Communication

As kids enter their school years, they become increasingly independent, spending much of their days outside the home in school and with peers. But talking with your child is still essential to bonding, so share ideas, opinions, and information.

Communicating With Your Child

Here are a few suggestions to aid communication:

• Make time to hear about the day’s activities; be sure your child knows you’re actively interested and listening carefully.
• Remember to talk with your kids, not at them.
• Ask questions that go beyond “yes” or “no” answers to prompt more developed conversation.
• Take advantage of time during car trips or standing in line at stores to talk with your child.
• Make time for sporting and school events, playing games, and talking about current events.
• Encourage your child to read books and stories that are slightly above his or her competency level.

Vocabulary and Communication Patterns

As kids progress in school, their comprehension and use of language will become more sophisticated. Usually, kids will understand more vocabulary words and concepts than they can express. Your child should be able to engage in narrative discourse and share ideas and opinions in clear speech.

If You Suspect a Problem

You should have ongoing communication with your child’s teacher about overall language skills and progress. Kids with language comprehension and usage problems are at risk for academic difficulties.

A child who has a specific communication difficulty, such as persistent stuttering or a lisp, should be referred to the school speech-language pathologist (an expert who evaluates and treats speech and language disorders). Stay in touch with the therapist about therapy goals, language activities to practice at home, and your child’s progress.

If your child’s teacher suspects a language-based learning disability, comprehensive testing will be done. This can include a hearing test, psychoeducational assessment (standardized testing to evaluate your child’s learning style as well as cognitive processes), and speech-language evaluation.

Typical Communication Problems

Problems in communication skills may include:

• hearing difficulties
• difficulty with attention or following directions in the classroom
• difficulty retaining information
• poor vocabulary acquisition
• difficulties with grammar and syntax
• difficulties with organization of expressive language or with narrative discourse
• difficulties with academic achievement, reading, and writing
• unclear speech
• persistent stuttering or a lisp
• voice-quality abnormalities, such as a strained, hoarse sound (may require a medical examination by an otolaryngologist — an ear, nose, and throat specialist)

Medical professionals, such as speech pathologists, therapists, and your doctor, can help your child overcome communication problems.

During these months, your baby might say “mama” or “dada” for the first time, and will communicate using body language, like pointing and shaking his or her head.

Your baby will pay even more attention to your words and gestures and will try very hard to imitate you — so be careful what you say!

How Babies Communicate

Babies this age test their verbal skills as they prepare for their big speaking debut. From babbling strings of consonants like “babababa,” they will begin to produce recognizable syllables, such as “ga,” “ba,” and “da.” By seeing their parents’ excitement at hearing “dada” or “mama,” babies soon learn to connect a word with its meaning.

Even before babies can talk, they communicate through gestures — pointing, shaking their head “no,” and waving bye-bye all demonstrate their ability to communicate, understand, and respond to language.

You’ll know your baby understands what you say when you ask “Where’s Daddy?” and your little one looks his way, or you point and say “Go find the blue ball” and he or she crawls right to it. Your baby should respond well to his or her own name, and should look up (and at least pause) when you say a firm “NO!”

By the end of the first year, your baby will follow simple requests from you (“Wave bye-bye”), enjoy peek-a-boo, say “mama” and “dada,” and babble with inflections of typical speech.

What Should I Do?

Continue talking to your baby using names as well as repetitive word games, like “This little piggy.” Ask your baby to point to familiar objects and ask “Where’s the cup?” Or point to a ball and ask “What’s that?” Pause before you provide the answer. Soon your baby will be pointing and saying “bah?” as though asking a question.

Labeling objects during the course of the day reinforces the message that everything has its own name. From milk in the morning to a teddy bear at night, naming familiar objects will help your little one learn what they’re called and store this information for the day when he or she can form the right words.

Make learning a whole-body experience: Touch your baby’s toe when you say the word “toe.” Or point out your own ear and say, “Mommy’s (or Daddy’s) ear.” Face your baby when you speak to let him or her see your facial expression and lip movements.

Be musical and sing to your baby to encourage language learning. By listening to the words, babies learn to recognize and repeat them. Throw in hand gestures and vary the style and tempo of the music to keep your baby’s attention. Babies also respond to rhymes, which show how playful language can be.

Read to your baby from large, colorful picture books, and encourage him or her to turn the pages. Give your baby a chance to “read” and “answer” your questions.

If You’re Concerned

By the 12 months, babies usually:

• respond to “no”
• follow simple commands
• use simple gestures, like pointing or shaking their heads
• say mama and dada

When it comes to language development, there is a wide range of normal. If you have concerns about your baby’s language skills or hearing, talk to your doctor.

