SEEK Expert Interview: Language & Speech Development


SEEK talks with Ana Stefanovska, pediatric Speech-Language pathologist, and Melanie Smith, ASHA certified pediatric Speech Language Pathologist, about your child’s language development and what you can do to help it along.


By Becky Horace


SEEK: At what point should we as parents be worried about a child’s speech development and at what age should we consider visiting a specialist?

Ana: Parents should monitor their child’s language and speech development from their birth as they progress through the stages of language development.  Neurotypically, infants should start bubbling by the age of 5 months. Around age of 10-13 months children should begin to produce a few single words, but understand much more. The two words phrases emerge around age of 18-20 months and children start to use short multi-word sentences after their second year.

Parents should refer to a Speech-Language Pathologist if their child is delayed in meeting the language and speech developmental milestones and/or if they feel their child doesn’t understand simple commands, repeats what has been said to her/him, has no or poor eye contact, doesn’t or hardly communicates with other children, doesn’t seem to progress language wise from month to month, doesn’t develop symbolic play, etc.

Melanie: I believe that parents know their child best. If a parent is concerned about their child’s speech, language, and/or hearing, then it is time to seek help. I have many parents who regretfully chose to wait rather than seeking help, but have yet to meet a parent who regretted getting help early. There is no specific age in which parents should suddenly become concerned. If you feel that there is a problem, it is better to be safe than sorry.


SEEK: Scenario- A child has a hard time with pronouncing words or stutters. Will the child outgrow this behavior or would you recommend they will need to seek out assistance?

Ana: It is normal for children to have speech errors when they learn to speak. Most kids will go on to learn how to accurately produce all the sounds. However, at age of 3 their speech should be 70-80% intelligible to strangers and 100 % by age of 4, even though some articulation or phonological differences are likely to be present. 

Normal developmental disfluency (irregularities) and early signs of stuttering are often difficult to differentiate. Many children pass through stages of speech disfluency associated with their attempts to learn how to talk. Children with normal disfluencies in the early years will exhibit repetitions of sounds, syllables, and words, especially at the beginning of sentences.  This happens when they suddenly get “boost” of language and are quickly learning lots of new vocabulary and language structures.  

Melanie:A child who has a hard time articulating words may or may not be in need of assistance. Speech sounds are developmental and are acquired over time. Children under the age of three should be able to use sounds such as p, b, m, n, t, d, h, and w. Some later developing sounds include l, sh, ch, and blends such as tr and st. If your child experiences speech sound errors that negatively impact his overall speech intelligibility or causes frustration, it may be time to have an evaluation.

Stuttering, also called dysfluency, is another speech disorder. It is not uncommon for children between two and four years of age to experience some dysfluency. Children learning speech will stutter as they move from single words to phrases and sentences. However, a dysfluency that persists for more than six months, worsens, or is accompanied by behaviors such as facial grimaces, tension in the head or neck, and eye blinking should be evaluated.

SEEK: Scenario-A parent has been told their little one needs speech therapy; this can be a scary thought.

  • Could you please describe what would happen in a typical session?

Ana: Before making a clinical decision whether the child needs speech and language therapy, a speech and language evaluation should be conducted in order to determine the child’s speech and language levels and from there specific therapy objectives will be determined should the child need speech and language therapy. Therapy sessions differ depending on the child’s age, type and severity of the disorder and child’s personality and behavior.

Melanie: The first session with a speech pathologist is the evaluation and consists of a parent interview and child assessment. If intervention is needed, therapy will revolve around a series of goals set to help your child increase their communication skills. Young children often will not attend long enough to complete flash cards or seat work, therefore goals are targeted through play. Play is an effective way of teaching communication and we make it fun so that your child wants to communicate.

  • Could you give our readers any advice for a first timer who is worried about their child?

Ana: If you are concerned about your child’s speech and language development and/or about the way he/she communicates, do not waste time thinking they will grow the problem, but seek professional advice. Time is precious and the prognosis and pace of development depend a lot on child’s age.

Melanie: It is normal for a parent to worry. Use your concern to educate yourself and seek out professional advice if needed.


SEEK: Are there activities, games, reading aloud, narrating throughout the day or really anything that a parent can do to boost language development in the early years (before they are talking)?

