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Speech Delays in Preschoolers

Berkeley Parents Network > Advice > Preschool-aged Kids > Speech Delays in Preschoolers


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4-year-old with "articulation disorder"

Feb 2011

We no longer live in the Bay Area, so I don't need specific provider referrals, but...my 4-year old son has been diagnosed by the school early childhood special ed screening program as having an ''articulation disorder.'' However, he did not qualify for services (not severe enough technically). He doesn't make s, s blends, z, and f sounds in conversation (uses the back of his throat for those rather than the front-sounds like German). He is now capable of making these sounds when I remind him to use the front of his mouth, and the sounds are popping occasionally now into his regular speech. Still, if you don't know him he's hard to understand and I'm sure it'll be an issue in K if not fixed. He is advanced as far as language development and in general otherwise. He was referred to an ENT, who said that his tonsils and possibly his adenoids were enlarged and scheduled him to get them removed. The speech therapist in the ENT clinic also thought she could help him. Problem is-we have an extremely high deductible plus lots of medical bills we're still paying off-and can't afford either the surgery or the therapy. If you are a speech clinician or knowledgeable in this area...will my practicing with him perhaps help him overcome this? What else could we do? Preschooler's mom


You don't say where you live now, but I beleive that anywhere in California, if your child is over 3 years old, the school district in which you reside is required by law to evaluate your child. You have to contact the school district and request an evaluation in writing. If they determine he qualifies for speech therapy, then they are supposed to provide it free! I'd check with your pediatrician where you live now, they should know. Bay Area Pediatrician
My daughter still had issues with sh, th, ch, and j sounds at 4. Like your son, she eventually became able to produce all of the sounds when reminded. As time went on and she got a little older and more self-aware, she started correcting herself (e.g., ''sue, no, SHoe!,'' ''zheese, no, CHeese!''). Now, in kindergarten a couple of months from turning 6, the correct sounds come automatically. This may happen to your son. We considered getting speech therapy and I am so glad we waited because we saved so much money and trouble, and she never had to think of it as a big deal. Anon

4 YO challenged with A,B,C's, speech delay

Jan 2011

We have two daughters - one just turned 6 and the other just turned 4. The 4 year old, who was born 2 months premature, is delayed approx. 1.5 years in most developmental milestones (potty training, speaking, fine motor skills, etc) when compared with the 6 year old. (Thus the older daughter was able to do the same things as the younger daughter at approximately age 2.5). The 4 year old has also recently qualified for 1 year of speech therapy from the Albany school district since she has speech delays. (For example, she says ''wong'' instead of ''wrong'' or ''dare'' instead of ''there''.) The 6 year old is doing just fine in Albany Kindergarten and is speaking, reading and writing simple words and doing simple math. Both children are happy and healthy.

When we visited our pediatrician, she said the 4 year old is not significantly delayed since she can prepare cereal, brush her teeth, play board games, dress self, copy a circle, draw a person, do a broad jump, etc, but she did suggest that we can have her start receiving some physical therapy to help with some of her fine motor development.

I am concerned because I want both girls to be prepared and do well in school. I have started working with them for about an hour a day, including workbook excercises and reading.

Both girls appear to be enjoying this but it's been a few weeks, and my 4 year old has not yet learned to recognize the letters in her name Isabella. (She has, however, enjoyed the mazes which we do, and she's become much better at holding a pencil.) I show her the letters - A, B, and she gets them. Then I ask show her the "I" and "S" and she says, "I don't know!"

Given her speech issues and her delay compared to her sister, does this indicate a long term issue or is it normal? Do children like this catch up? What should we do for the next 1.5 years to prepare her for Kindergarten? We have decided to have her attend another year of pre-school so she will be 5.75 when starting Kindergarten. We are also considering to switch her from the play based school to a school with a more structured Pre-K program?


I am not an expert, but your younger daughter sounds like she might be in the normal range. Mine is in kindergarten now, and the kids' skills vary. Some did not even know their letters going in, and most cannot read more than the most simple words even this late in the year. Anon
My son was speech delayed and premie. We found the dvds by leapfrog helped a lot. They have the letter factory, word factory as well as reading and math for older kids. Once my son saw the 30 min letter factory dvd, he conquered most of his sounds and knew the alphabet (after viewing several times). He still had other issues w/th, s and r, but w/speech therapy most of these have been corrected (still has a lisp). Also, his grammar wasn't the greatest, but much better as he's in 4th grade. Once he start reading a lot, spelling and grammar seem to come easier to him. Having your daughter begin K later is a great idea. There are a lot of demands on kids in the younger years now and many need time to develop. Putting them in class too early can make them feel bad when they see others catching on quicker than they do. A more structured preschool prior to K is a good idea which we didn't do, but wished we did with our son. I would avoid heavy on academics and still have a lot of socializing and play w/academics as part of the program. It sounds like your daughter isn't ready to move on re:the other letters of the alphabet. She may catch on better watching a video or presenting letters w/manipulatives (blocks or wooden letter puzzles). Maybe introduce a letter a week and have fun finding things as you go about your day that begin w/that letter. The more fun it is the more likely she won't get frustrated or shut down (particularily if she sees her older sister being able to get the letters right away). I found my son would shut down if I pushed him to learn the ''traditional'' way (worksheets moving right through to the next thing rather than taking is slowly and using other methods than worksheets). He was ''slow'' to read - really caught on after the Christmas break in 2nd grade. He's in 4th grade now and reads, speaks and writes pretty well. Good luck! anon
I wonder if your 4 year old is as delayed as you think. You compare her to how your six-year old was at that age, but that may not tell you very much. What is probably more helpful is comparing your child to a range of other 4 year olds. What does her preschool teacher think? A preschool teacher has a better idea of what the range of ''normal'' is for four-year olds, and he/she may be able to give you a more accurate picture of your child's development.