Do you remember your baby’s very first cry? From the moment of birth, babies begin to communicate.

At first, your newborn’s cries may seem like a foreign language. But before you know it, you’ll learn your baby’s “language” and be able to answer your little one’s needs.

How Babies Communicate

Babies are born with the ability to cry, which is how they communicate for a while. Your baby’s cries generally tell you that something is wrong: an empty belly, a wet bottom, cold feet, being tired, or a need to be held and cuddled, etc.

Sometimes what a baby needs can be identified by the type of cry — for example, the “I’m hungry” cry may be short and low-pitched, while “I’m upset” may sound choppy. Before you know it, you’ll probably be able to recognize which need your baby is expressing and respond accordingly.

But babies also can cry when feeling overwhelmed by all of the sights and sounds of the world — or for no clear reason at all. So if your baby cries and you aren’t able to console him or her immediately, remember that crying is one way babies shut out stimuli when they’re overloaded.

While crying is the main way that babies communicate, they also use other, more subtle forms. Learning to recognize them is rewarding and can strengthen your bond with your baby.

A newborn can tell the difference between a human voice and other sounds. Try to pay attention to how your little one responds to your voice, which is already associated with care: food, warmth, touch.

If your baby is crying in the bassinet, see how quickly your approaching voice quiets him or her. See how closely your baby listens when you talk in loving tones. Your baby may not yet coordinate looking and listening, but even when staring into the distance, will be paying close attention to your voice as you speak. Your baby may subtly adjust body position or facial expression, or even move the arms and legs in time with your speech.

Sometime during your newborn’s first month, you may get a glimpse of a first smile — a welcome addition to your baby’s communication skills!

What Should I Do?

As soon as you hold your baby after birth, you’ll begin to communicate with each other by exchanging your first glances, sounds, and touches. Babies quickly learn about the world through their senses.

As the days after birth pass, your newborn will become accustomed to seeing you and will begin to focus on your face. The senses of touch and hearing are especially important, though.

Your baby will be curious about noises, but none more so than the spoken voice. Talk to your baby whenever you have the chance. Even though your baby doesn’t understand what you’re saying, your calm, reassuring voice conveys safety. Your newborn is learning about life with almost every touch, so provide lots of tender kisses and your little one will find the world a soothing place.

Communicating with newborns is a matter of meeting their needs. Always respond to your newborn’s cries — babies cannot be spoiled with too much attention. Indeed, quick responses to babies’ cries lets them know that they’re important and worthy of attention.

There will probably be times when you have met all needs, yet your baby continues to cry. Don’t despair — your little one might be overstimulated, have too much energy, or just need a good cry for no apparent reason.

It’s common for babies to have a fussy period about the same time every day, generally between early evening and midnight. Though all newborns cry and show some fussiness, when an infant who is otherwise healthy cries for more than 3 hours per day, more than 3 days per week for at least 3 weeks, it is a condition known as colic. This can be upsetting, but the good news is that it’s short-lived — most babies outgrow it at around 3 or 4 months of age.

Try to soothe your baby. Some are comforted by motion, such as rocking or being walked back and forth across the room, while others respond to sounds, like soft music or the hum of a vacuum cleaner. It may take some time to find out what best comforts your baby during these stressful periods.

Should I Be Concerned?

Talk to your doctor if your baby seems to cry for an unusual length of time, if the cries sound odd to you, or if the crying is associated with decreased activity, poor feeding, or unusual breathing or movements. Your doctor will be able to reassure you or look for a medical reason for your baby’s distress. Chances are there is nothing wrong, and knowing this can help you relax and stay calm when your baby is upset.

Here are some other reasons for prolonged crying:

• The baby is ill. A baby who cries more when being held or rocked may be sick. Call your doctor, especially if the baby has a temperature of 100.4°F (38°C) or more.
• The baby has an eye irritation. A scratched cornea or “foreign body” in a baby’s eye can cause redness and tearing. Call your doctor.
• The baby is in pain. An open diaper pin or other object could be hurting the baby’s skin. Take a close look everywhere, even each finger and toe (sometimes hair can get wrapped around a baby’s tiny digits and cause pain; this is known as a hair tourniquet).

If you have any questions about your newborn’s ability to see or hear, contact your doctor immediately. Even newborns can be tested using sophisticated equipment, if necessary. The sooner a potential problem is caught, the better it can be treated.

