Category Archives: Speech and Language Milestones

Causes of speech and language disorders: Some answers to parent’s “why’s”

When parents walk through our door, they often want to know ‘WHY’ their child is not understanding and talking like other children; ‘WHY’ they aren’t pronouncing sounds like others; or ‘WHY’ they’re stuttering. Listed below are some factors that are known to predispose or precipitate speech and language disorders.

Neurological factors: Specific areas in the brain control our speech and language functions. Understanding what others say to us, expressing our thoughts and needs, remembering details of what was said, reading, and writing are all controlled by regions in the brain. There is evidence in the literature to suggest that children with language disorders may have a neurological involvement contributing to their speech and language difficulties. This means that there may be obvious or subtle differences in the brain which makes the child susceptible to a language disorder. No one pattern of brain architecture has been consistently shown in all individuals with language impairments, which makes this all still a bit of a mystery.

Motor and Sensory factors: Our senses serve as channels for us to perceive the external environment. Be it our sense of vision, hearing, touch, taste, and smell; they offer us with different ways to perceive things from the external environment. If any of these senses are not functioning optimally, it would limit the essential information that we receive from our environment. For example, children with vision or hearing problems will not be able to use those senses to see by reading, or hear someone speaking in their environment, making them more susceptible to a speech or language disorder. Having adequate motor skills is also essential to speech and language development. Early on, children move around and explore their environment. This exploration fosters early language and cognitive development as they are exposed to new ideas and vocabulary. Children who have limited motor abilities may be at a disadvantage because of not being able to actively explore their environment. Adequate motor abilities are also required for the movement of the voice and oral structures (lips, teeth, tongue etc.) required for speech. Thus, any difficulty with speaking movements may impact a child’s speech and language development.

Cognitive: Intact cognition (the ability to think, know, perceive, judge, reason etc.) is an important foundation on which we build our speech and language skills. Vice versa, developing our speech and language skills helps us improve our cognitive abilities. Hence, children with cognitive challenges may be at risk for developing speech and language disorders. These children may have trouble associating different words with their meanings, remembering words, recognizing patterns and sorting words into different categories, and learning new concepts in general.

Genetic factors: Speech and language disorders tend to run in families, suggesting a possible genetic involvement in causing these disorders. However, it is also true that many people with speech/language disorders’ children do not have any difficulties, and that children with speech/language disorders have no family history of it in the past.

Environmental factors: Environmental information is key in fostering speech and language development. Providing a language rich environment with an adequate amount of stimulation is necessary to support children in developing age-appropriate speech and language skills. Children who have a less language rich environment and stimulation may be at risk for developing speech and language disorders.

Acquired factors: Some individuals may acquire speech and language skills as per typical milestones and then lose some of these skills due to an acquired injury or illness. Some examples of these include a traumatic brain injury, infections such as meningitis, tumors, strokes, etc.

It is important to note that this list is not exhaustive, but is an overview of some of the reasons we may see speech-language disorders.

If you are concerned about  your child’s speech and language development, see a Speech-Language Pathologist to address your concerns.

Nisha Balakrishnan M.A. SLP, Reg. CASLPO
Speech-Language Pathologist
The Speech Therapy Centres of Canada

Reference: Paul, R. (2007). Language Disorders from Infancy through Adolescence- Assessment and Intervention. (3rd ed.). St. Louis, Missouri: Mosby Inc.


SLP’s, Reading, and Math

Parents often ask why, we, as SLPs work with their school-aged kids on reading and math. It is sometimes difficult to see what our role is in these subjects. We are not tutors, we are not teachers, we are language specialists. What this means is that as SLPs, we need to figure out whether your child is having difficulty with actual math and reading concepts, or if the breakdown in comprehending the language used in those particular subjects.

For examle, in math the most difficult tasks are word problems. Most children will find this to be the most difficult, but it is not the addition/subtraction/ multiplication/division that causes the breakdown; rather it’s the way the questions are worded. These students are having a problems identifying what the question is asking, distinguishing the most important from the irrelevant information among other language tasks. Without these skills,  students will not be able to answer or interpret the problem properly.

As another example, with reading tasks, so often we see kids that can read well but when it comes to comprehending the story and answering questions about the story they become lost. Once again this is a breakdown in the comprehension of story, rather than in the reading itself.

As speech-langauge pathologists, it is our responsibility to target the comprehension of language to ensure academic success. We will provide students with strategies to search for key information, as well as aid teachers in modifying questions and instructions in a way that will be understood by the students. With these strategies in place your child’s academic career will be fruitful and successful!

Melissa Oziel
Speech-Language Pathologist
The Speech Therapy Centres of Canada

Early vocabulary – what should I be teaching my toddler?

Often when parents think of what kind of words they would like their toddler to learn, these are some of the ones that come to mind: mama, dada, ball, bear, blanket, bottle, book, movie, car, home.

Now take a look at what types of words all of the above are.  Think way back to grade school when you learned about grammar and words classes.  How would you classify them?  They are all nouns – a person, place or thing. 