What you have described to me does not sound alarming. That being said, if the school district is offering some speech/language or OT services, it certainly won't hurt to accept them. Your child's preschool teacher can also give you a better idea of how ready your daughter is for kindergarten and whether or not it is wise to wait a year. Your child does not need to know all her letters upon entering kindergarten, but kinder has gotten quite academic these days, and in first grade the reading instruction comes fast and furious. Not all kids are ready for it, and they often fall behind before they barely start. good luck


Should I be concerned about 4-y-o's speech?

Dec 2010

My son turned 4 in October. He is extremely bright and very verbal. My concern is that he still sounds a bit like Elmer Fudd. His rs and ls still sound like ws, and his js and chs sounds like zhs consistently, among a few more. He is aware that some of his speech isn't clear to others and doesn't get frustrated, but simply explains until we understand. For example, Him: Mama, I saw a guy dressed like a pie-wit. Me:Pilot or pirate? Him: Pie-wit. You know, the guy that fwies the airpwane. The last time I spoke to his pediatrician about it, it was about a year ago and she said it was not time to worry. When should I be or is this something he will just grow out of? do we need speech therapy?


He sounds adorable! I love how you can so accurately mimic his speech with your writing Please check with your school district and see what early intervention programs they offer for pre-schoolers. In my town (Lafayette) there is a very active early intervention program where they work on speech issues among other things in an effort to improve kindergarten readiness. Best wishes! Christina
Hi, my son has similar speech patterns, and is now 5 and in Kindergarten. At his parent teacher conference we brought this up, as I know that in the Berkeley schools the kids are assessed by a panel of specialists from day one, including a speech therapist. The teacher said he was assessed, but does not need help as of now. At this young age, speech impediments like this are somewhat normal, and the kids often self-correct, or outgrow the problem. berkeley mom of 3
You should be able to contact your school district and have your child's assessed by a speech therapist. Chances are he'll need speech therapy for a bit. Start with the school district you're in and go from there. If you get the ST through the district, it will be free. Here in Berkeley my son (when he was 4) saw a wonderful ST at Cragmont School and he corrected his speech relatively quickly and enjoyed his sessions. Plus, it was great to have people be able to understand him! Good luck. anon
Go on line and search for phoneme development/language development. Here's what I found:
at 4 years:  ''l'' as in lay; ''sh'' as in she; ''ch'' as in chew
at 4.6 years:  ''j'' as in jaw
at 5 years:  ''r'' as in red
Remember that all targets should be broad not spot on. (In other words, some children attain a sound at an earlier age, some later.) Also speech development has nothing to do with intelligence.

Talking to your pediatrician is a good place to start if you have any developmental delay concerns. Ask to get a hearing test from an audiologist if you still are worried. It can't hurt.

My son has major speech delays that have impacted his ability to learn to read phonetically. What you are noticing seems minor to me but every child deserves to have an accurate assessment of any delays that could impact learning. Just because everybody's else's child did fine without any intervention, doesn't mean that's best for your child. On the other hand, pushing a child to do something he/she is not developmentally capable of doing (like accurately pronouncing a particular phoneme) will lead to a lot of frustration for you and your son. SLB


