Communication and Your Newborn

Do you remember your baby's very first cry? From the moment of birth, your baby began to communicate. At first, your newborn's cries may seem like a foreign language to you. But before you know it, you will learn your baby's "language" and be able to provide him with what he needs.

Right after birth, you introduced your baby to your own ways of communicating: touching, soothing, holding and making facial gestures. Your baby will learn your "language," just as you will learn his.

How does my baby communicate?

Your baby is born with the ability to cry, which is how he will do most of his communicating for a while. Your baby's cries generally tell you that something is wrong in his world: his belly is empty, his bottom is wet, his feet are cold, he's tired, he needs to be held and cuddled. Soon you will be able to recognize which need your baby is expressing and respond accordingly. In fact, sometimes what a baby needs can be identified by his cry - for example, the "I'm hungry" cry may be short and low-pitched, while "I'm upset" may sound choppy.

Your baby may also cry when he is overwhelmed by all of the sights and sounds of the world. Sometimes he may cry for no apparent reason at all. Don't be too upset when your baby cries and you aren't able to console him immediately: crying is one of his ways of shutting out stimuli when he's overloaded.

Crying is your baby's main method of communication, but he is also capable of other, more subtle forms. Learning to recognize them is exciting and rewarding and can strengthen your bond with your baby.

A newborn can differentiate between the sound of a human voice and other sounds. Try to pay attention to how he responds to your voice. He already associates your voice with care: food, warmth, touch. If he's crying in his bassinet, see how quickly your approaching voice quiets him. See how closely he listens when you are talking to him in loving tones. He may not yet coordinate looking and listening, but even if he stares into the distance, he'll be paying close attention to your voice as you speak. He may subtly adjust his body position or facial expression, or even move his arms and legs in time with your speech.

Sometime during your newborn's first month, you may get a glimpse of his first smile and perhaps hear his first laugh or giggle. What welcome additions these are to his communication repertoire!

What should I do?

As soon as you hold your baby after birth, you will begin to communicate with each other by exchanging your first glances, sounds, and touches. Your newborn is already learning about the world through his senses.

As the days after birth pass, your newborn will become accustomed to seeing you and will begin to focus on your face. His senses of touch and hearing are especially important, though. Your infant will be curious about noises he hears, but none more so than the spoken voice. Talk to your baby whenever you have the chance. Even though he doesn't understand what you're saying, your calm, reassuring voice is what he needs to feel safe. With almost every touch your newborn is learning about life, so provide him with lots of tender kisses, and he'll find the world a soothing place to be.

Communicating with a newborn is really a matter of meeting his needs. Always respond to your newborn's cries - he cannot be spoiled with too much attention. Your prompt response when your baby communicates will let him know that he's important and worthy of attention.

There will probably be times when you have met all of your baby's needs, yet he continues to cry. Don't despair - your baby may be overly stimulated, have gastric distress, or may have too much energy and need a good cry. It is common for babies to have a fussy period at the same time every night, generally between early evening and midnight. This can be very upsetting, but the good news is that it's short-lived; most babies outgrow it around three months. There are some things you can try to soothe your baby. Some babies are comforted by motion, such as rocking or being walked back and forth across the room, while others respond to sounds, like soft music or the hum of a vacuum cleaner. It may take some time to find out what best comforts your baby during these stressful periods.

Should I be concerned?

You may want to talk to your doctor if your baby seems to cry for an unusual length of time, if the cries sound odd to you, or if the crying is associated with decreased activity, poor feeding, or unusual breathing or movements. Your doctor will be able to reassure you or look for a medical reason for your baby's distress. Chances are there is nothing wrong, and knowing this can help you relax and stay calm when your baby is upset.

Here are some other reasons for prolonged crying:

If you have any questions about your newborn's ability to see or hear, you should bring them to your doctor's attention immediately. Even newborns can be tested using sophisticated equipment, if necessary. The sooner a potential problem is caught, the better it can be treated.


© Copyright 1997 American Medical Association.
All rights reserved.

This article is provided by Medem, Inc. All rights reserved


Communication and Your 1-2 Year Old

Language development really takes off during this time, especially as your baby approaches his second birthday. He is better able to comprehend what you say and express what he wants. He will take joy in his ability to understand more complex directions - and he won't hesitate to give you directions.

How does my baby communicate?

Most babies say their first words toward the beginning of this period, though some start even sooner and others don't start talking until they are nearly 2 years old. If your baby is preoccupied with learning to walk, he may push talking to the back burner; this is not unusual and nothing to be alarmed about.