Children start saying words at around 1 year old.  Nouns are great for children at this stage of language use.  They can ask for the people and things that are most important to them. 

So what happens next?  Children begin combining words at around 2 years old.  In order to combine words, we need more than just nouns in our vocabulary.  Think about these common toddler phrases:

Mama up             (noun+preposition)

Go home             (verb+noun)

Want cookie      (verb+noun)

Bear sleeping    (noun+verb)

Baby hungry       (noun+adjective)

These all include nouns plus other kinds of words!  So when you think about teaching your toddler new words, consider some of these:

  • Verbs or action words: Actions your child may encounter often are eat, sleep, wave, read, want, and go. 
  • Prepositions or location words: in, on, up, down
  • Adjectives or descriptor words: hungry, thirsty, big, small, fast, slow

Now you may be wondering how do you teach your child.   Try something speech-language pathologists call focused stimulation.  This involves you setting up a situation where you can use a target word many times so your child gets the input on how the word is used.

Using a pretend kitchen set, pretend food or even pots and pans, try the following:

To focus on “eat”:  Prepare and eat different pretend foods.  This helps children learn lots of different names for foods and can help you focus on the word “eat” as you eat bananas, eat cake or eat sandwiches.

 To focus on “on”: Once you are done preparing your pretend feast, set the table or a picnic blanket.  Put the cups on the blanket, the plates on the table, seat yourself on a chair etc…

To focus on “hungry”: Bring more people, dolls or animals into your pretend play.  Mom is hungry, dad is hungry, bear is hungry, bear is still hungry.

Playing is a way for children to expand their vocabulary, so be imaginative and have fun!

Premature Infants and Language Development

According to the March of Dime, 8% of infants born each year in Canada are premature. The World Health Organization’s definition of premature is an infant born before 37 weeks gestation.  Often infants who are born premature have delays in early milestones of development including speech and language. Some of these delays may be due to medical issues related to being premature or the simple fact that they need to focus on earlier growth and development after birth that would have happened before birth with a full-term infant. Wide spread understanding is that these delays and the gap between full term and pre-term infants narrows as the child grows.

Early intervention in the areas of speech and language for children who were born premature can help to narrow this developmental gap. Speech-Language pathologists can work with parents to implement strategies to increase language development, help parents to understand the stage in language development that their child may be at, what to expect and where to go from that point. As with any skill which may be delayed or difficult, early identification and intervention is key to success; and key to narrowing the developmental gap for premature infants.

Written by:  Stephanie Mathias, Speech-Language Pathologist, The Speech Therapy Centres of Canada Ltd.

Help! What does a motor speech disorder mean?

If your child has a motor speech disorder you may notice that he/she can produce specific sounds correctly one time, and differently the next, for example they can say the word “Mom” easily but if they are asked to say “bye Mom” your child suddenly has difficulty. You may also find that they produce more errors in their speech when the sentence is longer or in conversations with others.

The ability to produce speech requires many parts of the brain to work together, beginning with the intent to communicate, and ending with speech production. In between are a series of complicated steps that are susceptible to problems. These steps are what are called a “motor plan”- starting with a thought and ending with a motor movement (lips closing, tongue moving etc.). 

When you see your child trying to produce the sound, moving their mouth as if they are trying to find where to put it, it is because they are trying to coordinate the message from their brain, carry out the sequential movements and hold the correct positions long enough to produce the sound(s). Speech-Language Pathologists work with children to help them build these motor plans by attempting to teach the brain how to sequence the movements the correct way, often practicing sounds using “drill-like” activities.

Research has shown that repetition and having a visual model to follow i.e., watching moms’ face or the S-LP’s mouth movements in therapy, is most effective in building these motor plans. In addition, some children need a prompt to trigger their brains to tell their muscles where to move their lips or tongue, which is why you may see the S-LP using specific placements of their fingers to cue your child. This is only one method of treatment; however there are many ways to help your child with motor speech difficulties.

Work with your S-LP to set goals and create plans together to help make it easier for your child to communicate with others! The brain is a complicated structure- always feel free to ask your S-LP questions and for additional resources.

Written by: Ashleigh Wishen, Speech-Language Pathologist, The Speech Therapy Centres of Canada Ltd.

Should We Wait And See? When to See a Speech-Language Pathologist

When a child has difficulty with speech and/or language, parents often get all sorts of (well meaning!) advice: “Wait it out”, “He’s a late bloomer”, “She’ll get it eventually”. When should you start to consider the involvement of a speech-language pathologist?

The following is a list of ages and stages for certain sounds and grammatical concepts, as well as the age at which treatment is indicated. Whenever you’re in doubt, ask a speech-language pathologist: he/she has the training required to identify when children should begin treatment and for how long other children can wait.