Your son is 2 years old and still isn’t talking. He says a few words, but compared with his peers you think he’s way behind. You remember that his sister could put whole sentences together at the same age. Hoping he will catch up, you postpone seeking professional advice. Some kids are early walkers and some are early talkers, you tell yourself. Nothing to worry about…

This scenario is common among parents of kids who are slow to speak. Unless they observe other areas of “slowness” during early development, parents may hesitate to seek advice. Some may excuse the lack of talking by reassuring themselves that “he’ll outgrow it” or “she’s just more interested in physical things.”

Knowing what’s “normal” and what’s not in speech and language development can help you figure out if you should be concerned or if your child is right on schedule.

Normal Speech & Language Development

It’s important to discuss early speech and language development, as well as other developmental concerns, with your doctor at every routine well-child visit. It can be difficult to tell whether a child is just immature in his or her ability to communicate or has a problem that requires professional attention.

These developmental norms may provide clues:

Before 12 Months

It’s important for kids this age to be watched for signs that they’re using their voices to relate to their environment. Cooing and babbling are early stages of speech development. As babies get older (often around 9 months), they begin to string sounds together, incorporate the different tones of speech, and say words like “mama” and “dada” (without really understanding what those words mean).

Before 12 months of age, babies also should be attentive to sound and begin to recognize names of common objects (bottle, binky, etc.). Babies who watch intently but don’t react to sound may be showing signs of hearing loss.

By 12 to 15 Months

Kids this age should have a wide range of speech sounds in their babbling (like p, b, m, d, or n), begin to imitate and approximate sounds and words modeled by family members, and typically say one or more words (not including “mama” and “dada”) spontaneously. Nouns usually come first, like “baby” and “ball.” Your child also should be able to understand and follow simple one-step directions (“Please give me the toy,” etc.).

From 18 to 24 Months

Though there is a lot of variability, most toddlers are saying about 20 words by 18 months and 50 or more words by the time they turn 2. By age 2, kids are starting to combine two words to make simple sentences, such as “baby crying” or “Daddy big.” A 2-year-old should be able to identify common objects (in person and in pictures), points to eyes, ears, or nose when asked, and follow two-step commands (“Please pick up the toy and give it to me,” for example).

From 2 to 3 Years

Parents often see huge gains in their child’s speech. Your toddler’s vocabulary should increase (to too many words to count) and he or she should routinely combine three or more words into sentences.

Comprehension also should increase — by 3 years of age, a child should begin to understand what it means to “put it on the table” or “put it under the bed.” Your child also should begin to identify colors and comprehend descriptive concepts (big versus little, for example).

The Difference Between Speech and Language

Speech and language are often confused, but there is a distinction between the two:

• Speech is the verbal expression of language and includes articulation, which is the way sounds and words are formed.
• Language is much broader and refers to the entire system of expressing and receiving information in a way that’s meaningful. It’s understanding and being understood through communication — verbal, nonverbal, and written.

Although problems in speech and language differ, they often overlap. A child with a language problem may be able to pronounce words well but be unable to put more than two words together. Another child’s speech may be difficult to understand, but he or she may use words and phrases to express ideas. And another child may speak well but have difficulty following directions.

Warning Signs of a Possible Problem

If you’re concerned about your child’s speech and language development, there are some things to watch for. An infant who isn’t responding to sound or who isn’t vocalizing is of particular concern.

Between 12 and 24 months, reasons for concern include a child who:

• isn’t using gestures, such as pointing or waving bye-bye, by 12 months
• prefers gestures over vocalizations to communicate at 18 months
• has trouble imitating sounds by 18 months
• has difficulty understanding simple verbal requests

Seek an evaluation if a child over 2 years old:

• can only imitate speech or actions and doesn’t produce words or phrases spontaneously
• says only certain sounds or words repeatedly and can’t use oral language to communicate more than his or her immediate needs
• can’t follow simple directions
• has an unusual tone of voice (such as raspy or nasal sounding)
• is more difficult to understand than expected for his or her age. Parents and regular caregivers should understand about half of a child’s speech at 2 years and about three quarters at 3 years. By 4 years old, a child should be mostly understood, even by people who don’t know the child.

Causes of Delayed Speech or Language

Many things can cause delays in speech and language development. Speech delays in an otherwise normally developing child can sometimes be caused by oral impairments, like problems with the tongue or palate (the roof of the mouth). A short frenulum (the fold beneath the tongue) can limit tongue movement for speech production.

Many kids with speech delays have oral-motor problems, meaning there’s inefficient communication in the areas of the brain responsible for speech production. The child encounters difficulty using and coordinating the lips, tongue, and jaw to produce speech sounds. Speech may be the only problem or may be accompanied by other oral-motor problems such as feeding difficulties. A speech delay may also be a part of (instead of indicate) a more “global” (or general) developmental delay.

