Download When to be concerned about a child`s speech

When to be concerned about a child’s speech
Age
range:
1½-2 
years
(18-24
months)


Child would usually:
Don’t worry if:
Have concerns if:
What to do if you are concerned:
- The child may begin using
a small number of speech
sounds in simple words e.g.
‘p’, ‘b’, ‘m’ and ‘w’.
- The child’s words are
not always clear.
- After 2 years of age, the child
makes only a very limited range
of noises e.g. noises for animals
(moo for cow) transport (beep,
choo choo) and actions (uh oh).
It would be helpful for you to try the following and let us know the outcome if you refer
to the service:
Don’t worry if:
Have concern if:
What to do if concerned:
- Some words and/or
sounds are still unclear.
- The child makes only a very
limited range of sounds e.g.
vowel sounds such as ‘ee’ and
‘oo’, sounds for animals, or
humming.
It would be helpful for you to try the following and let us know the outcome if you refer
to the service:
-Children will often miss the
ends off words.
- Baby talk/babble is
still used for some
words.
- Likely to make several
sound errors so words
won’t be pronounced
exactly like adults say them.
Age
range:
2-3 years
(24-36
months)
- At 2 years of age, parents
should understand at least
50% of what their child
says.
Child would usually:
- A child will use a variety of
speech sounds including ‘p’,
‘b’, ‘m’, ‘n’, ‘w’ and ‘h’, in
everyday words.
- The child may begin to use
the speech sounds ‘t’ and
‘d’ in words.
- At 3 years of age, parents
should understand at least
75% of what child says.
- Continues to use
some babble.
- The child can’t say the
following speech
sounds or doesn’t use
them in words- ‘k/c,’
‘g’, ‘f’, ‘s’, ‘v’, ‘z’, ‘l’, ‘sh’,
‘ch’, ‘j’.
-The child uses ‘t’ and
‘d’ for the speech
sounds ‘k/c’ and ‘g’ e.g.
1 - Listen to your child's speech and make notes about the sounds you notice they can
and can’t say. If you notice sounds your child cannot say what do they say instead?
2. If you are worried your child may have a hearing difficulty speak to your child’s G.P
or Health Visitor to discuss a referral for a hearing test.
3 - Discuss your concerns with your child’s Key Worker at Preschool as they may have
noticed the same as you and be able to offer you some advice.
4 - Contact your child’s Health Visitor who can provide advice/support e.g. Talking Tips,
and access to local Children’s Centre groups.
5. You can check your child’s progress and access further advice from the following
website: http://www.talkingpoint.org.uk/directory/free-resources-parents
6 – If you are still unsure about whether your child should be seen by a Speech and
Language Therapist, then please contact the Speech and Language Therapy Helpline
on: 01208 834488 to discuss your concerns. Please note this is a call back service and a
qualified Speech and Language Therapist will return your call.
1 - Listen to your child's speech and make notes about the sounds you notice they can
and can’t say. If you notice sounds your child cannot say what do they say instead?
2. If you are worried your child may have a hearing difficulty speak to your child’s G.P
or Health Visitor to discuss a referral for a hearing test.
3 - Discuss your concerns with your child’s Key Worker at Preschool as they may have
noticed the same as you and be able to offer you some advice.
4 - Contact your child’s Health Visitor who can provide advice/support e.g. Talking Tips,
and access to local Children’s Centre groups.
5. You can check your child’s progress and access further advice from the following
website: http://www.talkingpoint.org.uk/directory/free-resources-parents
6 – If you are still unsure about whether your child should be seen by a Speech and
Language Therapist, then please contact the Speech and Language Therapy Helpline
on: 01208 834488 to discuss your concerns. Please note this is a call back service and a
car is pronounced ‘tar’.
and girl is pronounced
‘dirl’.
Age
range:
3-4 years
(36-40
months)
Child would usually:
- A child is likely to use the
sounds ‘p’,’b’, ‘m’, ‘n’, ‘w’,
‘h’, ‘t’, ‘d’, within words.
- A child may begin to use
the sounds ‘k/c’, ‘g’, ‘ f’, ‘v’
and ‘s’, as well as some
blends e.g. bl,(blue) and sp
(spider).
- At 4 years of age,
unfamiliar adults should
understand what the child
says in context and the
child’s speech is easily
understood by family
members.
