understood reasonably well by the
time they’re three.”
Interestingly, boys tend to be at
higher risk for speech and language
challenges and their progression is
more variable. Girls seem to have a
neater pathway in this particular area
of child development. Dads will delight
in knowing they’re right – science tells
us women are natural talkers!
When it comes to speech problems,
Melinda says, “Parents shouldn’t
assume just because there is something
wrong with early speech and language
development their child has a serious
disorder. That isn’t the case. Many,
many children show a delay in
their overall pattern of speech and
language.”
Parents with concerns about
speech – or those working through
some identified delays – are not alone.
Melinda says, “Of all developmental
disorders, speech and language are
the most common; especially in pre-
schoolers.”
When it comes to speech and
language, there are three common
issues that present in young children.
These are:
A lack of language
“The biggest cause of referral, other
than issues known from birth, is
failure of speech to appear,” says
Melinda. “Quite often we see children
who are coming up to two but who
have quite limited speech. That’s
something we’re obviously concerned
about but we have to remember this is
about their expressive language – the
vocabulary they’ve learnt and how
they’re using these words. At that
stage, we’re obviously worried about it
but we first want to identify how well
they’re understanding language.”
By the age of two, ways to check
language comprehension include
seeing if a child can follow simple
instructions; asking them to point to
items they want; and noting if they’re
starting to remember people’s names
and everyday nouns, such as common
objects and body parts. Melinda says,
“In the early stages, it’s generally the
comprehension of language that we’re
more worried about.”
Context of language
“Along with concerns about delayed
language, many referrals are now
made because the child’s pattern of
communication is not following a
typical sequence of development,”
explains Melinda.
What does ‘the child’s pattern of
communication’ mean? From a very
young age, children quickly learn
the rules of social communication.
Melinda explains, “There’s so much
awareness now of the early signs
of autism. Parents are becoming
much more alert to children who
just don’t seem interested in social
communication. They don’t attend
very well to the language around them
or react to common social cues. This
can present as a kind of awkwardness
because these children aren’t picking
up important cues in a social context.”
In Melinda’s experience, parents
are becoming more aware of these
differences in the early stages of their
child’s communication development.
Often, these children are producing
language - they may be picking up
words or phrases from cartoons or
movies - but they’re using it in an
unusual way. It’s not how much
language the child has, but in the
way the child uses that language to
communicate.
Formation of language
“Here again there are differences
between children and very often they
are gender- based, but not always,”
says Melinda. There are some children
who have a very efficient language
learning system – they can hear a very
complex word at the age of two and
repeat it back, almost, with a mature
adult articulation. There are other
children who cannot do that – they
have difficulty forming the sounds or
building them into words accurately.”
So, how can mums know when
their child is behind in this area?
“There are fairly predictable stages
of development of a young child’s
sound system,” says Melinda. A speech
therapist will be able to offer advice or
reassurance as to whether there is any
cause for concern.
Hearing and speech
development
Hearing and speech are closely linked
throughout life, but particularly so
in the early years of communication
development. This seems very obvious
but it is a powerful and symbiotic
relationship. Children who experience
recurrent ear problems, such as ear
infections, can struggle with speech
and language in their pre-school years.
This is of particular importance for
mums in Hong Kong, where pre-
school years are known to be more
academic for a young student.
Melinda explains, “Children can
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