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Is a Lisp Normal in Preschool?

As children begin to develop their speech and language skills, it is important to remember that speech sounds are acquired in specific patterns around approximate age ranges. Therefore, most Blog-Lisp-Main-Landscapechildren go through periods of development where their overall speech intelligibility is reduced.

In order to understand if a lisp is considered normal, one must first understand what a lisp actually is. Lisps can present themselves in a different manner, primarily as lateral and interdental, with misarticulations primarily on /s/ and /z/, though productions of “sh,” “ch,” and “j” are typically impacted as well. In order to accurately produce these speech sounds, airflow needs to be channeled down the middle of the tongue.

A lateral lisp occurs when the airflow passes over the sides of the tongue, which causes significantly distorted production of the targeted speech sounds. The manner of the production will have a “slushy” quality, and lateralized productions of speech sounds can be difficult to correct.

Another common lisp is the interdental lisp, in which the tongue protrudes between the upper and lower teeth distorting the airflow that is forced through the space during speech production. This type of lisp is often heard as a substituted “th” rather than an accurate /s/ or /z/.

In the preschool years, children are expected to have mastery of early speech sounds, and errors on later-developing speech sounds are considered typical. Therefore, distortions of /s/ and /z/ that present themselves as a lisp are often seen in children this age. However, around the age of five when children enter kindergarten, they should be more accurate with their speech sound production skills.

If a child continues to present with difficulty on particular sounds, further assessment may be beneficial. This is particularly true if the child presents with a lateralized lisp, as speech-language therapy is warranted to help re-mediate the place and manner of the errors. Evaluation is also recommended if the child presents with either inconsistent productions of speech sounds, or is significantly difficult to understand, regardless of age.

Read our blog on what to expect in a pediatric speech and language evaluation.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Administering Effective Healthcare in ASHA

I attended a graduate school program that took great pride in a multi-disciplinary approach. They ASHAheavily emphasized the importance of working together to obtain the most accurate diagnosis within a medical model that was centered on patient wellness and experience. “It’s the wave of the future!” they said, “Funding in healthcare will be directly related to a patient outcome!”

When I started working at North Shore Pediatric Therapy, I couldn’t believe that the ‘wave of the future’ concept (simply translated to: increased and improved communication between patients and health care providers) was something that had been fundamental to this practice for so many years! They were so ahead of their time because they thought about how they wanted their family, friends, and children to be treated within a healthcare setting. It’s something that I find value in everyday and would like to share more information about in the upcoming paragraphs. *Of note, this blog post is in response to information derived from an article found in The ASHA (the American Speech-Language-Hearing Association) Leader (a monthly publication sent to licensed speech-language pathologists) titled What Does the Patient Want? by Sarah W. Blackstone.

This blog post seeks to explain the ways in which the model of care NSPT has implemented for so many years is compliant with the recent changes in health care laws, policies, and regulations for patient-centered, communication-supportive care.

  • Why has the government recently realized this as a need in healthcare? Because, “Successful patient-provider communication correlates positively with patient safety, patient satisfaction, positive health outcomes, adherence to recommended treatment, self-management of disease and lower costs.”At NSPT, we have been working this way since day 1! We’re familiar with the positives of this model and know how to set up the challenges for success. We use these skills to impact our patients and improve our practice every day!
    • NSPT EXAMPLE: A colleague of mine had a client with a speech impediment and an upcoming school play. She reached out to the girl’s teacher (with the permission of her mother of course!) and they worked together to obtain a passage that had fewer of the sounds that were difficult for her. After the performance, all 3 parties rated the experience to review how the collaboration worked for everyone!
  • Participation in interprofessional rounds to generate relevant concerns and questions for our patients!
    • NSPT Example: I am a speech-language pathologist that works with physical therapists, occupational therapists, behavior therapists, social workers, and family child advocates. Some of our more involved kiddos see more than one therapist to address multiple areas of concern. This is where “rounding” is particularly helpful. It is the process of checking in and making sure that everyone is on the same page regarding the plan of care. Rounds are also a place to problem solve new challenges and talk about a client’s recent progress!

These are only a few of the ways that NSPT has already incorporated novel health care concepts into the foundation of what we do to convey our appreciation for the wonderful families we work with!