Your baby may have learned fragments of dozens of words that probably won't be recognizable yet. When he gets around to talking, though, he'll probably progress quickly. He'll soon be able to point at something familiar and say its name, and recognize names of familiar people, objects and body parts. By two years, he may use phrases and even two- to four-word sentences.

No matter when your child says his first words, it's a sure bet he'll be understanding much of what you say to him well before that. He should be able to respond to commands ("Roll the ball to Mommy") and should be fully aware of the names of familiar objects and family members.

You will undoubtedly find yourself struggling with your toddler to do as you say, only to have him ignore you or scream in protest. He's merely testing your limits and his degree of control. By 18 months, he will probably have mastered saying "no" with authority, and by age 2 he may throw a tantrum when he's unwilling to do something you ask. He'll also show signs of possessiveness, and you'll frequently hear "mine" or see tears if something is taken away or you show attention toward someone else.

What should I do?

Your baby is listening to everything you say, and he's storing it away at an incredible rate. Instead of using "baby" words, teach him the correct names for people, places and things. Speak slowly and clearly, and keep it simple.

Your baby may still be communicating with gestures such as pointing to something he wants. Gestures are OK, but you should use a running commentary such as, "Do you want a drink?" (when he points to the refrigerator), then wait for a response. Then say, "What do you want? Apple juice? OK, let's get some apple juice." Such behavior encourages your baby to respond and participate in conversations. But don't frustrate your baby by withholding food or drink waiting for a response.

Between 15 months and 18 months, your baby will probably begin to enjoy language games that ask him to identify things, such as: "Where's your ear?" and "Where is Mommy?" His vocabulary will grow quickly, but his pronunciation isn't likely to keep pace. Resist the temptation to correct your baby's pronunciation; most babies mispronounce their words. Instead, emphasize the correct pronunciation in your response.

Should I be concerned?

Some babies don't talk until their second birthday and choose instead to get by with the use of gestures and sounds. Vocabulary varies widely at this age, too; some babies say dozens of words, others only a few.

Most babies this age have these communication milestones in common:

Hearing problems may become more apparent during this stage because of the emergence of speech. Don't hesitate to report any concerns you have to your doctor immediately, especially if you feel your child is not babbling or responding to your speech patterns. Sometimes chronic ear infections can leave children with excessive fluid buildup that can interfere with normal hearing. Special tests can check for hearing loss.


© Copyright 1997 American Medical Association
All rights reserved.

This article is provided by Medem, Inc. All rights reserved.


Communication and Your 2-3 Year Old

Why is it important to communicate with a child in this age group?

Communicating with your child, from infancy onward, is one of the most pleasurable and rewarding experiences for both parent and child. Children are avid learners at all ages, absorbing information through daily interactions and experiences with other children, adults, and the world.

How can parents communicate with a child in this age group?

The more interactive conversation and play a child is involved in, the more a child learns. Reading books, singing, playing word games, and simply talking to your child will increase her vocabulary while providing increased listening opportunities. Here are a few suggestions to help improve your child's communication skills:

Typical vocabulary/communication patterns for a child in this age group?

Between the ages of 2 and 3, children experience a tremendous "growth spurt" in language skills. Although each child develops at her own individual pace, when it comes to language skills, by the age of 2, most children can follow simple directions and can speak about 50 to 200 words. By age 2, children may also begin to echo what they hear and begin to combine words in short phrases.

By about 21/2 years of age, a child should have at least 200 words in her vocabulary and use fragmented phrases and small phrases. She will also be able to follow additional instructions, such as "Come to Daddy." A 3-year-old child's vocabulary will be between 200 and 300 words, and, by this time, many children will begin to string words together in short sentences.

Kids at this stage of language development will understand more and speak more clearly, and they are usually able to use language to engage in a simple question-and-answer format. By age 3, children should be using language freely, experimenting with verbal sounds, and beginning to use language to solve problems and learn concepts.

What should parents do if they suspect a problem in communication?

Parents who suspect that their child is having trouble with hearing, language acquisition, or speech clarity should not hesitate to talk with their child's doctor. A hearing test can be one of the first referral/diagnostic measures to determine if there might be a hearing problem. If you suspect that your child has a hearing problem at any age, she should undergo an evaluation. Two years of age is not too young for a referral for a speech/language evaluation, particularly if a child is not following directions or answering "yes" or "no" to simple questions.

