Markham Stoufville Hospital Child Development Programs

Speech & Language FAQ

Frequently Asked Questions

Do babies understand what we say to them?

Children understand more words (receptive language) than they use (expressive language). Babies may not understand the meaning of our words at first, but they understand our tone of voice and the situation. Your baby is learning about sounds and how they become words, so use your language, tone of voice and facial expressions to teach them.

Should we wait for school to deal with speech and language problems?

No. If you think your child has a problem, call right away. Early identification and treatment of speech and language problems will help your child prepare for the future learning demands of a junior kindergarten classroom.

Is it common when the younger children in larger families don’t talk?

Early signs of language delay should be taken seriously in all children. So if your child is having problems, call us.

Will my child grow out of it?

Some children do grow out of speech and language delays, but many won’t, so do not wait and see. The earlier a problem is discovered and treated, the better the outcome for your child.

Should I worry if my child stutters?

Many children repeat words or phrases as they learn to talk or when they are excited or tired. This can happen for short periods of time and then disappear. However, if you notice that this is happening frequently and for more than a few months – call us.

Do I need a doctor’s referral to have my child seen by York Region Preschool Speech and Language Services?

No. Parents can self-refer by calling us directly at 1-888-703-5437 when they have a concern. Parents generally know their child best and if you are concerned about your child’s speech and language development do not hesitate to call.

Does my child need a hearing test?

If you have any concerns about your child’s speech and language development and are wondering whether your child has difficulty hearing, you should arrange to have your child’s hearing assessed. Hearing problems can have a significant impact on the development of your child’s communication development.

If your child is under 2 years and has not had hearing screening, please call: Tri-Regional Infant Hearing Program at 1-888-703-5437 ext. 4 to arrange hearing screening. Over the age of 2 years, you can ask your family doctor for a referral to an audiologist, if your child hasn’t been screened, has had ear infections or there are other reasons to be concerned about your child’s hearing.

Does my child mispronounce sounds because they are lazy?

No. Your child does not intentionally mispronounce sounds. They have developed a speech pattern over time that is unconscious, but certainly within their control to change with instruction.
We don’t know why children develop different speech patterns. In many cases, the sounds are simply delayed in their acquisition, and with time will likely develop on their own. Providing families with suggestions to encourage the development of these sounds is often very helpful.

Other children’s speech patterns are much more complex and vary from a typical developmental pattern. These children usually require direct speech therapy. It may be that a similar speech pattern has occurred in the family, suggesting a hereditary link, or a hearing loss as early as 12 months due to recurrent ear infections can also affect sound acquisition. For many children, however, the cause is unknown. What we do know however, is that your child is not willingly trying to talk this way, it is simply the only way they know how to use their sounds!

If I use sign language with my child, will it not stop my child from trying to talk?

No. Sign language is a type of Augmentative Communication. Signs can actually help a child to talk. Studies have actually demonstrated that children as young as 9 months have developed a large sign vocabulary, much earlier than their spoken vocabulary, and that these same children spoke earlier than same aged children.

Talking is a very complicated process requiring the child to be able to know what a word means, know when it is appropriate to use that word, remember how the word is pronounced and then physically being able to put the sounds together to produce the word.

Sign language helps a child understand what a word means because it is visual and can be “seen”, rather than just sounds in space. Similarly by observing others using signs in conjunction with the spoken word, the child learns when the sign/word is to be used. This then allows the brain to focus more on the co-ordination of all the muscles required for the pronunciation of the word.

The added bonus is that during your child’s learning of word pronunciation (which can sometimes take months for this connection to occur) they have a way to communicate with you that is not as physically challenging, thereby reducing everyone’s frustration!

If my child is struggling with English at school, should we stop speaking our first language and speak only English at home?

No. Learning more than one language can be good for a child’s overall language and learning abilities in school.  A child raised with more than one language will possibly:

  • Develop a larger vocabulary
  • Have a better understanding of how words sound and rhyme. This will help them when learning to write and spell
  • Have access to more than one culture
  • Research shows children who are strongly proficient in their first language will become strongly proficient in English. They will also do better in reading.

