Welcome to Toddlerhood: Communication 12-24 months
It’s a wonderful feeling when your baby begins to communicate with you. The first time they say “mamma” or “dada” is cause for much celebration. The skills your baby learns in the first two years of life lay an important foundation for a lifetime of communication and interacting with others and significantly impacts cognitive, social and emotional development.
Broadly speaking there are two parts to communication: Receptive communication and expressive communication. Receptive communication is “the ability to understand information. It involves understanding the words, sentences, and meaning of what others say or what is read.” This involves sound traveling from the outer ear, to the inner ear and being translated into nerve signals and onto to the hearing and understanding centers of the brain. Expressive language is the ability to “put thoughts into words and sentences, in a way that makes sense and is grammatically accurate.” (Sources: Afasic.org & NIDCD) This includes gestures, and later in childhood the ability to write information. At the toddler stage, expressive language is through gestures and verbal communication. Because communication is complex and involves several areas of the brain, as well as the ears, throat, and mouth, when there is a delay, it can be difficult to isolate the exact cause.
The skills your baby learns in the first two years of life lay an important foundation for a lifetime of communication and interacting with others.
It is likely that before her first birthday your baby will be making gestures like “bye bye” and “up”, playing peek-a-boo and pat-a-cake and turning and looking towards sounds. She will listen when spoken to and understand a few simple words like “dog” and “shoe”. She will also speak in non-specific babble, delight in engaging you and may use one or two words like “mamma” and “dada” and imitate sounds like “moo”.
Around her first birthday, she will start using use other words with meaning, respond to her own name, and perform a one-step command with a gesture like “up”. Then comes the word “no”, along with shaking of the head, which may drive you crazy: “do you want a banana” - “no”; “time for bed” - “no”, and so on! Around 15 months she will start to point at one body part and her vocabulary will be increasing up to around 5 words and she may start using jargon.
Around 18 months, your child may be able to say up to 10 words, point to 3 body parts and starting to point at, and labeling familiar objects and people. She may be using jargon embedded in short phrases, with other words. She will be enjoying pretend play, simple stories, songs, and rhymes and may point to pictures in a book. During this time her vocabulary should be increasing weekly. By her second birthday, she may be using up to 50 words, of which 50% will be easy to understand. At this stage, she may be able to follow a 2 to 3 step command like “roll the ball”. She may be starting to use 2-word phrases and personal pronouns (I, me, you) and some plurals. She may have started to ask 1 or 2-word questions such as “where mama?” and she should be using a variety of consonants at the beginning of words. (Sources: University of Alberta & ASHA )
Children born prematurely will usually reach milestones based on their due date, rather than their birth date. All milestones have a broad range of ages at which they are achieved. If you would like further information the CDC has a good summary of all developmental milestones.
Helping Your Toddler Develop Communication Skills
The American Speech, Language and Hearing Association offers some great advice on how to help your child develop good communication skills, at this crucial stage of development:
· When you are with your child talk to him in simple, grammatically correct language. For example, when you go for a walk you might point to a cat and say, “Look, there is a cat. The cats says meow. The cat is black.”
· Take a “sound walk” around the house and tell him new words, exaggerating the consonant at the beginning like b-b-b-brick. Point out more subtle sounds like a clock and imitate them.
· When your child says a word, expand on it. For example, she says, “cat”, you say, “Yes, it’s a big black cat”. Don’t make a fuss about incorrect pronunciation; just repeat back in the correct way.
· Sing action songs and read age-appropriate books to your child every day. They should have only a few words or phrases on each page and have bright, colorful pictures. Take your time, describe and point at details in the pictures. Later, ask him point to the pictures. As he masters this you might start to ask, “what’s that?", if he doesn’t answer tell him until one-day delight you by saying the name himself.
· Play with imagination toys, such as animals or toy food and model how to play and tell stories. Avoid toys that play loud music or speech, as these can stifle imagination.
· Don’t ask too many questions, as this can make him feel pressured.
A quick mention of the thorny subject of toddlers and television. A 2008 Thai study found that language delay was six times more common in toddlers who watched television for more than 2 a day. The American Academy of Pediatrics recommends that children under two do not watch television (see previous article). Realistically this may not be possible, for busy families and watching television for 20 minutes, may give parents a much-needed respite. If you are concerned that your child may have hearing problems or language delay it may be best to strictly adhere to the no television or radio guidelines, to see if it makes a difference.
Red flags: When to call your doctor
The American Academy of Pediatrics suggests developmental checks at 9 months, 18 months and 24 or 30 months. Children who were premature, low birth weight or have other health problems may be screened more frequently. If you are worried you can request an assessment at any time. As communication is complex you may want to request both an audiology (hearing) and speech and language assessment.
If you think your child is showing unusual signs don’t panic, there may be a very simple reason; every child is different. Signs to report to your doctor include:
● Problems with feeding or swallowing,
● Child does not respond to sound appropriately,
● Delay in reaching communication milestones,
● Recurrent ear or throat infections (may be associated with hearing loss),
● By 2 years most words are still difficult to understand,
● Cries instead of communicating her needs,
● Does not use or understand gestures and doesn’t have a variety of facial expressions,
● Loss of skills previously gained (regression).
It is recommended that you keep a record of your child’s development: if you are concerned it may help reassure you that your child is, in fact, progressing and if the need arises it will provide useful information for your doctor.