NAPNAP's Developmental-Behavioral & Mental Health SIG
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Developmental Delay: 
Speech and Language

Page Contributors:  Tiffany Lambright, MPH, RN, Anita Allouche, RN, BSN, BA, Kameron A. Sperduto, BSN, RN, and Heather Jenkins-Rosales, BSN, RN
Overview
  • Speech Disorders caused by difficulties with the production of sounds, with articulation or pronunciation, stuttering, or vocal problems.
  • Language disorders caused by problems understanding language (receptive language disorder) or difficulty communicating thoughts, ideas and/or feelings in words (expressive language disorder).
  • Language delay is when a child’s develops language in the expected order but at a slower rate than average.
  • Different types and causes of Childhood Speech & Language Disorders (American Speech-Language-Hearing Association, 2015)
  • Speech and Language Delay and Disorder - University of Michigan Health System website
  • Speech development by age (table)
Consider a referral for speech/language development evaluation for any child who (ASHA, 2013):
  • doesn’t smile or interact with others (birth–3 months),
  • doesn’t babble (4–7 months),
  • makes only a few sounds or gestures (eg, pointing; 7–12 months),
  • says few words (12–18 months),
  • doesn’t understand what others say (7 months–2 years),
  • doesn’t put words together (18 months–2 years),
  • has speech that is unintelligible to unfamiliar listeners (2–3 years),
  • struggles to say sounds or words (2½–3 years).

Assessment & Screening

  • Ages and Stages Questionnaire for development screening ($)
  • Parents’ Evaluation of Developmental Status (PEDS) ($)
  • The Survey of the Wellbeing of Young Children



Position Papers

  • Screening for Speech and Language Delay and Disorders in Children Aged 5 Years or Younger: US Preventive Services Task Force Recommendation Statement (2015) 
  • Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening (AAP, 2006) -- Open Access AAP Policy Statement *Includes table of screening tools: AAP Council on Children with Disabilities.

Articles

  • Speech-Language Impairment: How to Identify the Most Common and Least Diagnosed Disability of Childhood (Prelock, et al, 2008)
  • Ten questions about terminology for children with unexplained language problems (Bishop, 2014) 
  • Management of Developmental Speech and Language Disorders (O'Hare & Bremner, 2016)
  • Validity of the ages and stages questionnaires in term and preterm infants (Schonhaut, et al, 2013)

Resources

Treatment 
  • In California, if under the age of 3, refer to local regional center. If over 33 month of age, refer to local school district.
Interventions
  • Find your local Regional Center (California)
  • Reach out and Read
  • Hanen Centre
  • Activities to promote speech
Other resources: 
  • Information about Early Intervention Law
  • Healthy Children.org -- Speech and Language
  • CDC page on Developmental Monitoring and Screening in Children
  • Ability Path (Parents) -- includes video on speech and language development
  • Kids Health - Delayed Speech or Language Development (Parents)
  • Tips for Helping Toddlers Develop Language at Home - video

Organizations

  • American Speech Language Hearing Association
  • Parent to Parent USA
  • Apraxia Kids (Providers and Parents) *Includes Webinars ($) 
  • Healthy Child.Org (From the American Academy of Pediatrics): www.healthychildren.org
  • Developmental Delay Resources (DDR): www.devdelay.org/
  • Help Me Grow National Center: www.helpmegrownational.org
  • First Signs: www.firstsigns.org
  • Act Early! National Center on Birth Defects and Developmental Disabilities: www.cdc.gov/ncbddd/autism/ActEarly/default.htm
  • National Center of Medical Home Initiatives for Children with Special Needs: www.medicalhomeinfo.org/
  • Zero to Three: www.zerotothree.org
  • National Institute of Health (providers)
  • Center for Parent information and Resources (ParentHub)






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