Ages and Stages:  Articulation (How our lips, tongue, and teeth come together to make speech sounds)

Sounds that should have developed by 3 years:  p, b, m, t, d, n, h, w, vowels (a, e, i, o, u)
Age for concern?  3 years and over

Sounds that should have developed by 3-3 ½ years: k, g, ing, f, s, y, s-blends
Age for concern?  3 ½ years

Sounds that should have developed by 3 ½ -4 years:  z, sh, l
Age for concern?  4 years

Sounds that should have developed by 4-5 years: l-blends, ch, j
Age for concern?  5 years

Sounds that should have developed by 5 years +: v, r, r-blends, th
Age for concern?   5 ½ – 6 years

Ages and Stages: Language (How our brain understands and puts together strings of words in sentences) 
Grammar concepts that should have developed by 3 years: early pronouns
Age of concern:  3 years +

Grammar concepts that should have developed by 3-3 ½ years: regular plurals (s, -es), possessives (‘s) auxiliary/copula (is/are), present progressive (-ing), early prepositions (in, on, under)
Age for concern? 3 ½ years

Grammar concepts that should have developed by 4 years: pronouns (he/she/they), 3rd person singular(-s)
Age for concern?  4 years

Grammar concepts that should have developed by 4-5 years: possessive pronouns (his/hers/theirs), objective pronouns (him/her/them), later prepositions (behind, in front, beside), regular past tense (-ed)
Age for concern? 5 years

Grammar concepts that should have developed by 5 years +: future tense (will), irregular past tense (ate, drank…)
Age for concern?  5 ½ – 6 years

Written by:  Jessica Goldberg, Speech-Language Pathologist, The Speech Therapy Centres of Canada Ltd.


When children begin school, they need to extend their language skills to include reading and writing. Telling and listening to stories provides a bridge between the oral language skills of early childhood and the more formal language of print. With the ability to tell stories develops the ability to talk about things outside the here and now, to understand how we use language to express cause and effect, and to talk about feelings and motivation. Story telling skills are used in social situations, for understanding Math word problems and even for writing up Chemistry lab reports.

By the time a child is five, his or her stories should have a clear beginning, middle and end. To encourage this ability in your child, ask her to retell a story you have just read. Ask questions like, “Who is in this story?” “What happened first?” “What happened in the end?” Use puppets and other props to help your child retell the story. As your child improves in her ability to tell stories, you can ask questions and make comments about cause and effect and feelings, such as, “How did he feel when that happened?” and “I wonder why she did that.”

Difficulty with understanding and producing stories can be a sign of a learning disability. A speech-language pathologist can help your child to develop the story telling skills that will help him to succeed in school and social situations.

Written by: Suzanne Bassett, speech-language pathologist, The Speech Therapy Centres of Canada Ltd.

The Importance of Playtime in the Development of Speech and Language Skills in Children

We all like to play – children, adolescents, and adults alike. But did you know that the development of play skills is integral to the development of a child’s speech and language skills? Who would have thought something so fun could be so beneficial!
A play context, in fact,  provides primary communicative opportunities for young children. This means that play can increase a child’s exposure to many vocabulary items, different forms of language, the many uses of language, as well as opportunities to experiment with their own gestures, sounds, and/or words in a safe and comfortable environment. Yes, all that in one context! 
Given the important nature of play in the development of speech and language skills, take a peek at the following tips on how to select toys and create a rich play environment that will help with your child’s speech and language.
Toy Selection
1.)    When selecting toys for play, try to include the use of toys that allow for both realistic and imaginative play. This way, your child will have opportunities to engage in both concrete and pretend play – two very important forms of play! 
2.)   Toys should also be easy to hold, carry, and manipulate – especially for children who have motor difficulties. The importance here is that the quality of motor ability to manipulate objects appears to be related to early communication development.  
Play Environment
1.)    Play should always be fun and never work. Therefore, let your child lead the play. This means letting him/her engage in whichever activity, in whichever manner they so choose. Even if it means repeatedly putting play-dough back into the container without even molding any shapes — let them lead the play! Kids pay the most attention to what they have chosen and are interested in, not always to what we are interested in. 
2.)    Keep play a positive and pressure-free environment. Try to refrain from asking your child questions during play and instead talk about what is going on during play. Describe what you see, hear, feel, and smell. This will help keep any communicative pressures to a minimum and allow for a comfortable communication environment!

Written by: Mia Majorahn, speech-language pathologist, The Speech Therapy Centres of Canada Ltd.

Early Literacy During the Pre-School Years

As our children get ready to go back to school or daycare, it is a great time to freshen up on our “teaching” skills as parents.  Below are a few helpful tips on how you can make early literacy a priority (and more interesting!) for your little ones.

2-3 Year Olds:

  •  Read to your child everyday, even if it is only for a few minutes
  •  Encourage your child to bring you his/her favourite books so you can read them together
  •  Talk with your child throughout the day about what is happening
  •  Point to pictures and name them out loud
  •  Be patient when your child wants to read the same book many times
  •  Encourage your child to play with books (flip them from front to back, turn   pages)

4-5 Year Olds:

  •  Help your child hear words that rhyme (like cat and hat)
  •  Let your child choose the book s/he wants
  •  Help your child hear and say the first sound of a word (ball, bear)
  •  Point out signs and labels that have letters
  •  Ask “what?”, “where?”, and “how?” questions when reading
  •  Introduce new words
  •  Make connections from stories to things that happen in real life

Happy Reading!

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