts success
Research tells us that Communication Disorders are the most common childhood disorders, that a child's oral language at school start predicts their academic and social success, and that early identification, diagnosis and treatment of communication difficulties is what changes outcomes for children with Communication Disorders.
We therefore recommend that children who do not reach the following milestones should have their hearing tested and be evaluated by a Speech-Language Therapist:
By 12 months
Children should repeat strings of syllables (babbles) that gradually become more varied and more speech-like (e.g.: ba-ba-pa-ta-mi-bi-bi) and start using words.
By 15 months
Children should use 5 - 10 words.
By 18 months
Children should use at least 20 words including nouns, verbs, prepositions, adjectives and social words.
By 24 months
Children should use at least 100 words, be combining 2 words together, and be using at least 2 verbs. Word combinations should be actively generated by the child, e.g.: "More drink" or "Mummy gone." Memorised expressions do not count, e.g.: "What’s that?" and "Yes please" and "Bye-bye." Children should be understood by familiar listeners most of the time.
By 30 months
Children should use a minimum of 2 early sentences (including both a subject and a verb) inside half an hour’s play time with a parent. They should be building their own sentences rather than using mostly memorised expressions.
By 3 yrs
Children should be understood by unfamiliar listeners 75% of the time.
By 4 yrs
Children should use basic sentence forms and adult grammar and be understood by unfamiliar listeners 100% of the time.
We therefore recommend that children who do not reach the following milestones should have their hearing tested and be evaluated by a Speech-Language Therapist:
By 12 months
Children should repeat strings of syllables (babbles) that gradually become more varied and more speech-like (e.g.: ba-ba-pa-ta-mi-bi-bi) and start using words.
By 15 months
Children should use 5 - 10 words.
By 18 months
Children should use at least 20 words including nouns, verbs, prepositions, adjectives and social words.
By 24 months
Children should use at least 100 words, be combining 2 words together, and be using at least 2 verbs. Word combinations should be actively generated by the child, e.g.: "More drink" or "Mummy gone." Memorised expressions do not count, e.g.: "What’s that?" and "Yes please" and "Bye-bye." Children should be understood by familiar listeners most of the time.
By 30 months
Children should use a minimum of 2 early sentences (including both a subject and a verb) inside half an hour’s play time with a parent. They should be building their own sentences rather than using mostly memorised expressions.
By 3 yrs
Children should be understood by unfamiliar listeners 75% of the time.
By 4 yrs
Children should use basic sentence forms and adult grammar and be understood by unfamiliar listeners 100% of the time.
'Late Talkers'
A late talker is a toddler between 18 and 30 months who says few words for their age and has difficulty talking in the context of otherwise good understanding and normal general development. Late talkers are more likely to be male, have a family history of late talking and to have been born at less than 85% of their optimal birth weight or have been born before 37 weeks.
Late talkers are at greatest risk of continuing language difficulties when they have a family history of communication delay, learning, or academic difficulties, have difficulties understanding, or use few gestures to communicate.
Some late talkers "grow out of it" by the time they start school, but most late talkers go on to have weaker oral language skills than other children. So we recommend intervention for all toddlers who are late talkers to prevent difficulties later on at school.
Late talkers are at greatest risk of continuing language difficulties when they have a family history of communication delay, learning, or academic difficulties, have difficulties understanding, or use few gestures to communicate.
Some late talkers "grow out of it" by the time they start school, but most late talkers go on to have weaker oral language skills than other children. So we recommend intervention for all toddlers who are late talkers to prevent difficulties later on at school.
Developmental Language Disorder
When a child has language difficulties that create obstacles to communication and learning in everyday life and these language problems are unlikely to resolve or have not resolved by age 5;0, they can be diagnosed as having a Developmental Language Disorder or DLD.
DLD comes with lifelong communication complications and long term negative impact for a person's social, employment, and economic success. Sadly, despite the fact that it can be diagnosed by age 5, DLD tends to be a hidden disorder.
The best way to 'catch' children at risk of DLD is through formal, objective, standardised, norm-referenced, and comprehensive speech, language, and communication screening. We do not recommend a subjective 'can you take a quick look at this child' screening approach.
We also do not recommend isolated evaluation of the specific area of concern mentioned by the child's parents or teacher and instead recommend comprehensive assessment of a child's total speech, language, and communication skills to rule in or rule out DLD or another Communication Disorder.
DLD comes with lifelong communication complications and long term negative impact for a person's social, employment, and economic success. Sadly, despite the fact that it can be diagnosed by age 5, DLD tends to be a hidden disorder.
The best way to 'catch' children at risk of DLD is through formal, objective, standardised, norm-referenced, and comprehensive speech, language, and communication screening. We do not recommend a subjective 'can you take a quick look at this child' screening approach.
We also do not recommend isolated evaluation of the specific area of concern mentioned by the child's parents or teacher and instead recommend comprehensive assessment of a child's total speech, language, and communication skills to rule in or rule out DLD or another Communication Disorder.
Language Difficulties
When a child has language difficulties but does not meet the criteria for DLD, they can be diagnosed as having communication difficulties. The term 'language delay' is not valid and should not be used.
Speech Sound Disorder
Speech Sound Disorders are the most common Communication Disorder in children ages 3 to 8. When children have speech difficulties that prevent them from being understood by others and cause communication break downs, they can be diagnosed as having a Speech Sound Disorder or SSD.
To avoid negative impacts for literacy learning and making friends, children with SSDs need careful assessment and quality, intensive intervention from a Speech-Language Therapist as early as possible so that by the time they start school their speech is easily understood by others.
To avoid negative impacts for literacy learning and making friends, children with SSDs need careful assessment and quality, intensive intervention from a Speech-Language Therapist as early as possible so that by the time they start school their speech is easily understood by others.
Hearing Disorder
This refers to communication deficits arising specifically from hearing impairment.
Auditory Processing Disorder (APD)*
This refers to deficits in the information processing of audible signals that cannot be attributed to impaired peripheral hearing sensitivity or intellectual impairment.
*This is a highly controversial (if not completely invalid) diagnosis, as it does not meet the criteria for a legitimate clinical entity.
*This is a highly controversial (if not completely invalid) diagnosis, as it does not meet the criteria for a legitimate clinical entity.
Communication Variations
Communication difference
When a person speaks a dialect of English, another English language, or a different language altogether, any difficulties they might have with speaking NZ English are considered a communication difference and should not be considered disordered. A Communication Disorder could only be considered if the person showed disordered communication in their own dialect or native language.
Augmentative/ Alternative Communication (AAC)
Examples of AAC systems are New Zealand Sign Language / NZSL and communication devices or software (e.g.: Stephen Hawking) to enable people to get around impairments in gestural, spoken, and/or written communication arising from a disability.
When a person speaks a dialect of English, another English language, or a different language altogether, any difficulties they might have with speaking NZ English are considered a communication difference and should not be considered disordered. A Communication Disorder could only be considered if the person showed disordered communication in their own dialect or native language.
Augmentative/ Alternative Communication (AAC)
Examples of AAC systems are New Zealand Sign Language / NZSL and communication devices or software (e.g.: Stephen Hawking) to enable people to get around impairments in gestural, spoken, and/or written communication arising from a disability.
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