Resources:

Blackstone, S. W. (2016, March). What Does the Patient Want?. The ASHA Leader, 38-44.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Tips for Teaching Language to Your Toddler During Daily Routines

As a busy parent, hearing that your child needs help talking can be overwhelming. You already have a Teaching Languageto-do list that feels a mile long— When are you supposed to find time to work on teaching language? The good news is there are ways to incorporate language into the routines that you already do every day! One of the tricks to helping your toddler talk is for YOU to do a lot of the talking. Children need to hear words over and over again to understand them. Just like if you’ve ever learned a second language, they want to hear it a lot before trying it out for themselves! The key here is to focus on doing the talking to build up your toddler’s understanding, which will help her to become confident and ready to use the words with less and less help.

Here are a few daily routines that are perfect to work on teaching language:

Bath time:

  • Describe what you are doing during bath time. Remember to keep the language simple so your toddler can focus on the words. As you do this every day, your toddler will remember the routine, and may begin to fill in the blanks (e.g. Dad: “Shirt on! Socks….” Toddler: “On!”). While doing these actions, tell your child:
    • “Shirt off! Socks off! Pants off!”
    • “Diaper on! Socks on! Shirt on!  Pants on!”
    • “Duck in! Boat in!”
    • “Duck out! Boat out!”
  • Use action words while playing in the bath tub
    • A cup can be a great toy for playing. You can show your child how to “pour” the water. If your child is working on requests, she can request for you to “pour,” she can say “my turn” to have a turn pouring (just be careful so she doesn’t try to drink the bath water!), and she can request “all done” when she wants to finish playing with the cup.
    • Describe cleaning actions to your child. Tell her “Wash,” “Rinse,” and “Wipe” while you are giving her a bath. These words are especially important as your little one may be working on washing her hands more independently soon.

Bringing in the groceries:

  • Talk to your child about what you are doing while putting groceries away. This is a great opportunity for your child to practice following directions and to learn food and action vocabulary.
    • “Carry the bag”
    • “Beans! Put the beans in” (while putting a can of beans in the cabinet)
    • “Apples! Put apples in” (while putting apples in a basket)
    • After you have exposed your child to food vocabulary, you can have him identify foods for you. Take out an apple, a banana, and a carrot. Ask your child “Can I have the apple?” He has to find the food and follow directions to give it to you. As your child learns more, you can give him more items to choose from and ask for two items. When he begins naming foods (e.g. “Nana” for “banana”) smile and encourage him. You can expand his language by telling him “Banana! You found the yellow banana!” You may be surprised by how motivating this can be! Children love to be included and help you.

Getting dressed:

  • Have your toddler request which clothes to put on first. You can give him choices to assist with language production. Showing him one item at a time, ask “Do you want PANTS? (show the pants in one hand)  or Do you want SHIRT?” (show the shirt with the other hand). Remember to hold the clothes out of your child’s reach so that he has to communicate to you by pointing or talking. Your child can pick which one to put on first. Watch what he points to and, if he points to shirt, encourage him to say “Shirt.” If your child does not repeat the word, honor his choice and say the word “shirt” for him while putting the shirt on him.
  • Once your child is more familiar with clothing vocabulary, have him find the clothing. Put a shirt, pants, and socks on the floor for him to find. Tell him, “Give me the socks,” and wait for him to find the socks and bring them to you. Remember to say the direction the same way and slowly so that your child can focus on your words. If your child prefers to be more independent, you can lay out two outfits so that he can choose which pants and shirt to put together.

Tips & Tricks:

  • Keep your language simple
  • Speak slowly
  • Talk for them instead of asking questions (e.g. “It’s a duck! Quack quack.” instead of “What is it? Do you see it?  What color is it? What does it say?” –Questions can be overwhelming, and asking too many makes your child unsure of what to answer).
  • WAIT for your child to respond
  • Accept their attempts at saying a word, such as “dah” for “dog”
  • Model the word for them & expand on what they say: “Dog!  You see a dog.”
  • Honor their choice
  • Have fun!

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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At Home Speech and Language Games

Who says that practicing speech and language skills can’t be fun? While most games were not created Blog-Speech-and-Language-Games-Main-Portrait (1)with the intent to work on speech and language skills, there are many games that can actually be used for this reason. In fact, you may be targeting these skills at home without even knowing!

