AN OVERVIEW OF SPEECH AND
LANGUAGE DEVELOPMENT
Nicola Hall
Speech and Language Therapist
Agenda
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Background to speech and language therapy
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What is communication?
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Where the breakdown can occur
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Speech and Language Therapy Input
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Questions and Answers
Background
What does a Speech and Language Therapist do?
A Speech and Language Therapist is a person trained to work
with people of any age with communication or swallowing
difficulties.
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We are trained to deal with neonates up to elderly
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This may include:
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Assessment
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Diagnosis
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Treatment
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Pre-referral Work and Health Education
What is Communication?
What do speech and language therapists consider?
Where can the
breakdown occur?
Listening
Attention
STAGE 1 – 1ST yr: Period of extreme distractibility
STAGE 2 – 2nd yr: The child can concentrate for some time on a
concrete task of his own choosing
STAGE 3 – 3rd yr: Attention is single channelled, but more flexible
STAGE 4 – 4th yr: Child can control his own attention focus
STAGE 5 – 5th yr: The child’s attention becomes two channelled
STAGE 6 – 6th yr: Integrated attention is well established and well
sustained
Language

STAGE 1: DISCOVERER (birth to 8 months)
The infant goes from communicating reflexively to becoming really interested in
others and wanting attention. She does not yet know how to send messages
directly to another person to get what she wants.
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STAGE 2: COMMUNICATOR (8 to 13 months)
The infant sends purposeful messages directly to others using a combination of
eye gaze, facial expressions, sounds and gestures. She becomes very sociable.
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STAGE 3: FIRST WORDS USER (12 to 18 months)
The infant cracks the language code and begins to use single words.
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STAGE 4: COMBINER (18 to 24 months)
The child demonstrates a burst in vocabulary and begins to combine words.
She also starts to take more turns in conversation
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STAGE 5: EARLY SENTENCE USER (2 to 3 years)
The child progresses from using two-word combinations to five-word
sentences and can now hold short conversations
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STAGE 6: LATER SENTENCE USER (3 to 5 years)
The child uses long, complex sentences and holds conversations
Speech Development
50% children
90% children
All common vowel sounds
1.5yrs – 2yrs
3yrs
p, b, t, d, m, n, w
1.5yrs – 2yrs
3yrs
k, g, f, h, y as in ‘yet’
2.5yrs – 3yrs
4yrs
s, ing as in ‘ring’
2.5yrs – 3yrs
5yrs
l
3yrs – 3.5yrs
6yrs
sh as in ‘shoe’, ch as in ‘chin’, j as 3.5yrs – 4.5yrs
in ‘joke’, z, v
6yrs
r, th as in ‘thin’, voiced th as in
‘there’
7yrs
4.5yrs – 5yrs
Where there are 2 sounds at the beginning of a word, eg st, sn, br, fl, these
take longer to develop. Often not before 5yrs old
Fluency
Children will often stop, pause, start again and stumble over words when
they are learning to talk.

Between the ages of two and five years it is normal for a child to repeat
words and phrases and hesitate with ‘um’s and ‘er’s when they are thinking
what to say next.

About 5 in every 100 children stammer for a time when they are learning
to talk. Many find it easier to talk as they get older. Others continue to find
talking difficult and often get stuck.

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More boys than girls have persistent stammers.
Warning bells:
o
does anyone else in the family have (or had) a stammer?
o
has the child been stammering for longer than 6 months?
o
is the child beginning to do other actions eg screwing their face
up, blinking, foot tapping, word avoidance to ‘help’ their
speaking?
o
has the child had difficulties with speech and language skills
previously?
Social Skills

Can be the result of underlying language difficulty

ASD

Aspergers Syndrome
Social Communication
Social Interaction
Play skills
Eating and Drinking - Risk Factors
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Prematurity or low birth weight
Syndromes – Down Syndrome, Prader Wili
Neurological Disorders – cerebral palsy, meningitis
Acquired trauma – head injury
Delayed introduction of textured food
Structural problems – cleft lip/palate, tracheostomy
Heart disease
Gastro-intestinal conditions
Signs and Symptoms
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Poor feeding
Difficulties chewing
Difficulties in drinking
Refusing food/drink
Coughing/choking
Eyes watering
Colour change
Gurgly/wet voice
Breathing difficulties
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Gagging/vomiting
Frequent chest infections
Poor weight gain
General distress around
eating/drinking
Avoiding certain foodstuffs
eg. Crunchy things, lumps
that require lots of chewing
Prolonged feeding times
Speech and Language
Therapy Input
Who Should I Refer?
Not just the disorder but how this impacts on the individual
child and family

How does this affect the child’s development in everyday life?

What does this stop the child/family doing?
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How does this make the child/family feel?
Role of the Speech & Language
Therapist

Pre-referral (Public Health)
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Referral
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Open referral system
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Triage

Assessment
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Intervention

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Determine level of SLT risk
Diagnosis & description
Intervention plan
Direct
Indirect
Discharge
General Advice
 Suggest nursery placement for children not yet in education.
 In Greater Glasgow give Helpline number to parents
 In all situations, asking children to repeat what they are
saying is likely to increase stress. Advise parents not to
pressure the child into repeating or speaking to people.
Listen to WHAT the child is communicating not HOW
 Consider referring to audiology if any concerns about
hearing.
 Consider involving other services eg CDC if any concerns
regarding social interaction.
Consultation & Advice
Line
Anyone involved with a child can call (Glasgow only at the moment)
Staffed by an experienced speech and language therapist who can
give general advice and/or advise on appropriateness of referral
Wednesday: 1.00pm to 4.00pm
274 2075
Friday: 9.30am to 11.30am
531 6843
Bilingual Families
Where there are 2 (or more) languages being spoken…..
o
Never advise giving up mother tongue
o
The adults should be consistent with the languages, try not to
mix them
o
SLT would be involved if child has problems in all languages,
not just learning English
Useful Websites
www.talkingpoint.org
www.rcslt.org
www.hpc-uk.org
www.stammering.co.uk
www.talktoyourbaby.org.uk
www.afasic.org.uk
www.nas.org.uk
QUESTIONS
&
ANSWERS
nicolahall@nhs.net