Speech and Language Development in Young Children

By Megan Remenap, MS, CCC-SLP, CBIS
Rainbow Rehabilitation Centers

Although there is no single way in which a child learns how to communicate, there is a general pattern of speech and language development. This pattern of development occurs at a different rate for all children due to intellect, personality, learning style, family structure, birth order, and socioeconomic status.

Large changes in speech and language skills occur within brief periods of time, and girls often develop these skills faster than boys. It is more important that children show steady progress rather than achieve milestones at a specific age.

By providing an engaging, language-rich environment, parents can help those skills develop to their full potential.  Listening and responding to your child, following your child’s interests, using gestures and non-verbal communication to enhance your messages, reading on a daily basis, talking about what you see, hear, feel, etc., and engaging in play with your child are all ways in which parents can help foster those skills.

Younger children learn and respond best to interacting with people during the first few years of life. In order to best understand how to help those skills develop, let’s look at what “speech” and “language” skills are.

The term “speech” refers to the verbal means of communicating and consists of the following: articulation (how sounds are produced), voice (vocal fold movement and breathing patterns), and fluency (the rhythm of speech).(1)

Speech requires precise neuromuscular coordination in order to produce specific sounds and sound combinations.  Since their fine motor skills are developing and not as fine-tuned as an adults, children’s speech can be expected to sound different.

Two children are playing while sitting on the floor, isolated over white

Children will typically have “sound replacements,” otherwise called phonological patterns. These phonological patterns are a normal part of development and disappear as motor skills become fine-tuned.

Potential problems with speech development include: stuttering (non-fluent speech), apraxia (inability to coordinate motor movements to produce the sounds), dysarthria (motor speech disorder affecting the ability to produce sounds clearly), and voice impairments.

Reading, writing, gesturing, and speaking are all types of language. Language can be divided into the following categories: expressive, receptive, and pragmatic.

Expressive language refers to the ability to state thoughts, ideas, and needs. Receptive language is the ability to understand what is said and pragmatic language refers to our social skills or ability to interact with others.  This includes skills such as knowing how and when to respond to questions, identifying the non-verbal aspects of communication (eye contact, body language, etc.), maintaining a topic of communication, maintaining personal space when interacting with others, making appropriate comments, and determining the appropriate way in which to talk with different people.

A child can have a delay with one type of language, such as expressive language, or with multiple areas of language.  Language learning occurs through interactions with people and the environment. It is important to observe children’s content, form, and use of language in order to determine if there is a problem with development.

Effects of Traumatic Brain Injury on Speech and Language Skills

The general pattern of language development can easily be disrupted by a traumatic brain injury (TBI), which is the leading cause of death and disability in children.(2) Children’s brains develop in spurts, with an explosion of language skills occurring in the first few years of life.

Early childhood TBI is associated with a number of cognitive outcomes, including deficits in memory, attention, intellectual functioning, and language acquisition.3 Specifically, children between the ages of two and seven at the time of a TBI are more likely to have impaired expressive language, attention, and academic achievement and show less recovery of IQ compared with children injured at later ages (4,5,6,7,8,9) as cited in Tayler et al., 2008.(10)

Deficits might not be immediately apparent after the injury due to limited communication skills and developmental level. Impairments may be identified later when skills don’t develop as they should. Ronald Savage described TBI in childhood as a developing disability that needed to be closely monitored to prevent deficits from getting worse. The severity of the injury and family environment can be expected to have an impact on outcomes of TBI.(11)

Speech and language development should be monitored by parents and health professionals following a TBI at a young age. The first step is to discuss your concerns with your child’s pediatrician. He/she can then recommend a speech–language pathologist (SLP) to assist if needed. A speech–language pathologist is a specialist trained in identifying and correcting communication problems.

Don’t hesitate to report issues to your health care provider or set up an evaluation. Remember, you are the expert on your child. If you feel that something isn’t right, follow through with your instincts. A child is never too young to be evaluated by an SLP.

Visit the American Speech-Language-Hearing Association (ASHA) website at www.asha.org for more information and useful checklists.  ❚

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References:

  1. What is Language? What is Speech? (n.d.) Educational article from ASHA. Retrieved 9 November, 2015 from http://www.asha.org/public/speech/development/language_speech/
  2. Giza, CC. 2006. Lasting effects of pediatric traumatic brain injury. Indian Journal of Neurotrauma. 3(1): 19-26,
  3. McKinlay, A & Anderson, V. (n.d.) Issues associated with pre-school child traumatic brain injury. International Brain Injury Association website. Retrieved 19 February, 2015, from http://www.internationalbrain.org/issues-associated-with-preschool-child-traumatic-brain-injury/
  4. Anderson, V & Catroppa, C. 2005. Recovery of executive skills following pediatric traumatic brain injury (TBI): A 2-year follow-up. Brain Injury. 19(6): 459-470.
  5. Barnes, MA, Dennis, M, Wilkinson, M. 1999. Reading after closed head injury in childhood: Effects on accuracy, fluency, and comprehension. Developmental Neuropsychology. 7(1): 1-24.
  6. Ewing-Cobbs, L, Prasad, MR, Landry, SH, Kramer, L, DeLeon, R. 2004. Executive functions following traumatic brain injury in young children: A preliminary analysis. Developmental Neuropsychology. 26 (1): 487-512.
  7. Dennis, M, Wilkinson, M, Koski, L & Humphreys, RP. Attention deficits in the long term after childhood head injury. Traumatic Head Injury in Children. Oxford University Press. 1995. p. 165-187.
  8. Kaufmann, PM, Fletcher, JM, Levin, HS, Miner, ME, Ewing-Cobbs, L. 1993. Attentional disturbance after pediatric closed head injury. Journal of Child Neurology. 8(4): 348-353.
  9. Verger, K, Junque, C, Jurado, MA, Tresserras, P, Bartumeus, F, Nogues, P, Poch, JM. 2000. Age effects on long-term neuropsychological outcome in paediatric traumatic brain injury. Brain Injury. 14(6): 495-503.
  10. Taylor GH, Swartwout M, Yeates KO, Walz NC, Stancin T, & Wade SL. 2008. Traumatic Brain Injury in young children: Post-acute effects on cognitive and school readiness skills. Journal of International Neuropsychological Society. 14(5): 734-745.
  11. Speech and Language Developmental Milestones. NIH-National Institute of Deafness and Other Communication Disorders. U.S. Department of Health and Human Services, 2010. Retrieved 12 December, 2014, from http://www.nidcd.nih.gov/health/voice/pages/speechandlanguage.aspx