Frequently Asked Questions

At what age should I be concerned about my child’s communication? Between 12-18 months of age, a child’s understanding of words increases dramatically.

The child understands many simple instructions, knows the names of the people they are close to, attempts to copy words and actions and engage in simple play routines. They start to speak their first words.

If your child is 18 months and does not seem to follow simple everyday instructions, does not point, does not say any word, then it is advisable to see a speech therapist for screening to rule out any difficulties or otherwise.

• My two-year-old child follows every instruction but is not yet talking. What could be the problem?

There are several reasons why a child may not be talking. A child may not be talking because they are having difficulties expressing themselves using language or their brain may be having difficulty sending messages to the muscles in the lips, jaws, teeth, tongue. This process; when and how to move to the right spot is known as childhood apraxia of speech.

Children with hearing loss may have difficulties with saying words as they may not be hearing the sounds well enough to produce them but may be able to follow instructions because of the cues they get from the environment.

A child with an anxiety disorder which results in a persistent inability to speak in specific social situations may sometimes have this presentation (selective mutism). The best way to understand why this is happening is to see a speech therapist for an assessment.

• My child used to say some words, but suddenly stopped talking. Are they intentionally refusing to talk?

No, they are not intentionally refusing to talk. Sometimes children have speech regression after something traumatic in their lives such as death of a parent, birth of another child, moving houses etc.

It is reported that about ¼ (one-quarter) of children with autism suddenly or gradually lose their words between 18 months and 24 months. The best thing to do if you notice this is to see a speech therapist for an assessment.

• We speak two or more languages at home with the child, could it be that their language difficulty is because he finds the combination of languages confusing?

Children with language difficulties certainly have the capacity to learn more than one language. They do not appear to develop their two languages differently or to a lower level of proficiency than children who speak one language.

There is no reason to therefore stop bilingual development on the grounds that these children’s language learning difficulties might worsen if they have two languages to deal with instead of one.

The causes of speech, language and communication difficulties are varied and complex. Bilingualism or multilingualism is however not one of them.

• My child is two years and not talking. My husband spoke at three years. Should I be worried?

Although the family history of speech, language and communication development is very important, we cannot rule out that in some instances it may not be the same thing happening and for which reason we cannot use the ‘wait and see’ approach. It is always advisable to see a speech therapist to rule out any concerns early on.

• I have been going for speech therapy for some months now, but my child is not talking. Why?

Speech and language therapy does not only focus on talking but on communication as a whole i.e. such as being able to get their message across. Your speech therapist will often explain to you what the goals for your child are after assessment.

The goals vary from child to child. There are some basic skills that need to develop before speech develops. If your child has difficulties with those skills, your therapist may focus on building on those first.

• My child is two years and was recently diagnosed with autism, will he ever talk?

It is difficult to tell if your two-year-old will be verbal. Early intervention however makes a huge difference in the lives of children with autism and the outcome is often good.

It is therefore helpful to see a speech and language therapist who will assess your child and provide them with the appropriate intervention.

The writer is Speech & Language Therapist/Clinical Tutor, University of Ghana. E-mail: jobamp@hotmail.com