After an evaluation, the speech-language pathologist (an expert who evaluates and treats speech and language disorders) may recommend direct therapy, referral to a developmental pediatrician if there is suspicion of a global developmental delay (delay in more than one area of development, including gross motor, fine motor, problem solving, language, and social skills), early intervention services, or simply a follow-up assessment to see if a child will catch up.

Typical Communication Problems for This Age Group

Communication problems for 2- to 3-year-olds include:

Problems - such as stuttering - may be a developmental process that some children will outgrow. For others, more intensive therapy may be needed. These communication problems can be helped by medical professionals, such as speech pathologists, therapists, or your child's doctor.


© Copyright 1999 American Medical Association
All rights reserved.

This article is provided by Medem, Inc. All rights reserved.


Communication and Your 4-5 Year Old

Why is it important for parents to communicate with a child in this age group?

Communicating with your child, from infancy onward, is one of the most pleasurable and rewarding experiences for both parent and child. Children are avid learners at all ages, absorbing information through daily interactions and experiences with other children, adults and the world.

Between the ages of 4 and 5, many children begin to enter preschool or kindergarten programs, making language competency necessary for better learning in the classroom.

How can parents communicate with a child in this age group?

The more interactive conversation and play a child is involved in, the more a child learns. Reading books, singing, playing word games, and simply talking to your child will increase his vocabulary while providing increased listening opportunities. Here are a few suggestions to help improve your child's communication skills:

What is a typical vocabulary/communication pattern for a child in this age group?

As children gain more mastery over their language skills, they become more sophisticated in their conversational abilities. A 4- to 5-year-old child follows complex directions and enthusiastically talks about things that happen to him. He can make up stories, listen attentively to stories and retell stories himself.

Children ages 4 to 5 are also able to understand that letters and numbers are symbols of real things and ideas, "write" as a way to tell stories and offer information, and "read" on their own.

Sentence structures now incorporate up to eight words, while vocabulary is between 1,000 and 2,000 words. Ninety percent of the time, speech should be clearly intelligible; although there may be some developmental sound errors and stuttering, particularly among boys.

Young preschoolers make comments and requests and tell others what to do. By 4 or 5, they should know the names and gender of family members and other personal information. They often play with words and make up silly words and stories.

What should parents do if they suspect a problem in communication?

Parents worried about a child's hearing, language acquisition, or speech clarity should not hesitate to consult with their child's doctor. A hearing test may be one of the first referral/diagnostic measures to determine if there has been a hearing problem. If the doctor suspects a specific communication deficit or delay, a referral for a speech-language evaluation may be recommended. If a child appears to be delayed in all areas of development, it may be more appropriate to refer him to a developmental pediatrician and/or psychologist.

After an evaluation, the speech-language pathologist (an expert who evaluates and treats speech and language disorders) may recommend direct therapy, preschool special education services, or possible referrals to an audiologist (a hearing specialist), developmental pediatrician, and/or psychologist.

Typical Communication Problems for This Age Group

Communication problems among children in this age group include:

Common problems, such as stuttering, often may be a developmental process that some children will outgrow. For others, more intensive therapy may be needed. These communication problems can be helped by medical professionals, such as speech pathologists, therapists, or your child's doctor.


© Copyright 1999 American Medical Association
All rights reserved.

This article is provided by Medem, Inc. All rights reserved.


Communication and Your 6- to 12-Year-Old

Why is it important to communicate with a child in this age group?

Communicating with your child, from infancy onward, is one of the most pleasurable and rewarding experiences for both parent and child. Children are avid learners at all ages, absorbing information through daily interactions and experiences with other children, adults, and the world.

How can parents communicate with children in this age group?

As children enter their grade-school years they become increasingly independent, spending much of their days outside the home in school and with peers. Talking with your child is essential to bond with her and share ideas, opinions, and information. Here are a few suggestions to aid communication with your child:

What is a typical vocabulary/communication pattern for a child in this age group?

As children progress in school, both their comprehension and usage of language will become more sophisticated. Usually, they will understand more vocabulary and concepts than they may express. Children should be able to engage in narrative discourse and share ideas and opinions in clear speech.

What should parents do if they suspect a problem in communication?

Parents need to have ongoing communication with their child's teacher about overall language skills and progress. Children with language comprehension and usage problems are at risk for increased academic difficulties.

