When should I worry about my child’s speech delay?

How do I know when to panic!?

Ok the title is a bit dramatic (can you tell I did a GCSE I drama!?) but I was asked this question this week. When is it just a child developing at their own rate vs. when should you ‘worry’.

The person I have having this conversation with was telling me how stressful they find milestones. Which I totally understand. They don’t give s true picture of what’s going on, and it feels horrible to stress particularly if that stress is not needed.

The other side of that argument involves something to do with burying heads in sand and early intervention being the best. So here are my recommendations on what to do if you’ve check the milestones and your little one isn’t quite where they should be.

0-3 months behind where they should be:

This falls into the ‘every child develops at their own rate camp’ I wouldn’t worry too much about your little one being ‘behind’. There is never any harm in following good communication practice (basically all the advice on my blog or Instagram page) e.g.  getting down at their level, replacing questions with comments, repeating back what they say, following their interests etc. and I many cases this will be enough to support your little one’s continued development.

4-7 months behind where they should be:

This is the stage when we want to start being a little more ‘active’ with looking for support. So this might be you if your child is 2 & 1/2 years old and is using single words but not yet 2 words together.

Things to do here: follow the same advice as above (good communication practice) and get those referrals in. NHS referrals can take a little while, and if by the time you’re at the top of the waitlist your child no longer needs support then no one has lost anything. This does happen by the way! Some children are a few months ‘behind’ for a bit and then just get there in their own time, but there is no harm making that referral.

Who should you refer to?

-       Audiology for a hearing test

-       Speech therapy or flag that they need support with communication, depending on their age and where you live this initial support might be provided by a health visitor or another service. If in doubt raise this with you GP.

My next parent training course is also appropriate for you if you’re in this bracket. The course increases your child’s ability to express themselves, reduces their frustration, and empowers you to understand their communication strengths and needs.

8-12 months behind where they should be:

If your little one’s delay is approaching 12 months then this is the time to get them that extra support. Previous recommendations are valid, in addition make their nursery aware of their communication needs, ask for a plan to be put in place to support them and if they can make a referral to any services that can support your little one.

If you haven’t already made a referral to speech therapy, do so, and ask how long the wait is likely to be.

If your little one is under 4 my parent course is still appropriate for you. I also have online and in person 1:1 support appointment slots available. Get in touch if you want to know more.

13 months+ behind where they should be:

If you are reading this and this is your little one, please don’t panic. The fact that you’re reading this is a sign to get your little one some support. All the previous recommendations apply and…

-       Have a chat with your GP about your child, sometimes they have a bit more power to get children seen sooner or to put additional referrals in.

-       It might be that it is worth having a paediatrician involved as, unlike GPs they are specialist in child development and will know what support your little one might benefit from.

-       It is really key to have open conversations with your child’s nursery and find out what support they are putting in place to help them. They may discuss an IEP (individual education plan) with you which is a way for them to put really specific (as opposed to generalist) support in place for your child, and track their progress.

They were developing typically and now they have paused or regresses:

This is something to keep a close eye on. It can happen when there is a bit of change in little one’s lives so isn’t always something to worry about. It can however indicate an episode of hearing loss or that there are some differences in the brain going on so it is an important thing to keep an eye on.

Record keeping is key here. I would recommend:

-       Writing down when you noticed a change happening and what that change was.

-       Putting a reminder in your phone/ calendar to check in a month to see where you are at. Are they still regressing or have they resumed where they were?

-       If there is a rapid regression over a short space of time and things do not feel right contact your GP.

-       If the regression is steady and goes on for 4+ months, contact your GP and follow my recommendations on referrals & support listed above.

They are doing things outside of ‘typical’ development:

This is one to keep an eye on. It depends on what your little one is doing, and if it is impacting them. Are they able to follow instructions, express their needs and make friends? If yes, then keep an eye on things and if any of those things change it is worth speaking to your GP. If they are struggling then get those referrals in, it’s particularly worth speaking to nursery as they may have a different learning style that needs us as adults to adapt to.