- Long words are
shortened e.g. ‘spider’
said as ‘-pider’ ,
‘banana’ said as ‘nana’.
Don’t worry if:
- A child’s speech is
difficult to understand
out of context.
-The child uses ‘t’ and
‘d’ for the speech
sounds ‘k/c’ and ‘g’ e.g.
car is pronounced ‘tar’.
- Speech sound blends
such as ‘sp’, ‘st’, ‘bl’,
‘cr’ have not yet
developed e.g. spoon
said as ‘poon’ and blue
said as ‘boo’.

-The child uses short
sounds e.g. ‘t’ and ‘d’
for long speech sounds
‘s’, ‘sh’ and ‘f’.
qualified Speech and Language Therapist will return your call.
Have concern if:
What to do if concerned:
-The child is using a limited
range of speech sounds and/or
overuses one particular sound
e.g. he/she might say “dat” for
all of the following words ‘sat’,
‘cat’, ‘mat’, ‘fat’ and ‘bat’.
It would be helpful for you to try the following and let us know the outcome if you refer
to the service:
-Missing off sounds at the
beginning, in the middle or at
the ends of words e.g. cat may
be said as ‘at’, elephant may be
said as ‘ele-ant’, dog may be
said as ‘do’.
-The child changes vowel
sounds in words, e.g. sun is
said as ‘sen’ or pear is said as
‘poor'.
-Does not use the correct
number of beats (syllables) in
words, e.g. bottle is said as
‘bo’, or elephant is said as
‘ephant’.
- Close family members
struggle to understand what
the child says on a daily basis
and/or the child is becoming
extremely frustrated.
1 - Listen to your child's speech and make notes about the sounds you notice they can
and can’t say. If you notice sounds your child cannot say what do they say instead?
2. If you are worried your child may have a hearing difficulty speak to your child’s G.P
or Health Visitor to discuss a referral for a hearing test.
3 - Discuss your concerns with your child’s Key Worker at Preschool as they may have
noticed the same as you and be able to offer you some advice.
4 - Contact your child’s Health Visitor who can provide advice/support e.g. Talking Tips,
and access to local Children’s Centre groups.
5 – If you notice only one or two speech sounds your child cannot say in words, and
your child can copy this sound easily on its own (away from words) then please watch
these videos for ideas about ways to practise individual speech sounds:
https://www.youtube.com/watch?v=90368Ahy6TQ
https://www.youtube.com/watch?v=hQ9AgwYLQAI
Picture resources can be downloaded for free from the following website:
http://mommyspeechtherapy.com/?page_id=55
6. You can check your child’s progress and access further advice from the following
website: http://www.talkingpoint.org.uk/directory/free-resources-parents
7 – If you are still unsure about whether your child should be seen by a Speech and
Language Therapist, then please contact the Speech and Language Therapy Helpline
on: 01208 834488 to discuss your concerns. Please note this is a call back service and a
qualified Speech and Language Therapist will return your call.
Age
range:
4 - 5 years
(Reception
Class)
Child would usually:
Don’t worry if:
Have concern if:
What to do if concerned:
- A child will begin to use
the sounds ‘v’, ‘s’, ‘z’, ‘l’,
‘sh’, ‘ch’, ‘j’ and more
sound blends e.g. cl and fr.
- A child cannot say ‘th’
clearly or says ‘f’ for ‘th’
e.g ‘three’ is
pronounced ‘free’.
- A child is making the ‘s’
sound by blowing air down
their nose.
It would be helpful for you to try the following and let us know the outcome if you refer
to the service:
- A child has a lisp, e.g.
‘saw’ is pronounced
‘thaw’.
- A child may continue
to simplify sound
blends e.g. “spoon”
said as “poon” or
“flower” as “fower”
- At 4 ½ years of age the child is
not yet using the following
speech sounds at the
beginning, in the middle or at
the ends of words: ‘k’, ‘g’, ‘f’,
‘v’, ‘s’, ‘z’, ‘p’, ‘t’, and ‘l’.
- A child cannot say ‘r’
clearly or says ‘w’ for ‘r’
e.g ‘rabbit’ is
pronounced ‘wabbit’.
Age
range:
5-7 years
(Key Stage
1)
1 - Listen to your child's speech and make notes about the sounds you notice they can
and can’t say. If you notice sounds your child cannot say what do they say instead?
2. If you are worried your child may have a hearing difficulty speak to your child’s G.P
to discuss a referral for a hearing test.
