Every child learns to talk at different times. If you are concerned, schedule a free consultation to talk about whether or not your child is on the right track, or take our quiz to see whether or not your child may need a speech therapy evaluation.

Below are some communication milestones to help you determine whether your child may be delayed in speech or language:

12-15 months: speaks first words, uses gestures such as pointing or waving bye-bye, responds to name, understands simple instructions, understands quite a few words and can identify an object or person by pointing or looking. For example if you say “Where’s daddy?” They should be able to find him in the room by looking.

21-24 months: uses two-word combinations, can point to identify objects or pictures in books, follows simple directions, knows names of familiar people and objects. Parents and regular caregivers can understand about 50% of the child’s speech. The child should have about 200-300 words in their vocabulary

36 months: frequent three-word combinations, can carry on simple conversation, asks why, where, what, when, and how questions

4 years: familiar and unfamiliar listeners can understand the child’s speech in conversation 90% of the time, says all speech sounds in words, follows 3-step directions like "put your pajamas on, brush your teeth and and wash your hands", keeps a conversation going

5 years: uses grammatically complete sentences most of the time, follows three-step directions (e.g., put on your shoes, get your coat and wait by the door), keeps a conversation going, can consistently say these speech sounds correctly: /p/, /b/, /m/, /h/, /n/, /w/, /d/, /k/, /g/, /d/, /f/, “y”, answers a variety of questions, including “yes/no”, “what”, “who”, “where”, “why”, “how”, “when”, and “how many” (as long as there are only a few things)

Parents are often told by pediatricians not to worry if their child is not yet talking, and that their child will "grow out of it". According to the Hanen Centre, "It can be difficult to predict which children will not catch up to their peers. However, a list of risk factors has been identified, which suggest that a child is more likely to have continuing language difficulties. These include:

-quiet as an infant; little babbling

-a history of ear infections

-limited number of consonant sounds (eg. p, b, m, t, d, n, y, k, g, etc.)

-does not link pretend ideas and actions together while playing

-does not imitate (copy) words

-uses mostly nouns (names of people, places, things), and few verbs (action words)

-difficulty playing with peers (social skills)

-a family history of communication delay, learning or academic difficulties

-a mild comprehension (understanding) delay for his or her age

-uses few gestures to communicate

Children who demonstrate the final three risk factors above (family history, comprehension problems, or few gestures) are at greatest risk for a continuing language delay. Instead of adopting a “let’s wait and see” approach, The Hanen Centre recommends getting help for toddlers who are late to talk as early as possible".

Below is an article that discusses the importance of early intervention:

Late Talker Study

Yes! There are many strategies you can use at home to help your child grow his or her communication skills. The following are some tools you can implement during your daily activities at home such as getting ready in the morning, play time, meal times, driving in the car, and getting ready for bed.

• Talk to your child throughout the day, even if they have not started talking yet. Talk about what you are doing, seeing, listening to, eating, or touching. For example, “I’m washing the dishes. Now I’m drying them. All done with dishes!” Keep it short and simple!

• Talk about what your child is doing when they are playing. For example “You’re building a tower. Your tower is so tall! Oh no, blocks fell down!”

• Expand your child’s language. Add in missing words to make it a grammatically correct sentence. For example, if they say “car” say “Yes, that’s a car. The car is red. The car goes fast!” Or if they say “baby cry”, you could say “The baby is crying”. The more language your child hears, the more likely they are to eventually use those words. A good rule of thumb is to repeat a word 3 times when you are targeting specific vocabulary. For example if you want to teach your child the word “mama”, you can say “Mama! Mama is here. Mama loves you”.

• Don’t expect your child to repeat you. Narrating language exposes your child to language and helps your child understand that talking is both useful and fun!

• Don’t ask too many questions. Asking questions can make your child feel like you’re testing them and may cause them to "shut down". Say your child picks up a toy car. Instead of asking your child “What is it?” You could say “That car is fast!” Then pause and wait a few seconds to see if they say anything. If not, add another comment. “I like your car”. Then after a few moments, you can throw in an open ended question like “Where is the car going?” Don’t be discouraged if they don’t respond, since open ended questions can be a difficult word retrieval task.

• Give choices. If your child isn’t responding well to questions, then offering choices may be a little easier. When we give choices, we are showing them that they have some control and that their input matters. Choices also encourage decision making and promote language development. “Do you want to play with the boat or the airplane?” Have them both in your hands and hold each one up while you present the choices. Offering a choice makes it easier for them to imitate and repeat and allows them to point or gesture if they are not talking yet.

A child’s speech and language development depends on many factors, including underlying diagnoses (e.g., autism, developmental delay, hearing loss), type and severity of the speech or language issue, attention span, the child’s willingness to participate, regular attendance, family involvement and at-home practice.

Your child’s treatment will be reassessed every six months in order to measure progress and make any necessary modifications to the plan of treatment.

According to ASHA, being bilingual does not cause delays in speech and language development. Although bilingual children may have some challenges starting school if they do not speak English, true speech/language disorders are not caused by exposure to two languages at a young age. In fact, studies have shown that being bilingual provides children with educational and other long-term advantages.

Children growing up in a bilingual home are expected to meet the same communication milestones as children who are exposed to only one language. Most bilingual children will speak their first word around age 1 (e.g., "mama", "dada"), and will use two-word phrases by age 2 (e.g., "more milk"). Some children may use words from both languages in the same sentence or mix grammar rules between the two languages. However, this is to be expected for bilingual language development and does not mean that the child has a true language disorder. Some children may not talk much when they start using a second language. This “silent period” may last for several months. This is considered normal and will most likely go away.

Bilingual children will typically use one language more than the other, and this dominant language may change over time. For example, the dominant language may be Spanish until the child begins attending school and learning English. The dominant language may eventually switch to English. Children will typically continue to understand Spanish and speak it occasionally, but become more proficient in speaking English.

No! It is fine to work with two speech therapists. The two therapists may collaborate to discuss the child’s goals and progress in therapy. The benefit of private therapy is that the therapist works with the child one-on-one. This is typically not the case in the school setting due to large student caseloads. Private therapy during the summer may help your child stay on track with his or her goals and prevent a regression in skills over the summer.

If your child had an evaluation at school or another therapy practice within the past six months, a full evaluation is not necessary. We just ask that you provide the therapist with a copy of the evaluation report, goals that were being worked on if any, and any additional paperwork or notes you have from previous speech evaluations or therapy.

We are currently in-network with Horizon Blue Cross Blue Shield of New Jersey, Aetna and Cigna.

Patients who have other health insurance plans may be eligible to be reimbursed a significant portion of our fee. At the end of your evaluation or session, the therapist will provide you with what is called a superbill. You may submit the superbill to your insurance company for potential reimbursement.

The patient is responsible for contacting the insurance company to determine if you are eligible for reimbursement for our services.

Here are some questions to ask your insurance company:

Do I have speech language pathology insurance benefits?

Do my benefits cover developmental speech language pathology services?

How much does my plan reimburse for an out-of-network provider? (What percentage of the fee will I be reimbursed?)

Is approval required from my primary care physician? Is pre-authorization required?

What is my deductible and has it been met?

How many sessions per year does my health insurance cover?

What is the coverage amount per therapy session?

Are there any other restrictions I should know about, or any other questions I should be asking?

No, a doctor’s referral is not necessary to receive an evaluation or treatment at Wise Choice Speech Therapy. However, certain health insurance benefits may require a written referral from a doctor. We recommend that you speak with your health insurance provider directly to determine if a doctor's referral is required to receive reimbursement for services.