Hearing problems are also commonly related to delayed speech, which is why a child’s hearing should be tested by an audiologist whenever there’s a speech concern. A child who has trouble hearing may have trouble articulating as well as understanding, imitating, and using language.

Ear infections, especially chronic infections, can affect hearing ability. Simple ear infections that have been adequately treated, though, should have no effect on speech. And, as long as there is normal hearing in at least one ear, speech and language will develop normally.

What Speech-Language Pathologists Do

If you or your doctor suspect that your child has a problem, early evaluation by a speech-language pathologist is crucial. Of course, if there turns out to be no problem after all, an evaluation can ease your fears.

Although you can seek out a speech-language pathologist on your own, your primary care doctor can refer you to one.

In conducting an evaluation, a speech-language pathologist will look at a child’s speech and language skills within the context of total development. Besides observing your child, the speech-language pathologist will conduct standardized tests and scales, and look for milestones in speech and language development.

The speech-language pathologist will also assess:

• what your child understands (called receptive language)
• what your child can say (called expressive language)
• if your child is attempting to communicate in other ways, such as pointing, head shaking, gesturing, etc.
• sound development and clarity of speech.
• your child’s oral-motor status (how a child’s mouth, tongue, palate, etc., work together for speech as well as eating and swallowing)

If the speech-language pathologist finds that your child needs speech therapy, your involvement will be very important. You can observe therapy sessions and learn to participate in the process. The speech therapist will show you how you can work with your child at home to improve speech and language skills.

Evaluation by a speech-language pathologist may find that your expectations are simply too high. Educational materials that outline developmental stages and milestones may help you look at your child more realistically.

What Parents Can Do

Like so many other things, speech development is a mixture of nature and nurture. Genetic makeup will, in part, determine intelligence and speech and language development. However, a lot of it depends on environment. Is a child adequately stimulated at home or at childcare? Are there opportunities for communication exchange and participation? What kind of feedback does the child get?

When speech, language, hearing, or developmental problems do exist, early intervention can provide the help a child needs. And when you have a better understanding of why your child isn’t talking, you can learn ways to encourage speech development.

Here are a few general tips to use at home:

• Spend a lot of time communicating with your child, even during infancy — talk, sing, and encourage imitation of sounds and gestures.
• Read to your child, starting as early as 6 months. You don’t have to finish a whole book, but look for age-appropriate soft or board books or picture books that encourage kids to look while you name the pictures. Try starting with a classic book (such as Pat the Bunny, in which your child imitates the patting motion) or books with textures that kids can touch. Later, let your child point to recognizable pictures and try to name them. Then move on to nursery rhymes, which have rhythmic appeal. Progress to predictable books (such as Brown Bear, Brown Bear) that let kids anticipate what happens. Your little one may even start to memorize favorite stories.
• Use everyday situations to reinforce your child’s speech and language. In other words, talk your way through the day. For example, name foods at the grocery store, explain what you’re doing as you cook a meal or clean a room, point out objects around the house, and as you drive, point out sounds you hear. Ask questions and acknowledge your child’s responses (even when they’re hard to understand). Keep things simple, but never use “baby talk.”

Whatever your child’s age, recognizing and treating problems early on is the best approach to help with speech and language delays. With proper therapy and time, your child will likely be better able to communicate with you and the rest of the world.

Are there any parents who haven’t felt complete and utter love for their toddler and, at the same time, frustration and anger?

Our beloved little ones test our nerves because they’re testing boundaries all around them. Every day, little by little, they’re mastering new abilities and accomplishing new feats, and are anxious and excited to use these skills.

Sometimes it’s tough to reel in a toddler, but it can be done. And setting rules and limits now — when your child is learning what behaviors are acceptable — will help prevent bigger problems down the road.

Here are some ways to help you keep your youngster on the right track.

Be Consistent

When it comes to discipline, it’s important to be consistent. Parents who don’t stick to the rules and consequences they set up don’t have kids who do either. For example, if you tell your toddler that a timeout is the repercussion for bad behavior, be sure to enforce it. Only issue warnings for things that you can follow through on. Empty threats undermine your authority.

And don’t forget that kids learn by watching adults, particularly their parents. So make sure your own behavior is role-model material. When asking your child to pick up toys, you’ll make a much stronger impression if you’ve put away your own belongings rather than leaving your stuff strewn around the room.

