Developmental Red Flags
to Emotional, Cognitive and Behavior Skills

As your baby grows, it's only natural to wonder if everything
is okay. How can you tell what your baby should be able to do
and when?
How can you tell if your child is on target to develop her
emotional, cognitive, and behavior skills? Look for the red flag
in each age group. If you notice these behaviors with your
child, discuss your concerns with your doctor.
Therapy Options

Thankfully, there are many ways to deal with delays in child
development and behaviors.
These include in-home services, outpatient (you take your child
to a clinic), inpatient (following injury or surgery) and school
based services. Which type of therapy should you choose?
Visit our Therapy
Options area to learn more.
Ask a Therapist

We understand developmental milestones and the challenges of
Special Needs children. We spend a great deal of time with
families understanding the inner workings of childhood routines
and interactions. Ask us about your child today!
Ask a Therapist
Articulation and Intelligibility of Speech in Young Children:
FAQ for Parents
What is articulation?
Articulation is the ability to make sounds clearly. Children learn
correct sound pronunciation by listening and imitating appropriate speech
role models. Articulation develops gradually over the first 8 years of life.
When should I be concerned about my child's articulation?
As therapists we typically are not concerned with a child's articulation
until they reach the age of 3. Under age 3 we expect children to make quite
a few articulation errors and substitutions and to be frustrated when they
are not understood. By age 3 a child should be using at least 200 words,
using 3-5 word phrases and be understood at least 80% of the time. By age 4
a child should be 100% intelligible even if they continue to have some
articulation errors. If you are concerned about your child's articulation or
intelligibility (how well you or others understand his/her speech) you
should have him/her seen by a licensed speech pathologist to rule out any
early concerns or delays.
What sounds do children learn to produce first and in what order?
Most children are able to produce the bilabial sounds (made with the
lips) of "b, p, m, w" first since these are sounds are visible on the lips.
They may also produce sounds such as "d, n, t" early on as well. These
sounds are called lingu-alveolar since they are produced with the tongue
behind the teeth against the alveolar ridge in the mouth. The acquisition of
new sounds is a developmental sequence for young children, but by the age of
8 all children should have a mastery of all speech sounds. So keep in mind
that some children will continue to work on mastery of the more difficult
sounds such as "r" and "s", as well as some blends like "sh" or "ch" until
around 3rd grade. In other words, if your 2 year old is not yet using the
'k" sound or 'r" sound correctly yet there is no need for concern.
General Guideline for Sound Production
3-4 years: p, b, m, w, h and all vowels
5-6 years: d, t, n, g, k, f, y, ng
7-8 years: r, l, s, ch, sh, z, j, v, th, sh
What interferes with articulation?
Children who have had multiple ear infections may be at risk for
articulation problems since having excess fluid in their ears is like
listening under water or in other words, sounds are muffled to some degree.
Even after getting tubes, children may still experience articulation errors
since they may continue to pronounce sounds as they heard/learned them when
they were experiencing a conductive hearing loss due to the ear infections.
Children who have a specific diagnosis, such as cerebral palsy or Down
syndrome or who have abnormalities of the face, oral cavity or jaw would
also be more prone to articulation problems.
How do you treat an articulation disorder?
Articulation treatment is provided by a licensed speech pathologist and
may involve demonstrating how to produce a sound correctly, learning to
recognize which sounds are correct and incorrect, and practicing sounds in
different words. For young children this is all done through fun and play
during natural daily routines.
Sources: ASHA, Hearing Speech & Deafness Center.
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