The following is a list of games that can be used and various skills that can be targeted for at home speech and language development:

  1. Go Fish
    • F or SH sound – Your child will get a lot of practice when saying “go fish!”
    • Asking questions – Your child will need to think of what card he needs and request the card by asking an appropriate question (e.g. “Do you have a four?”).
  2. Twister
    • Following directions – Your child will need to follow directions that contain three components (right vs. left, body part, color). If three components is too complex, the directions can be modified to have two components by eliminating right vs. left and only using the body part and color. An example containing three components would be “put your right foot on blue” and two components would be “put your foot on blue.”
  3. Hedbanz
    • Asking questions – Your child will work on asking yes/no questions to figure out what picture is on his or her head.
    • Word finding – The game can be altered where one person is describing the picture for someone else to name. When your child describes pictures and names, he or she can work on various word finding techniques such as identifying categories and attributes.
  4. Jenga
    • Jenga can be used to work on numerous speech and language skills by writing target skills on the Jenga blocks.
      • Speech – Any speech sound can be targeted by writing words, phrases, or sentences containing the specific sound(s) on the blocks. When your child removes a Jenga block from the stack, he will practice his sounds by reading what is written on the block.
      • Language – Many language skills can be targeted in the same way by writing various targets on the blocks. For instance, wh- questions (e.g. who, what, where) can be targeted by writing one wh- question on each block. Another language skill that can be targeted is categories. This can be done by writing a category name (e.g. animals) for your child to name or write items that are associated or writing items in the category (e.g. dog, cat, elephant) and having your child name the category.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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The Best Games for Language and Social Skill Development

Let’s be honest, who doesn’t love a good family game night? A little friendly competition, some yummy Blog-Language-Development-Main-Landscapesnacks and, of course, fun! As a pediatric speech therapist, I use games every day in my speech sessions. To be honest, I would be lost without them. Games are exciting, motivating, and best of all, they help children learn important speech and language skills without even realizing it!  There are many games that encourage the development of speech, language, and social skills. You can work on everything from learning how to take turns, to categorizing, making inferences, and oral narratives (i.e. story telling). Grab one of the following games for your next family game (and learning!) night!

These first few games are perfect for children who are just learning to play games as they are not language heavy. These games are great for promoting skills such as joint attention, turn-taking, cause and effect, commenting, and learning basic vocabulary and concepts (i.e. on, off, in, out, next). Some of these games introduce letter, shape and number concepts as well.

  • Sneaky, Snacky, Squirrel by Educational Insights
  • Frankie’s Food Truck Fiasco by Educational Insights
  • Frida’s Fruit Fiesta by Educational Insights
  • Hoot, Owl, Hoot by Peaceable Kingdom
  • Feed the Woozle by Peaceable Kingdom
  • Pop-Up Pirate by TOMY
  • Pop the Pig by Goliath Games
  • Zingo by Think Fun
    • There are many varieties of Zingo including numbers, letters, and telling time.

The next few games support turn-taking and overall social skills, but delve a little deeper into specific language skills.

Categorizing

  • Spot It! by Blue Orange
    • There are many varieties of Spot It, from Junior Edition to the special Frozen Spot It
  • Scattegories Junior
  • Speedeebee by Blue Orange
  • Rally Up by Blue Orange
  • HedBanz by Spin Master

Following Directions

  • Hullabaloo by Cranium
  • Cat in the Hat, I Can Do That! by Wonder Forge
  • Roll and Play by Think Fun
  • Ring It! by Blue Orange

Story Telling

  • Rory’s Story Cubes by Gamewright
  • Tell Tale by Blue Orange

Grab a game and have some fun!

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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Should I Be Concerned With My Child’s Speech?

As a parent, everyone wants the best for their child. They want their child to grow and Blog-Speech-Concerns-Main-Landscapedevelop appropriately, and flourish socially and academically. One component to success is your child’s ability to effectively communicate their wants, needs, and ideas. Which begs the question, when should you be concerned with your child’s speech and language development? In a world where no child is the same, one thing is for certain: early intervention is better than late intervention, and late intervention is better than no intervention at all. Look for these red flags early in development.

  • Difficulty following directions
  • Difficulty answering questions
  • Difficulty understanding gestures and nonverbal cues
  • Difficulty engaging in conversation
  • Difficulty identifying age-appropriate vocabulary and concepts
  • Frustration when communicating

Expressive Language

More specifically, children should be babbling between 6 and 8 months, with their first words produced around the age of 12 months. By 18 months, your child should possess an expressive vocabulary (spoken words) of approximately 50 words. Two-word combinations are expected around 24 months, with an expressive vocabulary growing to about 300 words. By the time your child is 36 months old, expect 3-5 word combinations (or more!), with most adult language structures mastered around 60 months (5 years).

Receptive Language

Children should follow basic commands around 12 months (“Come here”), and use gestures to communicate along with a few real words. They should be demonstrating comprehension of common objects and animals, by following commands involving those items or identifying them in books (puppy, cup, shoes, etc.) around 18 months of age. Look for your child to answer questions, ask questions, and talk about their day around the age of 3 years.