Is there a “best way” to teach the two languages?

Several equally valid ways exist for a child to learn two languages.

  • A child can learn two languages right from birth; where both parents use a lot of both languages in all daily situations, or
  • A child can learn the heritage language at home and then English at day-care, preschool or beginning in kindergarten, or
  • The ‘one person-one language’ approach, a child can learn two languages when each person speaks a different language to the child. Each parent should speak a lot of his/her language when talking with the child.
  • The route parents take depends on a number of things:
  • The language(s) spoken by the parents and the extended family. Some parents have no choice about which route to take because they themselves speak only their heritage language
  • How strongly the parents feel about maintaining their heritage language at home.
  • Children learn language best:
  • From people who are fluent in that language, so parents should speak the language that feels most comfortable. Their children will be exposed to a richer variety of words and well formed sentences
  • When they have a good relationship with their parents. This relationship is closer when the parent is communicating in their most natural, fluent language
  • When they are exposed to the language in all daily situations, play, books, music and from many people in their lives, their mother, father, brothers and sisters, grandparents, aunts and uncles etc.

Should a child with a language delay be raised with only one language?

There is no clear research to indicate that a child with a language delay should be exposed to only one language. This is the case even for children with a severe language delay.

Families may wish to discuss their options with a Speech-Language Pathologist and other caregivers who work with their child. Any language intervention plan should be based on your child’s need to communicate for different reasons with different people.

My child has a lisp. What should I do?

Some children present with what is known as a lisp. There are two kinds of lisps:

Frontal Lisp – is the most common and is characterized by protrusion of the tongue tip between the front teeth usually during the production of ‘S’ and ‘Z’ sounds resulting in a ‘TH’ sound, e.g. sun = “THUN”.

Lateral Lisp – is less common and is characterized by the sides of the tongue protruding between the molars also during the production of ‘S’ and ‘Z’ sounds resulting in a ‘slushy’ ‘SHLL’ sound, e.g. soup = “SHLLOUP”.

Children learn to produce different sounds at different times. The ‘S’ and ‘Z’ sounds are often only mastered by the time a child is 7 or 8 years old. The presence of a lisp does not typically affect how well a child’s speech is understood though it does make his speech sound different from other children at school.

If your child is demonstrating a lisp – model a clear and exaggerated ‘S’ sound by clenching your front teeth and making a BIG smile. Emphasize the spreading of your lips. When your child says “thun” for sun, it’s best if you repeat the word stressing the ‘S’ sound (“SSSSun”). You can remind your child to keep his tongue in his mouth by saying “Oops! I saw your tongue. Stay in your house Mr. Tongue!” Also encourage your child to keep his tongue tip anchored behind his lower front teeth by saying “Let’s pretend Mr. Tongue is standing at the bottom window” (your teeth are like windows!)
Most of all make it FUN!!!

Won’t the use of picture / augmentative and alternative communication (AAC) interfere with a child’s vocal development?

Research shows that AAC does not impede the development of speech and language skills.  It actually indicates that AAC facilitates spoken language by increasing interaction, improving language skills, and/or providing a voice output model for speech.  Additionally, research shows that children who are not able to communicate effectively by some means are at great risk for cognitive, social, emotional, and behavioral problems.  The purpose of AAC is to provide a functional communication system, which may be used short or long term.

For additional information, please see this resource: AAC: An Introduction

Supporting research:
Romski, M.A., Sevcik., R.A., Reumann, R., & Pate, J.L. (1989). Youngsters with moderate or severe retardation and severe spoken language impairments. I:  Extant communication patterns. Journal of Speech and Hearing Disorders, 54, 366-373.
Bodine, C. & Beukelman, D.R. (1991). Prediction of future speech performance among potential users of AAC systemsA survey. Augmentative and Alternative Communication, 7 (1), 100-111.
Millar, D., Light, J., and Schlosser, R.(1999). The impact of augmentative and alternative communication (AAC) on natural speech development: a meta-analysis. Poster session presented at the American Speech-Language-Hearing Association Annual Conference, San Francisco, CA