Eliminate Temptation

By now, you’ve figured out that your toddler wants to explore and investigate the world. Toddlers are naturally curious, so it’s wise to eliminate temptations whenever possible. That means items like TVs, phones, and video equipment should be kept out of reach, as well as choking hazards like jewelry, buttons, and small items that kids can put in their mouths.

And always keep cleaning supplies and medications stored safely away where kids can’t get to them.

Use Distraction

If your roving toddler does head toward an unacceptable or dangerous play object, calmly say “No” and either remove your child from the area or distract him or her with another activity.

It’s important to not spank, hit, or slap your child. At this age, kids are unlikely to be able to make a connection between the behavior and physical punishment. The message you send when you spank is that it’s OK to hit someone when you’re angry. The American Academy of Pediatrics (AAP) discourages spanking, which is no more effective than other forms of discipline, such as timeouts.

Practice Timeout

If you need to take a harder line with your child, timeouts can be an effective form of discipline. A 2- or 3-year-old who has been hitting, biting, or throwing food, for example, should be told why the behavior is unacceptable and taken to a designated timeout area — a kitchen chair or bottom stair — for a minute or two to calm down.

As a general rule, about 1 minute per year of age is a good guide for timeouts. Shorter timeouts can be effective, but longer ones have no added benefit and can sometimes undermine your efforts if your child gets up (and refuses to return) before you signal that the timeout has ended.

How to Avoid Temper Tantrums

Even the most well-behaved toddler can have a tantrum from time to time. Tantrums are common during toddlerhood because kids can understand more than they can express and this often leads to frustration when they can’t communicate their needs.

Toddlers get frustrated in other ways, too, like when they can’t dress a doll or keep up with an older sibling. Power struggles can ensue when your toddler wants more independence and autonomy too soon.

The best way to deal with tantrums is to avoid them in the first place, whenever possible. Here are some strategies that may help:

• Make sure your child isn’t acting up simply to get attention. Try to establish a habit of catching your child being good (“time-in”), which means rewarding your little one with attention for positive behavior.
• Give your toddler control over little things. This may fulfill the need for independence and ward off tantrums. Offer minor choices that you can live with, such as “Would you like an apple or banana with lunch?”
• When kids are playing or trying to master a new task, offer age-appropriate toys and games. Also, start with something simple before moving on to more challenging tasks.
• Consider the request carefully when your child wants something. Is it outrageous? Maybe it isn’t. Choose your battles; accommodate when you can.
• Know your child’s limits. If you know your toddler is tired, it’s not the best time to go grocery shopping or try to squeeze in one more errand.

When Tempers Flare

If your child does throw a tantrum, keep your cool. Don’t complicate the problem with your own frustration. Kids can sense when parents are becoming frazzled and this can just make their frustration worse. Try to understand where your child is coming from. For example, if your youngster has just had a great disappointment, you may need to provide comfort.

Ignoring the outburst is another way to handle it — if the tantrum poses no threat to your child or others. Continue your activities, paying no attention to your child but remaining within sight. Kids who are in danger of hurting themselves or others during a tantrum should be taken to a quiet, safe place to calm down.

Some kids will have a hard time stopping a tantrum. In these cases, it might help to say to say, “I’ll help you settle down now.” But whatever you do, do not reward your toddler by giving into desires. This will only prove that tantrums are an effective tactic for getting what he or she wants. Instead, verbally praise your child for regaining self-control.

As their language skills improve and they mature, kids become better at handling frustration and tantrums are less likely. If you’re having difficulty handling you child’s temper tantrums or have any questions about discipline, ask your pediatrician for advice.

My 2½-year-old daughter seems to talk less than her sister did at this age. I know that kids develop language skills at different times, but I’m still concerned. What’s “normal” for her age?
– Nina

As you mention, all children (yes, even siblings!) develop and refine their language skills at different times throughout their development, so the range of what’s “normal” is broad. However, some guidelines can help parents decide if their child might be at the latter end of the spectrum.

A typical 2-year-old should:

• speak in two-word phrases, like “more juice” and “go bye-bye”
• follow two-step commands
• name simple objects
• have a vocabulary of 50 or more words
• be understood at least 50% of the time by a parent

Between 2 and 3 years, vocabulary continues to build and comprehension also increases. By 3 years of age, a child should:

• speak in three-word sentences
• have a vocabulary of 200 words or more (basically, more than you can count)
• be understood 75% of the time
• understand prepositions (such as, “put it on the table” or “put it under the bed”)
• use pronouns (“me,” “you,” “it”)

If you feel that your child is not on track, talk to your doctor about your concerns.