Articulation

It is typical for a young child (1-2 years) to have some sound errors in their speech. However, by the age of 3, a child’s speech should be at least 75% intelligible to an unfamiliar listener, and more intelligible to familiar listeners. By age 3, a child should have the following sounds mastered: /b, d, h, m, n, p, f, g, k, t, w/. All speech sounds should be mastered by age 8.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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Understanding Your Child’s Speech and Language Assessment

Taking your child to a speech evaluation may seem intimidating. Below are some tips to help you navigate the results of your child’s speech and language assessment.Blog-Speech-Evaluation-Main-Landscape

Speech Intelligibility by Age: These percentages are an estimate of how much of your child’s speech should be understood by various listeners across a range of environments at a certain age.

  • 19-24 months of age: 25-50%
  • 2-3 years of age: 50-75%
  • 4-5 years of age: 75-90%
  • 5+ years of age: 90-100%

If you think an unfamiliar listener would estimate your child’s intelligibility percentage to be lower than what is listed above, they will most likely qualify for speech therapy. However, qualifying for speech therapy also depends on additional factors.

Phoneme Development: Listed below are specific speech sounds your child should have acquired by a certain age. They are listed in a range as children acquire different sounds at different ages.

  • 1-3 years of age: p, m, h, n, w, b
  • 2-4 years of age: k, g, d, f, t, ng, y
  • 3-6 years of age: r, l, s
  • 4-7 or 8 years of age: ch, sh, z, j, v
  • 5-8 years of age: voiced /th/ and voiceless /th/

When your child attends a speech and language evaluation for articulation concerns, the speech-language pathologist will conduct a formal assessment that will allow them to determine if your child has all of the age-appropriate sounds in their repertoire. The SLP may also try some exercises with your child during the assessment to see if your child is stimulable for these sounds. In other words, they may check to see if your child can produce these sounds with some modeling or if the sounds are extremely difficult for your child to produce.  If your child can produce these sounds without difficulty, the SLP may recommend monitoring your child and conducting a re-evaluation in the future as the sounds may develop on their own.  If your child cannot produce the sounds easily, the SLP will most likely recommend weekly speech therapy.

How long will my child need speech therapy?

This is a question we are frequently asked by parents and unfortunately, there is no definite answer.  Each child progresses at their own rate and some children may acquire sounds more easily than others.  The length of therapy will also depend on the severity of your child’s articulation delay.

What can I do to help?

Your child’s SLP will most likely send home weekly “homework” that will include articulation exercises you can do with your child.  The more practice, the better!

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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Speech and Language Games to Play on Spring Break

Spring Break – the weather is (hopefully) bright and sunny, flowers are beginning to Speech and Language Gamesbloom, and the kids are out of school. What better way to spend this week off than to take a vacation with the whole family. Not only can a Spring Break vacation be a wonderful way to recharge, it can be a great time to grow your child’s speech and language skills, all while playing games.

Many different types of games can help children with language development while also entertaining everyone in the family. These games can be played anytime and easily incorporated into any Spring Break vacation!

Speech and Language Games:

  • Car games: road trips can be a great way to spend quality time with our families. Playing word games on these long road trips can foster close relationships and increase phonological awareness (the knowledge of sounds and their rules in language).
    • With younger children, look at road signs for words beginning with A, B, C, and so on, to encourage letter identification skills. Whoever finds the most wins!
    • For older children, take it one step further and play Name-Place-Job. For example, if someone sees a sign for Baltimore (letter B), he or she has to come up with a name and job to go with it: “I’m Beth from Baltimore, and I’m a beekeeper.” Not only does this game involve more advanced skills (like alliteration), it encourages creativity and vocabulary growth.
  • Board games: board games are fun and educational for the whole family, and many of them are language-based – perfect for facilitating language growth.
    • Elementary-aged children can play Apples to Apples or Apples to Apples, Jr., both of which encourage vocabulary development and word-association networks.
    • Children in middle school can play Taboo, a game where the speaker describes a word to his or her team without saying “taboo” words. Taboo incorporates higher-level, more abstract language skills, such as idioms, multiple-meaning words, and comparing and contrasting.

Spring Break is the perfect time to enjoy some quality family time and focus on language skills.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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What to Expect in a Pediatric Speech and Language Evaluation

The purpose of a speech and language evaluation is to determine your child’s strengths and challenges related to a variety of areas and conclude if therapy would be beneficial in further developing skills and aiding his/her ability to communicate effectively with SLPmainothers. Parents may request an evaluation if they have concerns, or children may be referred by a pediatrician, teacher, or after a developmental screening. While it may vary across settings, the following is a general outline of what you can expect from a formal speech and language evaluation.

