At almost every pediatrician visit we parents are asked to quantify aspects of our child’s daily life – How much are they eating? How long are they sleeping? How much screen time (ugh, free pass on that one for the last two years, right!)?
And for years the standards by which our healthcare providers measured our responses remained fixed. But the CDC recently published some new guidelines for assessing pediatric development with the stated goal of helping identify more children for early intervention services and decreasing the use of the “wait and see” approach. We speech-language pathologists (SLPs) definitely understand and advocate for early intervention, so are we celebrating?
Not exactly.
The “new” speech and language milestones being suggested don’t jive with the evidence-based norms we have been using to measure development for decades. For example: the new guidelines recommend expecting an 18 month old child to be using around 3 different words. But on commonly used and well-supported language assessment tools, an expressive vocabulary of 3 words at this age would indicate a need for intervention. (We would expect closer to 25-50 words at this age).
If we lower standards such as the number/variety of words that we expect at a given age, that could actually DECREASE the number of kids who are identified as needing help and could prevent them from getting the services they need during the critical language development period.
So how does this impact families currently in or considering pursuing speech and language services for their child?
For families currently in treatment: Congratulations! You are on a path to help your child improve their communication skills. Your services won’t be impacted by this change in recommendations by the CDC. Your child has been evaluated by a professional and determined to be appropriate for services using evidence-based norms as well as consideration of the functional impact of their communication within their home and or community environments.
For those with concerns but not currently in treatment: Your pediatrician is often your first stop when you have a developmental concern about your child, but that doesn’t mean they have to be your last. When it comes to communication, SLPs are the experts! If you are concerned about how your child is expressing themself or understanding the communication of others, an evaluation or screening by an SLP is a good first step. You can also take a look at these speech and language specific milestone charts for children birth to age 5 or school age from the American Speech-Language-Hearing Association for some more guidance.
As a parent, you know your child best! If you’re concerned, it’s always worth an evaluation. Don’t be afraid to voice your concerns and ask for a referral. While milestone charts are a helpful tool to guide assessment, children are more than just the numbers with which we quantify them. A high-quality speech and language evaluation will look at the quantity (number of words, variety of sounds, frequency of gestures) AND quality (frustration with expression, social aspects of language) of their speech and language skills to make sure they are on track for communication success.
At Stewart SLP, we always provide free speech-language screenings to children ages 3-6 years and comprehensive speech-language evaluations for children of any age. We will let you know if your child is on the right track or if additional supports would be helpful. You can contact us for more info or to schedule an appointment. We’re here to help!