If a child has a specific communication difficulty, such as persistent stuttering or a lisp, he should be referred to the school speech-language pathologist (an expert who evaluates and treats speech and language disorders). If this is the case, the parents should routinely communicate with the therapist regarding the therapy goals, language activities that are to be practiced at home, and progress.

If a school suspects a language-based learning disability, comprehensive testing will be necessary. This can include a hearing test, psychoeducational assessment (standardized testing to assess a child's learning style as well as cognitive processes as measured by normative values, such as IQ), and speech-language evaluation.

Typical Communication Problems for This Age Group

Problems in communication skills for children ages 6 to 12 years may include:

These communication problems can be helped by medical professionals, such as speech pathologists, therapists or your child's doctor.


© Copyright 1999 American Medical Association
All rights reserved.

This article is provided by Medem, Inc. All rights reserved.


Language Development Chart

Age of Child Typical Language Development
6
Months
Vocalization with intonation
Responds to his name
Responds to human voices without visual cues by turning his head and eyes
Responds appropriately to friendly and angry tones
12
Months
Uses one or more words with meaning (this may be a fragment of a word)
Understands simple instructions, especially if  vocal or physical cues are given
Practices inflection
Is aware of the social value of speech
18
Months
Has vocabulary of approximately 5-20 words
Vocabulary made up chiefly of nouns
Some echolalia (repeating a word or phrase over and over)
Much jargon with emotional content
Is able to follow simple commands
24
Months
Can name a number of objects common to his surroundings
Is able to use at least two prepositions, usually chosen from the following: in, on, under
Combines words into a short sentence-largely noun-verb combinations (mean) length of sentences is given as 1.2 words
Approximately 2/3 of what child says should be intelligible
Vocabulary of approximately 150-300 words
Rhythm and fluency often poor
Volume and pitch of voice not yet well-controlled
Can use two pronouns correctly: I, me, you, although me and I are often confused
My and mine are beginning to emerge
Responds to such commands as "show me your eyes (nose, mouth, hair)"
36
Months
Use pronouns I, you, me correctly
Is using some plurals and past tenses
Knows at least three prepositions, usually in, on, under
Knows chief parts of body and should be able to indicate these if not name
Handles three word sentences easily
Has in the neighborhood of 900-1000 words
About 90% of what child says should be intelligible
Verbs begin to predominate
Understands most simple questions dealing with his environment and activities
Relates his experiences so that they can be followed with reason
Able to reason out such questions as "what must you do when you are sleepy, hungry, cool, or thirsty?"
Should be able to give his sex, name, age
Should not be expected to answer all questions even though he understands what is expected
48
Months
Knows names of familiar animals
Can use at least four prepositions or can demonstrate his understanding of their     meaning when given commands
Names common objects in picture books or magazines
Knows one or more colors
Can repeat 4 digits when they are given slowly
Can usually repeat words of four syllables
Demonstrates understanding of over and under
Has most vowels and diphthongs and the consonants p, b, m, w, n well established
Often indulges in make-believe
Extensive verbalization as he carries out activities
Understands such concepts as longer, larger, when a contrast is presented
Readily follows simple commands even thought the stimulus objects are not in sight
Much repetition of words, phrases, syllables, and even sounds
60
Months
Can use many descriptive words spontaneously-both adjectives and adverbs
Knows common opposites: big-little, hard-soft, heave-light, etc
Has number concepts of 4 or more
Can count to ten
Speech should be completely intelligible, in spite of articulation problems
Should have all vowels and the consonants, m,p,b,h,w,k,g,t,d,n,ng,y (yellow)
Should be able to repeat sentences as long as nine words
Should be able to define common objects in terms of use (hat, shoe, chair)
Should be able to follow three commands given without interruptions
Should know his age
Should have simple time concepts: morning, afternoon, night, day, later, after, while
Tomorrow, yesterday, today
Should be using fairly long sentences and should use some compound and some    complex sentences
Speech on the whole should be grammatically correct

Years
In addition to the above consonants these should be mastered: f, v, sh, zh, th,1
He should have concepts of  7
Speech should be completely intelligible and socially useful
Should be able to tell one a rather connected story about a picture, seeing relationships
Between objects and happenings

Years
Should have mastered the consonants s-z, r, voiceless th, ch, wh, and the soft g as in George
Should handle opposite analogies easily: girl-boy, man-woman, flies-swims, blunt-sharp short-long, sweet-sour, etc
Understands such terms as: alike, different, beginning, end, etc
Should be able to tell time to quarter hour
Should be able to do simple reading and to write or print many words

Years
Can relate rather involved accounts of events, many of which occurred at some time in  the past
Complex and compound sentences should be used easily
Should be few lapses in grammatical constrictions-tense, pronouns, plurals
All speech sounds, including consonant blends should be established
Should be reading with considerable ease and now writing simple compositions
Social amenities should be present in his speech in appropriate situations
Control of rate, pitch, and volume are generally well and appropriately established
Can carry on conversation at rather adult level
Follows fairly complex directions with little repetition
Has well developed time and number concepts





How Does Your Child Hear and Talk?