3 - Discuss your concerns with your child’s Class Teacher or Health Visitor as they may
have noticed the same as you and be able to offer you some advice.
4 – If you notice only one or two speech sounds your child cannot say in words, and
your child can copy this sound easily on its own (away from words) then please watch
these videos for ideas about ways to practise individual speech sounds:
https://www.youtube.com/watch?v=90368Ahy6TQ
https://www.youtube.com/watch?v=hQ9AgwYLQAI
Picture resources can be downloaded for free from the following website:
http://mommyspeechtherapy.com/?page_id=55
5. You can check your child’s progress and access further advice from the following
website: http://www.talkingpoint.org.uk/directory/free-resources-parents
Child would usually:
Don’t worry if:
Have concern if:
- A child will begin to
develop the speech sounds:
‘r’,’ th’ and more blends
e.g. str, br, and tr.
-The child is still
experiencing difficulty
saying some longer
words with difficult
sound
combinations, e.g.
hospital is pronounced
‘hopsital’, or ‘spaghetti’
is pronounced
- At 5 ½ years of age the child
deletes one sound from ‘s’
blends e.g. ‘sp’ is pronounced
‘pider’ or ‘sider’.
- At 5 ½ years of age the child
deletes one sound from ‘l’
blends e.g. ‘flower’ is
pronounced ‘fower’ or ‘lower’.
6 – If you are still unsure about whether your child should be seen by a Speech and
Language Therapist, then please contact the Speech and Language Therapy Helpline
on: 01208 834488 to discuss your concerns. Please note this is a call back service and a
qualified Speech and Language Therapist will return your call.
What to do if concerned:
It would be helpful for you to try the following and let us know the outcome if you refer
to the service:
1 - Listen to your child's speech and make notes about the sounds you notice they can
and can’t say. If you notice sounds your child cannot say what do they say instead?
2. If you are worried your child may have a hearing difficulty speak to your child’s G.P
or School Nurse to discuss a referral for a hearing test.
3 - Discuss your concerns with your child’s Class Teacher as they may have noticed the
same as you and be able to offer you some advice.
‘spahetti’.
- The child deletes one
sound from ‘r’ blends
e.g. ‘grass’ is said as
‘gass’ or ‘rass’.
Please note that there
is a wide range of
typical variations in
how children and
young people
say words. These often
cause concern,
however they do not
require a speech and
language
assessment including:
- says ‘f’ or ‘v’ for ‘th’
e.g ‘three’ is
pronounced ‘free’.
- does not use the
speech sound ‘r’ in
their everyday speech
and/or uses a ‘w’ sound
in ‘r’ blends e.g. ‘bread’
is said as ‘bwead’.
-The child leaves out “t”
in the middle or at the
end of words e.g.
‘butter’ is pronounced
‘buher’.
- A child has a lisp, e.g.
‘saw’ is pronounced
‘thaw’. This is a
common pattern and it
- At 5 ½ years of age the child
does not use the speech
sounds ‘sh’, ‘ch’ and/or ‘j ‘
within words.
-The family and other familiar
people cannot understand the
child some of the time.
4 – If you notice only one or two speech sounds your child cannot say in words, and
your child can copy this sound easily on its own (away from words) then please watch
these videos for ideas about ways to practise individual speech sounds:
https://www.youtube.com/watch?v=90368Ahy6TQ
https://www.youtube.com/watch?v=hQ9AgwYLQAI
Picture resources can be downloaded for free from the following website:
http://mommyspeechtherapy.com/?page_id=55
5 – If you are still unsure about whether your child should be seen by a Speech and
Language Therapist, then please contact the Speech and Language Therapy Helpline
on: 01208 834488 to discuss your concerns. Please note this is a call back service and a
qualified Speech and Language Therapist will return your call.
is likely it will disappear
as the child’s adult
teeth develop.
Age
range:
7 years
and above
Child would usually:
Don’t worry if:
Have concern if:
What to do if concerned:
- The child has a mature
speech system.
- The child has a dental
brace which makes
their speech unclear.
- If familiar and/or unfamiliar
adults struggle to understand
the child.
It would be helpful for you to try the following and let us know the outcome if you refer
to the service:
- The child is unable to
correctly pronounce
some speech sounds
because their adult
teeth are not in place.
-The child has a lisp and their
adult teeth are now in place,
they are motivated to work on
their speech and/or they are
being teased about their
speech.
