Goo-goo ga-ga and beyond
Author: Sara Rider

With a new baby, every family looks for milestones: the first smile, the first laugh, the first steps. And among these milestones, many of us also wait for a baby’s first words. In our rapid-pace world, sometimes we may think that an infant should quickly move along from gurgles to sentences. But learning a language takes time!

According to the National Institutes of Health, the first steps on the path to language occur when infants figure out that crying can lead to a response that they want – whether that’s food, companionship or a dry diaper. Infants also start sorting out the sounds that make up language and begin to recognize common sounds, such as the voice of a parent. But just how quickly should this process lead to “mama” and “dada?”

“In terms of speech and language, what we’re really looking at is communication,” explains Dr. Siv L. Fasci of Pediatric Specialty Services and Dell’s Children’s Medical Center, a specialist in developmental pediatrics. “Communication starts as early as the first year of life. But verbal speech may not occur until 18 months of age or later.”

According to the Mayo Clinic, babies often start to babble, laugh or gurgle between the ages of four and six months. During this time, a baby’s attention span and memory increase and babies start to hear the way words form sentences.

“In the first six months, babies communicate by cooing, which consists of vowel sounds,” describes Dr. Fasci. “Then, from six months to 12 months, it’s babbling. Babbling are strings of the same consonant-vowel sound and cooing.”

The Mayo Clinic reports that from seven to nine months of age, babies can begin to distinguish emotion by tone of voice and may repeat sounds that they hear. By the time a baby is one year old, he or she begins speaking in a variety of sounds.

“From 12 to 18 months, babies are speaking jargon,” says Dr. Fasci. “Jargon is different consonant-vowel strings with different intonations. It’s the baby’s own language, or baby talk.” At 18 months of age, children should have meaningful words, although this can occur as early as 10 months of age, according to Dr. Fasci.

“At one year of age, it’s typical for children to use ‘mama’ or ‘dada’ specifically,” Dr. Fasci states.

As a child’s understanding of language increases, parents should look for milestones in language development.

“We usually expect children to have a vocabulary of six words by the age of 18 months,” explains Dr. Fasci. “By the age of 24 months, they should have around 25 words as an average. By two, as much as 50 to 100 words. And by this age (two), they should start putting words together.”

Dr. Fasci suggests that an easy rule to remember is that children should be saying two-word phrases at age two, three-word phrases at age three and four- to five-word sentences at age four.

But the number of words isn’t the only way for parents to know if their young child’s communication skills are developing on schedule.

“Children can have verbal expression, but you want to be certain that they are using words meaningfully and communicating. So at 12 months, a child is usually pointing, and that’s a way of communicating. They might use other gestures like nodding yes or no, raising [his or her] hands to be picked up or waving. So you want to look for those nonverbal gestures and that usually happens before words.”

Parents should also pay attention to a child’s receptive language – how much children seem to be able to understand what is said to them.

“Receptive language is what we can understand, and that happens before we learn to use words,” reveals Dr. Fasci. “Receptively, children of one year are responding to their names. They are also understanding ‘no,’ and ‘stop.’ They will take turns listening to you and vocalizing, even if it’s only cooing or babbling. Before words, infants gesture and vocalize to get your attention, to request or show you something. Toddlers between one to two years can identify objects, body parts, pictures and follow simple directions.”

If some of these things aren’t happening, it may be time to get an outside evaluation.

“There are some definite red flags,” cautions Dr. Fasci. “If he’s not pointing by 15 months or using gestures, if he doesn’t have meaningful words by 18 months or if he’s not answering to his name, those are all red flags. Children who used to communicate with words and stopped should be evaluated by a medical professional.”

According to Dr. Fasci, the first step is to discuss your child’s development with your pediatrician.

“Most of the time, it can just be a simple speech delay,” encourages Dr. Fasci.” Or it could mean a child is not learning at the rate he should. If there’s a mixed receptive and expressive speech delay, there’s more concern. Your pediatrician can screen for other developmental delays and refer you to rule out hearing loss.”

“Children who have had frequent ear infections or chronic nasal congestion can develop longstanding fluid in their ears, which impairs hearing and leads to speech delays,” adds Dr. Fasci. “Another possibility is autism. The American Academy of Pediatrics recommends that all children be screened for autism at 18 to 24 months.”

Most causes of speech delay are treatable.

“Some issues take longer to treat than others, but with early recognition and intervention, most speech impairments can be improved or corrected with formal speech therapy,” says Dr. Fasci.

Parents can also help their children with language development, and that can begin at a very young age. The Mayo Clinic recommends using simple words and describing things around the house to your baby beginning as young as four months, and reading to your child as early as six months.

“Singing repetitive songs, nursery rhymes, songs with gestures, like ‘The Wheels on the Bus,’ all of those things help,” offers Dr. Fasci. “Playing games with him like pat-a-cake or peek-a-boo [help also]. Try to limit some of the noisemaking and mechanical toys and spend more time face-to-face in shared play. That can just be rolling balls back and forth or taking turns building with blocks. Infants and toddlers learn by copying caregivers’ speech and play.”

But if a parent is concerned, Dr. Fasci urges that he or she discuss it with his or her child’s pediatrician.

“One in five children will have speech/language delay. Simple speech delays are sometimes temporary, but we want to be certain that things do get checked so that we can rule out more serious problems that can contribute to a speech delay.”

Parents can also contact their Early Childhood Intervention program if their child is younger than three years old. For children older than three, parents can contact their local public schools if they have concerns their child’s speech and language are not developing as expected. These evaluations can be requested directly from parents and if significant delays are found, local public schools can provide treatment, suggests Dr. Fasci.

Although all children develop at their own rate, knowing more about what to expect can help parents promote strong communication skills and know when to seek professional help.

Sara Rider is a native Austinite who has worked with physicians and hospitals throughout Texas. She frequently writes freelance articles on health topics for newspapers and magazines.

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