  • Background and Developmental Information: Upon beginning the process, most facilities will request information regarding your child’s early developmental history. This will include things such as birth history, age milestones were met, and significant medical history. If your child has previously participated in therapy or related developmental/educational evaluations, providing copies of these reports to your therapist will be extremely beneficial in helping develop the whole picture of your child. In some settings, the therapist will obtain information from your child’s teacher regarding challenges specifically related to classroom learning and peer relationships.
  • Caregiver Interview: An essential portion of the evaluation will be information provided by the child’s family. The therapist will guide a discussion regarding your major concerns, what you would like to achieve by participating in the evaluation, and goals you might have for your child. The therapist may ask for specific examples of times you’ve noticed these challenges, thoughts about your child’s awareness toward the issue, and other questions to develop an overall understanding of how your child is communicating. Depending on the age of the child, he/she may participate in the interview portion to share feelings and thoughts on the area of difficulty, and what he/she would like to accomplish. Based on the background information provided and the caregiver interview, the therapist will choose assessment tool(s) to evaluate the area(s) of concern.
  • Assessment and Observation of the Child: Initially the therapist will spend time talking and/or playing with your child to develop rapport and make observations based on how he/she interacts and communicates in an unstructured setting. Then, your child will participate in assessments that may include:
    • Oral motor assessment to observe the structures of the face and mouth at rest and while speaking, as well as oral musculature and motor planning of oral movements.
    • Standardized assessment of the area(s) of concern (not an exhaustive list)
      • Expressive (what he/she produces) language and/or Receptive (what he/she understands) language
      • Speech production and fluency of speech
      • Pragmatic or social language
      • Feeding and Swallowing
      • Reading/Writing skills
  • Evaluation Report: The therapist will then compile all of the information gathered from the family, observations, and assessments and summarize it in a formal report. It will include a description of each area of assessment and its findings. Based on the results, the therapist will determine if therapy is necessary and if so, develop a plan for treatment. Specific goals to target the areas of need and a time frame for doing so will be included in the report.

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NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

language development throughout the day

5 Easy Ways to Encourage Your Baby’s Language Throughout the Day

Language is used everywhere around us, in multiple ways and in all facets of life. How does your little one learn language when she is so bright-eyed and bushy-tailed? When you think about talking to your baby, it may seem a bit silly since she isn’t talking back. However, she is communicating with you in other ways, such as with eye gaze, coos, and smiles. Interacting and speaking to your baby throughout the day is thought to facilitate language acquisition. It has been found that the amount of words addressed to 1- to- 2-year olds by their mothers is predictive of their vocabulary growth rate (Huttenlocher, Haight, Bryk, Seltzer, & Lyons, 1991).

Here are 5 easy ways to encourage your baby’s language development throughout the day:

  1. Use infant-directed speech: Also known as motherese, this is speech that is directed specifically at your baby5 easy ways to encourage your babies language throughout the day in a prosodic and deliberate manner. Research has shown that babies actually prefer motherese to its counterpart, adult-directed speech.
  1. Read books: Interacting and exposing your baby to books and the act of reading is a great way to encourage language. At this age, picture books are ideal and facilitate early learning of concepts such as colors, numbers, and animals. It also helps teach book orientation and direction of reading.
  1. Label: Give your child the names for common objects and objects that they are consistently exposed to. This input increases receptive language which will in turn increase expressive language. Thanks to fast-mapping (the ability to learn words with minimal exposure), typically-developing toddlers require minimal exposure to new words in order to learn their meaning and use them appropriately.
  1. Sing songs: Singing songs to your child such as ‘Rock a Bye Baby’ and ‘Twinkle Twinkle Little Star’ not only provides comfort but also includes exposure to repetitive language models.
  1. Use simple language: When speaking to your baby, use simple language by communicating in words and/or short phrases. This limits the amount of language that the child has to process and allows them to focus on the important parts of the message.

Before you know it (and before you may be ready for it), your baby will be talking, walking, and going to school. Facilitate their language learning by utilizing the tips mentioned above. If you become concerned (lack of interest, eye contact, gestures, and/or speech sounds, among others) with your baby’s language and speech skills, seek an evaluation with a certified speech and language pathologist.


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NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Reference: Huttenlocher, J., Haight, W., Bryk, A., Seltzer, M., & Lyons, T. (1991). Early vocabulary growth: Relation to language input and gender. Developmental Psychology, 27, 236-248.