Helping your child learn to talk

Speech delay is a common developmental problem presented to child health clinic. Many parents did not realise that their children's speech and language have not developed according to age. Hence only presented to doctors when going to kindergarten at the 4-5 years, when they realised that their children aren't speaking as good as their peers. This leaflet has set out to improve parental awareness of normal speech & language development with tips to facilitate that learning experience.

Normal speech & language development in children

At birth, babies communicate by crying, whether they are hungry, having dirty or wet pampers, feeling insecure, on in pain. They may have different pitches of crying depending on different situations. Soon after birth, they will become aware of the sounds around them, and learn to imitate those sounds. Within weeks, they will start to cooing sounds, e.g. "ah "oh"

At 4-6 months, babies may start to experiment different sounds, including playing with clowing raspberry.

After that, they may combine vowels like "ah" with consonant type or hard sounds, like "b". This will become "BA..". Later "bababa..." they will begin to respond to own names, and respond to familiar words, e.g. bye-bye, which they respond by waving hands.

At 9-12 months, babies will show more understanding of the spoken language when used along a routine activity, e.g. "open mouth" when feeding. They may start to combine talking with gestures such as pointing to what they want, shaking the head to mean "no", or even start have meaningful single words, e.g. "mama" "baba" "woof"

During 12-18 months, most children will follow simple command, such as "bring your shoes", and they will be interested in body parts, and learn to point to certain parts when asked to. They will continue speak in strings of sounds, with occasional recognisable single words, which we usually call this language as "jargon".

After 18 months, most children will use approximately 10-20 words, some will combine 2 words together "all gone", "baba bye-bye". Most of them enjoy nursery songs, and will hum and sing simple tunes.

By 2-3 years, children's spoken language will expand from short phrases to longer sentences. This varies largely from one child to another child, depending the environment and opportunities.

Who can help?

Parents and all other caretakers are the most important people in helping to learn how to express themselves and communicate with others.

How to help?

Three things to teach your child before he can learn to talk:

1. To pay attention to people around him. 

Encourage him to look at you for at least 50% of the time when he is interacting with you. You may try to improve his eye contacts by playing interesting activities, e.g. blowing bubbles, playing hand puppets, etc.

1. To pay attention to things and activities around him. 

Younger children cannot pay attention as long as older children or adults. Keep his interest by making the activities short and by using a variety of toys, teaching ideas.

1. To copy a person:

• in doing action
• in playing toys
• in making sounds

Start by copying what the child is doing. Then encourage the child to do it again. Give him time to response. Practise taking turns with the child while playing with his favourite games.

Understanding comes before talking

You may help your child's understanding of language more by:

1. Talking about what you are doing, e.g. "I am washing your face", "putting the shoes on"
2. Describe what the child is doing, e.g. "pushing a car" "feeding the doll"
3. Start with short sentence and familiar words, e.g. "get in car" "go to shop"

Some tips

• At birth-- Babies learn from birth by hearing the sounds around them. Encourage babies to make noise by copying the noises they are making, then introducing new sounds. After a while, go back and practise old sounds.

For example, if he can say "ah" and "oh", then repeat after him "ah" "ah" "oh" "oh"; then after a while, say "mm" and see if imitates you-- then go back to the old sounds he knows "ah" "oh"

• Repeat what the child says, e.g. if he points to his eyes and says "eye", you should smile and acknowledge, "yes, EYES"

This will tell the child that he has done well, and has used the correct word.

• Give reinforcement or rewards when your child does try to talk even if he cannot say the words clearly, e.g. if you want him to say "orange" and he says, "olen", you continue to praise him and give it to him. This will make him feel encouraged and try to speak the word more.

Remember

• Children need to hear and understand the meaning of words BEFORE they say words.
• Be patient. After speaking to the child, wait for him to respond for 5-10 seconds. What the child is trying to tell you is more important than how he says it.
• It is very important to keep talking your child about everyday things, things he dose and sees.
• It is especially important for you to keep talking though your child may not respond or seem to understand.
• It is important to follow the child's interest rather than your own.
• Limit the exposure of TV or multimedia to <2 hours a day for those >2 years. TV or multimedia is not recommended for infants.

Useful activities:

• Baby sign languages: We do have many body languages without realising, e.g. waving hands to indicate "good bye". You can expand on this and start teaching your baby sign language after 6 months, talk to your doctor about this.
• Nursery rhymes and songs: Listen to nursery rhymes or songs with your child, you may sing and even put in some actions.
• Reading books: Encourage your child to look at books, and let them turn the pages. You can point to the pictures, and introduce new words. You may introduce social stories to help your children understand daily activities.

Warning signs:

• Family history of childhood deafness
• Baby does seem to respond when talked to with loud noise.
• Not babbling by 9-month-old
• Poor eye contact and no non-verbal gestures, e.g. bye-bye, by 1-year-old.
• No single word with meaning by 18-month-old.
• Difficulty in understanding simple command by 18-month-old.
• Failed M-chat (A screening tool detect Autism for age 18-30 months)

Parents are encouraged to discuss speech and language development as well as other developmental concerns, with the doctor at every routine child health visit. It can be difficult to tell whether a child is just immature in communication or truly has underlying  cause. Depending on the history and assessment, your doctor may recommend some investigations, including hearing assessment to exclude deafness. Some may need lifestyle adjustment, e.g. cutting back TV exposure, and increasing interactive activities. Some may need further professional help, e.g. speech therapy and occupational therapy.

Useful speech therapists in Kuching include:

1. 20dB Hearing. Ground Floor, 72-C, SubLot 4, S3 Curve, Jalan Simpang Tiga. Tel : 1-800882032/ 082-411220/ 0168793021. www.20dbhearing.com
20dB has a team of speech therapists, who can perform hearing test, speech assessment and speech therapy. They run workshops for parents as well.

2. MED-EL Malaysia. Ground & 1st floor, SL13, Lot 9659, Block 11 MTLD, Jalan Setia Raja, 93350 Kuching. Tel: 082-575466, Fax: 082-578477. www.medel.com

3. The Therapy Playroom by Sue Walker
1st floor, 89, SubLot 3906, Sunny Commercial Centre, Jalan Dogan, Off Jalan Batu Kawa, Kuching. Tel: 082-572570/ 0168731376

Remember, the best therapist for the child is parents.