Speech Delays in Twins - Identifying Speech Delays in Multiples

Identifying Speech Problems In Your Children

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Should you be concerned when your toddler multiples say “love you” and it sounds like “lub ou”? Do your twins jabber to each other in a language that no one understands except them? Are your multiples’ communication skills worrying you?

As a parent, it is often difficult to discern when language skills are developing normally and when a child might need some outside help. Multiples tend to experience a higher rate of speech and language development disorders.

Many factors contribute to a speech and/or language delay in multiples.

• Multiples often engage in twin talk, a spoken language or a language of gestures and body language. Multiples are often so effective at communicating with each other that their speech and language development can be delayed.

• Personality differences and the gender of a child often influence the rate of speech and language development. Girls tend to be more verbal than boys. Shy and apprehensive children tend to be quieter.

• Multiples place increased demands on parents limiting the amount of one-on-one attention and interaction each child receives.

• One multiple may “talk” for another multiple reducing the need for the “quiet” child to talk. This can also occur with older siblings who are quick to talk for the child instead of having the child verbalize their feelings.

    These general guidelines can help you determine if your child could be experiencing a delay:

    Between 12-24 months, your children should:
    Combine two simple words
    Have a working vocabulary of between 10 – 20 words
    Be able to imitate some animal sounds
    Wave good-bye
    Be understood approximately 25% of time by non-family members

    Between 24-36 months, your children should:
    Ask simple “what” and “why” questions
    Have a 450-word vocabulary
    Be able to tell their name
    Answer “where” questions
    Match 3-4 colors
    Identify body parts
    Use 3-4 word combinations
    Follow simple instructions
    Be understood at least 50% of time by non-family members

    Between 3-4 years your children should:
    Use 4-5 word combinations, talking regularly in sentences
    Have a vocabulary of about 1,000 words
    Begin to name colors
    Be able to tell a story
    Be able to repeat a nursery rhyme
    Be understood at least 75% of time by non-family members
    Be able to follow 2-3 step instructions
    Understand most of what is spoken to them

    Between 4-5 years, your children should:
    Use past tense correctly
    Have a vocabulary of about 1,500 words
    Be able to identify major colors
    Understand concepts of opposites
    Speak clearly
    Use more than 5 words in a sentence
    Re-tell a story in own words

    Though speech/language delays may be common in multiples, they can have a profound effect on their success in school. Proper speech and language development are building blocks for good reading and writing skills. So what do you do if one or all of your multiples are not meeting these guidelines?

    If you suspect a delay in language development contact your pediatrician. You can also pursue an evaluation on your own through a private speech therapist (verify coverage with your insurance carrier) or through your local Early Intervention Program or school district. The Individuals with Disabilities Act (IDEA) ensures that every child is guaranteed to receive free and appropriate education, including speech and language therapy.

    The Evaluation Process

    Your pediatrician should refer your child to the proper agency for an evaluation. However, a pediatrician’s referral is not required. As a parent, you have the right to request an evaluation.

    If your child is under age 3 and you will not be utilizing a private speech therapist, you can contact your local Early Childhood Intervention program through your city or county Health Department. Check the blue pages in the phone book for a listing.

    After you make the initial contact, an evaluation will be scheduled. Normally, this means a team of qualified people will come to your home for the assessment. In-home evaluations allow the children to interact in a familiar environment. The evaluations are normally play-based and are enjoyable.

    For older multiples, the evaluation process will be arranged through the school district. After your child is referred for an assessment, an appointment will be made for an evaluation.

    The evaluation normally takes place in a play-based environment full of toys, puzzles, blocks, and other stimulants. Usually, the parent stays in the room while a team of qualified persons interacts with the children, recording their verbalizations. A screening may be performed to determine if a hearing loss exists.

    Receiving Therapy

    If the results of the assessment indicate a problem, therapy can help overcome it. Children under age 3 will probably benefit by receiving therapy in the home during visits from a degreed speech pathologist. The frequency of therapy will depend on your child’s needs and requirements. Your therapist will provide hints and strategies for you to use at home to encourage and strengthen your multiples' language and speech skills.

    Local school districts should provide therapy opportunities for children over 3. In most cases, a committee will determine the best course of therapy for each child, outlining the goals and objectives they would like to see the child accomplish. Programs vary and are based on need; some children may only require a weekly 30-minute session focusing on articulation. Others may qualify for preschool programs that emphasize speech and language development; these children attend 2 to 5 times a week for 2 to 3 hours per day.

    Most speech therapy is play-based, encouraging them to talk about and build on subjects of interest. Therapy for older children focuses in large part on language development, increasing their vocabulary and word combinations, as well as speech (articulation skills).

