The second year of life is a time of rapid development in expressive language skills. In the 12-month period between their first and second birthdays, the average middle-class toddler goes from a vocabulary of three words to one of over 200 words, words which are combined into three word phrases or telegraphic sentences. However, 10% to 14% of middle-class children have enough difficulty learning language that they are classified as “late talkers.” At 24 months of age, these children have a vocabulary of less than 50 words, and are not producing creative two-word combinations.

Parents of late talkers receive much conflicting advice. Conventional wisdom is that late talkers “catch up” and are indistinguishable from early talkers later in life. This results in a “wait and see” attitude, especially when the child is a boy, or has very verbal older siblings. We’ve all heard of some children who didn’t speak a word until after their third birthday and one day began talking in paragraphs! However, in the last decade, there has been a growing body of longitudinal research challenging these assumptions. Across the US, five research teams have been following late talkers and average talkers who are matched for non-verbal intelligence, sex, and socio-economic status. The results show clearly that late talking is associated with a very high incidence of language disorders, learning disabilities, poor academic outcomes, declining IQ as the child ages, and social or behavioral problems.

Often, late talking is the first sign of a serious problem such as hearing loss. Lack of expressive language development is often the first sign that “something is wrong” recognized by parents of children with mild to moderate autism. Parents typically report that, while they became concerned when their child was 18 months of age, the “wait and see” philosophy resulted in a lack of diagnosis and appropriate treatment prior to 36 months. As early treatment can mean the difference between an excellent outcome and a poor one, this delay is very significant. Autism is becoming a greater concern to parents of late talkers as its world-wide incidence has been steadily increasing by 15% per year over the last decade.

Pediatric speech-language pathologists have been researching the differences between late talkers who will truly “catch up” and those who will have life-long difficulties for over 25 years. As a result of these studies, we know that the following are “red flags” for more serious developmental delays:

• Any degree of difficulty understanding language. This includes difficulty following directions and answering questions. A delay of as little as 3 months correlates with significantly poorer outcome.
• Limited ability to use gesture to communicate between 10 and 24 months of age
• Lack of symbolic or “pretend” play
• Limited babbling in the first year of life
• Babbling that is predominately vowels, or contains a limited number of consonants
• Failure to imitate or echo single-word labels in the second year of life
• Parroting utterances that are much longer than the child can produce spontaneously
• Being non-verbal at 24 months of age. Research indicates that the later the child talks, the higher the incidence of significant disorders is.
• Parental concern. In over 30 years of practice, Lesley has only once evaluated a child with normal language skills whose mother thought he had a language disorder!

Early identification and remediation of language disorders is critical. A recent long-term study in an affluent Canadian community showed that children who entered kindergarten with only borderline language deficits had a significantly poorer academic and social outcome. An experienced pediatric speech-language pathologist can differentiate between children who will genuinely “catch up” and those who are at risk for significant long-term problems. An early consult can give the parent peace of mind as well as training on ways to speed up language learning. If a problem does exist, the earlier parent education and therapy for the child is begun, the better the outcome will be.

Testimonials

When my wife and I realized that our son had missed certain milestones in speech development by his 2nd birthday, we became concerned. As we watched him struggle to attempt words, we became very concerned. With my wife as a teacher and I as a health care professional, we decided to find the best speech-language pathologist we could for our son. The name that repeatedly came up in conversation was Lesley Boykin. From the moment we entered her clinic, her warmth, compassion, and professionalism impressed us. We began to see and hear immediate improvements in our son’s ability to communicate. From early stages of sign language to the present three-to-four-word sentences, we owe our gratitude to Lesley for helping our son find his voice.
Chris, whose son is now 2 years 10 months old

Lesley isn’t just treating my son; she is helping me too.
I learned more in just the first three sessions my son had with Lesley, than in the last year and a half in the school system or with three other therapists in private practice combined! I have learned ways to help develop my son’s receptive and expressive language and speech skills at home. Also, now I have a much better understanding of how language develops thanks to Lesley. My son’s language development can’t stop once the session is over with her; it has to continue with me the rest of the week, and thanks to Lesley, now I feel confident that I can continue the work that she does in her office at home with my son.
Michele, Mom to Nicklas, 2 yrs old

When our son was a toddler, he had speech and language evaluations at a local hospital, and our school system. Both diagnosed him with a receptive/expressive language disorder. We began seeing Lesley for speech therapy, and Donna and Gina for PT and OT when our son was 23 months old. He struggled with lack of eye contact. He couldn’t respond when he was called and he had a very minimal vocabulary. In the time that he has worked with Lesley and the Pediatric Potentials staff, our son has progressed exponentially. After 5 months of speech therapy, his speech has improved by a full-year. His vocabulary is well over 200 words, he responds to his name, holds eye contact, and now uses 3-4 word sentences. It is a joy to see him express his wants and dislikes as well as gain better muscle tone and improved gait.

Lesley makes our dreams a reality. Our son looks forward to coming to “school” each day, and even asks for his therapists by name on off days. The staff is very professional, caring, and devoted to giving their undivided attention during one-on-one sessions. Our son’s progress has been truly remarkable, and Lesley is directly responsible for opening the world to him and his to us.
Joel, father of a child with hypotonia and delayed development

• Pediatric Clinician with 35 + years
  experience
• Exceptional, functional results
• Evidence-based treatment
• Thorough evaluations with comprehensive written reports
• Individualized treatment plans
• Combination of relationship-focused and behavioral approaches
• Parent education and involvement
• Convenient Grosse Pointe Farms location, close to I-94

• Differential diagnosis of Late Talkers
• Autism Spectrum Disorders
• Severe Language Disorders
• Language Processing Disorders