Why Isn't My Child Talking?

This is the big question for speech-language pathologists. The answer may be many reasons, including medical concerns like premature birth, hearing loss, ear infections, ankyloglossia (tongue tie), genetic conditions (e.g. Down Syndrome), autism spectrum disorder, or the reason may be unknown. However, regardless of any diagnosis or other condition that may be impacting speech and language development, children typically master 11 prelinguistic skills before they are able to start talking. These include responding to the environment, responding to people, turn taking, attention span of between 3-6 minutes, joint attention, playing with a variety of toys, receptive language, vocalizing purposefully, imitating, using gestures, and finally, initiating.

Many of these skills develop very early in life. Babies are already able to respond to the environment while in their mother’s womb by recognizing mom’s voice or moving when prodded. Babies also start responding to people with social smiles around 6 weeks of age. Turn taking involves participation in social games such as patty-cake or even something as simple as, baby hits the table, mom hits the table, then back to baby. Attention span refers to being able to stay with an activity for a length of time, not including screen time. Joint attention differs from attention span because it’s the child’s ability to look at an object and then look at a person to share in that object. It’s including another person in the child’s experience, which is essential for him to attach meaning and connect a word with an object. The next skill, playing with a variety of toys, helps children develop cognitively. This is so important for learning language because cognition and language go hand-in-hand. Receptive language is a child’s ability to understand directions and point to objects that are named. Vocalizing purposefully is when we start to hear babbling (e.g. bababa, mamama), and we may see the child vocalizing to gain attention. Imitation includes baby copying mom or dad by waving bye-bye, fake coughing or sneezing, and eventually, words. Gestures involve baby lifting his arms up when he wants up, clapping hands, or nodding yes or no. The final skill, initiation, means that baby is doing something to gain attention, which may be vocalizing. Once a child has developed these skills, you will start hearing spontaneous words. The first word for children emerges around 12 months of age, so all of these prelinguistic skills have developed by the time they turn 1!