Ana: Parents play a crucial role in their child’s language development. Surrounding the child with language in different situations and talking to the child continuously throughout the day is the best thing parents can do. Activities like reading a story book and pointing at and describing pictures; enjoying music together, singing and dancing; making animal sounds; playing together; using gestures while talking to the child and many other interactive activities will help parents boost their child’s language development.

Melanie: The best way to boost language development is through exposure to language. There are many ways to expose your child to language. Read to your child, talk about your daily activities, and tell stories. Encourage your child to make consonant-vowel combinations such as ba-ba and environmental sounds such as vehicle and animal noises. Language development is much more than just the act of speaking. Children must also learn to make eye contact, perform gestures such as waving hello and goodbye, participate in imitation games like patty-cake, and take turns. Encouragement is also important for language development. Make sure to praise your child’s attempts to communicate.


SEEK: Are there toys you like as a specialist to boost development for speech?

AnaSome of the toys and activities that stimulate language and cognitive development are: blocks, stackers, play dough, kitchen play, farm play, dolls, Mr. Potato head, sensory table, musical instruments, etc. 

Melanie: I have found that the more bells and whistles a toy has, the less likely I will use it in therapy. A toy that makes a lot of noise and repeats a lot of words actually robs your child of the opportunity to use their own voice.

My go-to toys include bubbles, baby dolls, cars, trains, play food or farm animal sets, and Mr. Potato Head.  Remember that toys alone will not do much to develop speech and language. A child needs an adult to play with them using toys to help model speech and language. For example, use farm animals to teach the sound an animal makes, the name of an animal, and concepts such as up/down, on/off, and over/under. Overall, low tech toys and an engaged adult are most important.


SEEK: Why do some children talk very early compared to others? And why do girls seem to talk before boys?

Ana: Children learn to talk at different rates and acquire language at different pace. Speech acquisition may be impacted by genetics, general development, language development, hearing problems, environment, etc.

Melanie: Developmental charts describe skills that are acquired at an average age give or take a few months. Girls tend to be on the earlier side and boys on the later side. One theory is that the areas of the brain that process verbal language differ in boys and girls.


SEEK: For parents who are raising children in a bilingual household, those children seem to speak later; would it be better to only speak one language?

Ana: That is misconception. There is no scientific data that proves that hearing and speaking two languages from birth will cause speech or language delay. However, if a child has language delay in the most dominant language, it is recommended that parents should focus on one chosen language until the child is able to use it functionally.

Melanie: Some children raised in bilingual households do take a little longer to talk, but the delay is only temporary. Young children learning two languages often mix words and grammar from each language. This is a normal part of bilingual language development and is referred to as code switching. If a child has a speech or language disorder it will show up in both languages. At that time you may want to choose the language which is most comfortable.


SEEK: Here is a question just for fun! Why do children always seem to say dad first?

Ana: Most probably because mothers keep on repeating the word ‘daddy’ all the time. In most languages, mother and father are some kind of extension on ‘ma’ or ‘da’ because these are baby’s first sounds.

Melanie: Some believe that ‘dada’ is said earlier because it is easier for little ones to produce.


SEEK: What is your #1 tip for boosting speech development in little ones?

Ana: Surrounding the child with language in everything he/she does. Children need to hear language and interact so that they can develop good language skills later. Children should be encouraged to communicate their needs, first by pointing and gestures and later by words. If a child is not given a chance to do so, they will hardly ever learn to communicate effectively and understand the power of language and communication.

Melanie: I believe that the #1 tip for boosting speech development is an engaged adult who interacts and models speech and language for their child.


Ana and Melanie: Thank you so much for taking the time to answer the interview questions that our readers created for this article. We greatly appreciate your expertise.

*The views and opinions are of the experts being interviewed. If you believe your child needs to see a speech therapist, please take them to do so. Do not use this information as a substitute for an evaluation.


About our specialist

anaAna Stefanovska is a Speech-Language Pathologist, MSc. She graduated from SWU “Neofit Rilski” Bulgaria Bachelor in Speech-language pathology and has a Master’s degree in ‘Voice and fluency disorders’ from the same university. Ana has over five years of pediatric experience and is currently working at Atok- Acorn to Oaks Centre in Bangkok.



unknownMelanie Smith is an ASHA certified Speech Language Pathologist. She graduated from West Chester University with a bachelor’s degree in communication disorders and from California University of Pennsylvania with a master’s degree in speech pathology. She has worked in the public school system for eight years followed by pediatric private practice for the last five years.

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