-Make themselves
understood to familiar and
unfamiliar adults all of the
time.
- The child says ‘f’ or ‘v’
for ‘th’ e.g ‘three’ is
pronounced ‘free’.
- The child says ‘w’ for
‘r’ e.g rabbit is
pronounced ‘wabbit’.
-The child leaves out “t”
in the middle or at the
end of words e.g.
‘butter’ is pronounced
‘buher’.
- The child deletes one sound
from ‘r’ blends e.g. bread is
said as ‘wed’ or ‘bed’.
1 - Listen to your child's speech and make notes about the sounds you notice they can
and can’t say. If you notice sounds your child cannot say what do they say instead?
2 - Discuss your concerns with your child’s Class Teacher as they may have noticed the
same as you and be able to offer you some advice.
3 – If you notice only one or two speech sounds your child cannot say in words, and
your child can copy this sound easily on its own (away from words) then please watch
these videos for ideas about ways to practise individual speech sounds:
https://www.youtube.com/watch?v=90368Ahy6TQ
https://www.youtube.com/watch?v=hQ9AgwYLQAI
Picture resources can be downloaded for free from the following website:
http://mommyspeechtherapy.com/?page_id=55
4 – If you are still unsure about whether your child should be seen by a Speech and
Language Therapist, then please contact the Speech and Language Therapy Helpline
on: 01208 834488 to discuss your concerns. Please note this is a call back service and a
qualified Speech and Language Therapist will return your call.
Frequently Asked Questions: (taken from ICAN Help Speech Sounds Factsheet)
How does my child learn different sounds?
Children learn sounds by listening to people speaking around them. They have been tuning into the sounds around them since before they were born and they carry on developing their
ability to tune into environmental sounds and speech sounds. Babies begin by playing with sounds first of all, then babble. This babble develops into longer strings using a wider range of
sounds.
I can understand everything my child says but he/she has just started at nursery and staff say they can't understand what he/she is saying. Should I be worried?
As parents we are more tuned in to what our child is saying and other people who don't know them can find it difficult to understand. As a rough guide people who don't know your child as
well as you should be able to understand about 50% of what a child says when they're 2 years old, 75% at age 3, and most of what they say at 4 years old.
Why is my child difficult to understand?
The development of speech sounds is a gradual process, usually lasting the first four to five years as children are learning to talk. This means that they cannot say all their sounds straight
away, as some are later to develop than others. As a general guide, the above table outlines the ages sounds develop by. When children first begin to talk they make it easier for them to say
words by substituting sounds e.g. a 'b' or a 'd' for 'f' or 's' sounds. This is because some sounds are easier to produce than others, but it can mean that you can't quite understand everything
they say. Sometimes children also miss the beginning or end of words and reduce sound combinations such as ‘sp’ in spoon to 'poon' or 'boon'.
What can affect my child's ability to pronounce sounds?
Speech sound difficulties may be due to one or more of the following:






A family history of difficulties
Delayed language development
Difficulties with co-ordination of the tongue, lips and palate
Hearing difficulties
Additional difficulties e.g. Developmental Verbal Dyspraxia, Down Syndrome, Cerebral Palsy etc.
Using a dummy (for more information please click on this link: http://www.talkingpoint.org.uk/parents/speech-and-language/do-dummies-affect-speech)
Your child's phonological awareness may also affect their ability to say sounds. Phonological awareness involves knowing how words work – it is things like being able to hear the differences
between sounds in words. For example, being able to tell the difference between 'bee' and 'sea' or 'key' and 'tea' when they hear the words; being able to hear when words rhyme;
recognising the first sound of a word (e.g. cat begins with 'c') and knowing the sounds that make up words (e.g. cat is made up of c‐a‐t).
Is there another reason why my child is so difficult to understand? Other children of his/her age are much clearer.
Around 10% of children in the UK experience speech sound difficulties; it is more common in boys than girls (RCSLT). Sometimes children can struggle to use the sounds we expect from them
at the right age i.e. this part of their development is a little delayed. This means they can sound like a child younger than them, or their speech can be unclear. Often children will catch up
with a little support or practice at home and preschool/nursery. You may need to a Speech and Language Therapist if your child isn’t doing what would be expected for their age and they are
showing signs of the speech sound difficulties outlined in the ‘Have concern if….’ column.