Every child is unique and has an individual rate of development. This chart represents, on average, the age by which most children will accomplish the listed skills. Children typically do not master all items in a category until they reach the upper age in each age range. Just because your child has not accomplished one skill within an age range does not mean the child has a disorder. However, if you have answered no to the majority of items in an age range, seek the advice of an American Speech-Language-Hearing Association (ASHA) certified speech-language pathologist or audiologist. Use ASHA's online directory of speech-language pathologists and audiologists to locate a practitioner near you (www.asha.org).

Hearing and Understanding

Talking

Birth-3 Months
  • Startles to loud sounds.
  • Quiets or smiles when spoken to.
  • Seems to recognize your voice and quiets if crying.
  • Increases or decreases sucking behavior in response to sound.

Birth-3 Months

  • Makes pleasure sounds (cooing, gooing).
  • Cries differently for different needs.
  • Smiles when sees you.

4-6 Months

  • Moves eyes in direction of sounds.
  • Responds to changes in tone of your voice.
  • Notices toys that make sounds.
  • Pays attention to music.

4-6 Months

  • Babbling sounds more speech-like with many different sounds, including p, b and m.
  • Vocalizes excitement and displeasure.
  • Makes gurgling sounds when left alone and when playing with you.

7 Months-1 Year

  • Enjoys games like peek-o-boo and pat-a-cake.
  • Turns and looks in direction of sounds.
  • Listens when spoken to.
  • Recognizes words for common items like "cup", "shoe," "juice."
  • Begins to respond to requests ("Come here," "Want more?").

7 Months-1 Year

  • Babbling has both long and short groups of sounds such as "tata upup bibibibi."
  • Uses speech or non-crying sounds to get and keep attention.
  • Imitates different speech sounds.
  • Has 1 or 2 words (bye-bye, dada, mama) although they may not be clear.

1-2 Years

  • Points to a few body parts when asked.
  • Follows simple commands and understands simple questions ("Roll the ball," "Kiss the baby," "Where's your shoe?").
  • Listens to simple stories, songs, and rhymes.
  • Points to pictures in a book when named.

1-2 Years

  • Says more words every month.
  • Uses some 1-2 word questions ("Where kitty?" "Go bye-bye?" "What's that?").
  • Puts 2 words together ("more cookie," "no juice," "mommy book").
  • Uses many different consonant sounds of the beginning of words.

2-3 Years

  • Understands differences in meaning ("go-stop," "in-on," "big-little," "up-down").
  • Follows two requests ("Get the book and put it on the table.").

2-3 Years

  • Has a word for almost everything.
  • Uses 2-3-word "sentences" to talk about and ask for things.
  • Speech is understood by familiar listeners most of the time.
  • Often asks for or directs attention to objects by naming them.

3-4 Years

  • Hears you when call from another room.
  • Hears television or radio at the same loudness level as other family members.
  • Understands simple, "who?," "what?," "where?," "why?" questions.

3-4 Years

  • Talks about activities at school or at friends' homes.
  • People outside family usually understand child's speech.
  • Uses a lot of sentences that have 4 or more words.
  • Usually talks easily without repeating syllables or words.

4-5 Years

  • Pays attention to a short story and answers simple questions about it.
  • Hears and understands most of what is said at home and in school.

4-5 years

  • Voice sounds clear like other children's.
  • Uses sentences that give lots of details (e.g. "I like to read my books").
  • Tells stories that stick to topic.
  • Communicates easily with other children and adults.
  • Says most sounds correctly except a few like l, s, r, v, z, ch, sh, th.
  • Uses the same grammar as the rest of the family.

Where to Get Help:

If you think your child may have a speech, language, or hearing problem, you can contact an ASHA-certified

ASHA-certified speech-language pathologists and audiologists have completed their master's or doctoral degree and have earned ASHA's Certificate of Clinical Competence (CCC).

Speech-Language pathologists and audiologists work in many different types of facilities such as: