Monday, February 27, 2012

How many words does it take to be a late talker?

The Twenty-Five Words Every Toddler Needs to Know is getting a lot of press. This article is pretty much a fluff news piece with very little substantive content and no references. It was a written summary of someone's take home message from a talk a researcher did at a conference. I am not at all criticizing the researcher / presenter. I wasn't there. I have no idea of the quality of the research or presentation. I am questioning the "factual" information presented in this news article and the potential impact on parents who read it.

There are two concrete bits of information printed in the article.
  1. A late talker is a child who is using fewer than 25 words at age 2.
  2. When helping late talkers build their vocabulary, the 25 words that should form the building blocks of that vocabulary are: all gone, baby, ball, banana, bath, bye bye, book, car, cat, cookie, daddy, dog, eye, hat, hello/hi, hot, juice, milk, mommy, more, no, nose, shoe, thank you, and yes.

Now I have no major objections to the 25 words listed as good building blocks of an early vocabulary with one caveat. The caveat is that when working with children with a severe speech delay, sometimes you have to take whatever you can get and build from there rather than holding out for specific words you got from a list. You might have to start with exclamations, sound effects, or animal sounds before moving on to other words. You might have to kick start expressive language with a communication board or signs. A parent and therapist of a child with severely delayed speech need to be flexible rather than focused on any one ideal list.

I do have a major issue with the accuracy of the first statement: a late talker is a child who is using fewer than 25 words at age 2. Older research in the area of speech and communication disorders often defined "late talkers" as children who were using fewer than 50 words or lacked two-word combinations at age two. Even dated research wanted two year old children to be using at least 50 words at age two, not 25. More recent research shows that the average number of words girls produce at 24 months is 346 and boys produce 252. A vocabulary of below 92 for girls and 63 for boys puts a 24 month old at the 10th percentile. I'm taking this data from the introductory section of Language Outcomes of Late Talking Toddlers at Preschool and Beyond which is an excellent article.

The popularity of the Twenty-Five Words Every Toddler Needs to Know article concerns me because it may persuade parents that they can wait to have their child evaluated by a professional. In fact, children with a vocabulary of 25-50 words who are not using two-word combinations at 24 months should probably be evaluated by a professional.

On a personal note, reading the criterion for concern as a 92, 50, or even 25 word expressive vocabulary were all depressing. Ava had 3-5 words at that age. My worries at that time were completely valid and I certainly do not regret seeking a professional evaluation (other than my own) and early intervention. In fact, I credit intensive early intervention by excellent professionals and the work we do here at home for all the progress she has made in the past year.

2 comments:

  1. This is such a well-written response to that article. As a mother of a child with CAS, I really appreciate what you have to say. I'm so glad I stumbled across your blog. I bookmarked it and will refer back to it often. Thank you!

    ReplyDelete
  2. Thank you for this post, it is very interesting. What I would like to know if the same applies (roughly) to all languages and should we even bother to expose or expect a child with delayed speech to learn other languages? I am asking this because I started working in an ESL nursery class and there is an autistic child who has delayed speech as well...

    The most likely reason he is there is that there is a huge lack of nurseries in native language and practically none of them accept children with special needs - so they gravitate to expensive, private ESL nurseries and schools (practically every more expensive primary school has at least one special needs child as government schools can refuse to take them.)

    ReplyDelete

Web Analytics