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The Ins and Outs of Early Intervention

Assessing Articulation in Toddlers

Published June 9, 2015 9:49 AM by jasna cowan

It is common for parents to indicate they are concerned about their toddler’s speech sounds at age two. Although most of the time these concerns are typical and age appropriate, there are times when further evaluation or consideration for speech therapy is necessary.

We have all heard baby-talk, or children who use phonological processes. Phonological processes are speech sound substitutions that are consistent. For example, the child who says “tar” for “car” or “beebee” for “baby.” When I evaluate a toddler, I am looking to rule out that the speech sounds are consistent, words are always pronounced in the same fashion.

I tend to get concerned with a little one’s speech when parents indicate a few red flags. One of those red flags would be a parent who reports speech regression. The parent who says, “He used to say… but he doesn’t anymore.” This is atypical language development to me and usually needs more probing.

The other red flag is the child who speaks with his mouth closed. The child may actually vocalize as if he were humming. Sometimes it is difficult for a parent to realize that the child is actually saying a word because his mouth remains closed, and all you have to recognize that he is intending to say a word is by his intonation or by the number of syllables. I have evaluated toddlers that consistently vocalized “m-m” when I handed them a toy. I quickly determined that the child was intending to say “thank you” with their mouth closed. I have seen this time and time again and again in young children who may be exhibiting early signs of apraxia of speech.

SEE ALSO Eye-Gaze Development in Infants 

Another red flag would be when a child is having difficulty producing vowel sounds. Yes, speech sounds can be developing until age three, however when you have a child who cannot use a variety of vowel sounds, and vowel sounds in their imitation or spontaneous speech sound production is distorted, this is a concern. Toddlers who can only produce one vowel or one consonant at a time, or use primarily one syllable at a time and have difficulty producing more than one syllable at a time, can be having difficulty with motor production and the coordination of speech sound production which will indefinitely affect expressive language skills and the number of words a child can produce.

We have to stop looking at articulation like something that we only evaluate after age three. Even some of the standardized assessment tools on the market do not catch these sometimes subtle articulation concerns. Parents do not have the specific training we have in the area of speech sound production. We need to be specific in the way we ask questions so parents can give us clear information so we can make informed decisions about whether these toddlers also need help in the production of sounds. I have seen some of these red flags evolve into more serious speech disorders as the child gets into the preschool age if not properly identified as a toddler.

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I agree with the author--there is much more to articulation therapy than some clinicians might acknowledge.  Distorted vowels in toddlers is a red flag. Consider intervention when there's decreased speech intelligibility during connected speech--and less listener predictability due to the variable speech production errors.

Linda Chatalian Wyatt, , SLP Wachusett Regional December 27, 2015 10:23 AM
Jefferson MA

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