    For example, at snack time a child must verbalize what she wants, rather than pointing or grunting, in order to receive the snack. Children are always encouraged to talk and provided many opportunities and stimulants to create conversation through toys, games, circle time, etc. If articulation problems exist the therapist will play games with the child to strengthen the tongue and lips so the child is able to form them correctly when speaking.

    Whether your multiples are in an Early Intervention program or receiving therapy through the school district, their development is measured by how well they meet goals and objectives.

    Once they show measurable progress and meet or exceed those goals and objectives, they will be exited out of the program.

    To help prevent speech delays, or if you are concerned that your multiples may be experiencing a delay, there are some things you can do to help. Aside from seeking professional help, there are some strategies you can employ at home.

    1. READ! Read out loud to your twins every single day. It's a great opportunity to encourage language. Point and talk about pictures and words on each page. Ask them, "What do you think happens next?" and other questions.

    The more conversation there is between parent and child, the more opportunities for language skills to develop. Limit the amount of television your child watches. Those moments may provide a parent with much-needed sanity, but they do little to encourage language development.

    2. Repeat. When your multiples speak to you, show each child that you understand what he said by repeating back his words and expanding on the information given. For example, if Jack asks for milk by saying “milk,” respond with “Jack would like some milk. Look Jack, we have a green cup for your milk.”

    3. Talk. Talk often with each of your twins or multiples. Turn off the radio in the car and talk about where you are going and what you will do when you get there. For example, on the way to the zoo talk about all the animals you will see there, and the sounds that each animal makes. At home describe the different ingredients you are using as you cook.

    As you pick up around the house, talk about the toys you are putting away.

    4. Respond appropriately. If your toddler points or grunts at items, do not reward his lack of language by giving him what he wants. Instead, only respond when an effort to verbalize the request has been made. Any attempt to verbalize should be rewarded and praised.

    Don't frustrate the child by correcting or demanding that he “say it like this.” Instead, model the correct way, such as, “Cookie? Do you want a cookie? Here is your cookie.”

    5. Take turns. If you have older children who try to “talk” for the children, speak to them about the importance of letting the little ones ask for things. If your child’s twin is trying to do all the talking for him, encourage the twin to let “Jack have a turn to talk.”

    When my identical twin boys turned two, I suspected they were speech delayed. “That’s okay,” I told myself, “They are twins – it’s normal. They’ll catch up.” By 2 1/2 they talked in very simple 2-3 word combinations. My pediatrician said, “No need for concern as long as they are talking in 2-3 word combinations.”

    But more often than not they talked in 1-2 word combinations and the words they used were very simple.

    When we would listen to other two-year-olds, we knew that our boys weren’t where they should be. Yet, Jon was talking more and his vocabulary seemed to be growing. James too was making progress, but not at the same rate. My sister, a speech pathologist, encouraged me to seek help. “Call Early Childhood, Suzie. Get an evaluation. What do you have to lose?” But I hesitated. My pediatrician said they were fine. I was busy. I was apprehensive about labeling them “special needs.”

    As the boys approached their 3rd birthday my sister came to stay with us for a visit. This time she was not so gentle. “Suzie, the boys need to have an evaluation. You have GOT to call.”

    I quickly contacted the pediatrician who gave me the local Early Childhood Intervention phone number. Because the boys were approaching their third birthday they referred me directly to the school district. We are fortunate to live in a district with an excellent special needs program.

    The process was surprisingly easy. Jon and James were evaluated separately and thoroughly enjoyed the process. While they are identical twins, their speech development is not. Jon was too verbal to qualify for therapy. James, our quieter, smiley, more affectionate twin qualified for a “communication classroom” two hours a day, three times a week.

    For the first time in their lives, they faced separation. I debated sending James, wondering if I would do more harm than good by separating them. “He won’t understand why he has to go and Jon doesn’t,” I lamented. The first day was the toughest. James cried because Jon wasn’t going with him. After picking James up from school, Jon immediately ran up to James and said, “James you miss me?” To which James answered a big and sorrowful “Huh huh” (meaning yes) and they embraced for several minutes right in front of the Maggie Moo Ice Cream Store.

    While we approached the therapy with mixed emotions we can already see the benefits. In a few months, Jon will join James at the pre-school as a peer-based student. Though they will not be in the same classroom, perhaps James will have the comfort of knowing Jon is at the same school. James is learning every day that he doesn’t have to “lean” on Jon for his words and his companionship. I was right about them catching up. They are catching up; I just needed some help getting them there.

    More resources on speech delays:

    • Identifying speech delays in multiples
    • How to Get Help
    • Ways to Enhance Speech Development

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