The short answer is he needs speech therapy now. He is aware that his speech is difficult to understand. I don't think it matters much that the pediatrician is not very concerned, they sometimes are not even when intervention is appropriate. I brought up the need for a speech evaluation for my youngest at 2 when he was not babbling or talking, just barking and screeching. To his credit, our pediatrician gave me a long look and told me that this was my 4th child so he was not going to argue with my mother's intuition. My older son had also spoken late but the difference for me with this one was that he was becoming very frustrated where his big brother had just calmly and silently absorbed the world. From a developmental, medical and psychological standpoint, your son is not outgrowing this on his own and is aware of his difficulty. Insist on a speech evaluation. The worst that will happen is that he'll learn that there are ways to help him overcome difficulties in life Elizabeth
Our 4.5 year old has only recently been able to hear the difference between sss, th- and zzz sounds, so she's had a little lisp that I was vaguely wondering about (but also finding adorable I will admit). Every now and then I'd ask her if she could make a clear hissy s sound, and she'd nod, and then put that tongue tip between her teeth and do a nice loud th instead. But suddenly, she *can* hear it! Quite recently. And now she's very interested to know which words have which sounds. I have no idea what suddenly ''clicked'' in her head around this. We didn't do anything particular to address it. When my older kid started talking (back when I worried about everything!) I did look up some stuff about speech development and how to know if your kid was okay, because she was also making some tenacious errors in her speech (''fire f*ck'' for ''fire truck'', for example: not as cute as her little sister's lisp). I Googled ''children's speech development pronunciation'' or some such. My daughter's thing was called ''cluster reduction'', and it was normal for her at the age she was. It sounds as if your son's doing something called ''gliding of liquids'', if you can believe it. Those linguists and their crazy nomenclature! And they say that it's not a problem unless he gets past his 5th birthday and is still doing it.
My daughter had speech issues in preschool. I went to our city's school district and set up a request to get her speech therapy through the district. In Berkeley School District, there is a great pre-school speech teacher, Louise Fender - if she is still there. They will evaluate your child and see if they qualify for assistance, given their age and ability to make different sounds. Our daughter saw the speech therapist once a week for so at preschool and then at her elementary school. She can now make all the sounds,although when she is excited she forgets. So, it is a good age to pursue an IEP, since there is a bit of a waiting time and by the time your child is in kindergarten, their IEP will be all ready to go. Anon
We just had a speech evaluation for our 4 year old (July birthday) because of some of the same sorts of things you are seeing. The speech therapist basically said it is still developmentally appropriate that he talks like that but if it is still happening in 1st or 2nd grade then we should worry. You can call your school district and they will do a free evaluation. Anon
Please see a speech therapist. The articulation problems you describe are not entirely rare at 4 but, as you have noticed, can cause communication problems for the child and are often responsive to therapy. Sometimes kids outgrow the problem, but why prolong the situation? It is a kindness to help them get past it sooner, if possible. The older they get, the more conspicuous and engrained the problem becomes. former speech therapist
Yes, get speech therapy & yes you should be concerned. I am a parent of a boy who had speech therapy beginning at 3 years of age. We were told that is the age speech therapy should begin if there are speech issues. It took a good year of therapy before he was able to speak clearly. The teasing from other children can definitely be an issue, so the sooner you start the better. We got a referral from our pediatrician for speech therapy through Children's Hospital (however budget cuts have eliminated that department), but they would be good resource for a referral. Your insurance hopefully will pay for this. Another great resource is the school district you live in. Believe it or not, all school districts provide speech therapy for children beginning at age 3. All you have to do is send a letter to the school district requesting speech therapy and they are required to contact you within three weeks of your letter. I have to tell you that the best therapy our son received was through Children's Hospital - it was individual twice a week, but the schools give group therapy which didn't work as well for our son. I would also check in with your sons doctor to find out why they didn't refer you sooner. That seems odd. Good luck with this journey as it takes some time and is a lot of work to correct. I believe it corrects sooner now than waiting until elementary school. Good luck - I send you much energy for speech therapy. Parent who has been through it

Speech issue for almost-4 year old

Mar 2010

Our almost-4 year old makes a ''cchh'' sound (sounds like German or Arabic) instead of f, sh, and s. He is understandable if you know this and otherwise has clear speech. He is very verbal-talked early, large vocabulary, very complex sentences-in other words, no cognitive issues. I am hesitant to do the early childhood screening in our district (just moved out of CA) because I've heard horror stories about being ''labeled special ed'' and never losing the label. The preschool director said, ''he'd qualify for special ed for that speech issue,'' and later referred to her ''special ed kids.'' I just hate the idea of labeling kids-mine and others-so early and setting them up to be carefully monitored and assessed throughout their life in elementary school-all I would like is to have this corrected and be done with it. What causes this issue and how can we (if possible) address it to correct it? Is it likely something he can overcome before kindergarten and thus not become ''part of the system?'' -Hesitant parent


As a former Kindergarten teacher (also taught 2nd and 3rd), I spoke with many parents who were concerned about their child's speech. Popular advice, especially from speech therapists, is that you should have them evaluated as soon as possible in order to get them ''help'' with a specialist. It sounds like good advice, but in all honesty I've never seen it be helpful. Kids *do* get stigmatized. It *does* effect their self esteem. It even lowers teacher's expectations for the child, even though speech has nothing to do with intelligence. It makes sense that it's a concern, though. It does make it difficult for the child to communicate effectively. However, the majority of kids will improve without any intervention from a specialist. Several parents confessed their joy during Spring conferences at the unexpected improvement. I've only seen one child not improve by the time they were in older grades, and ironically, he did see a specialist. I think the best thing you could do is to find a Kindergarten teacher who works to make sure that teasing does not happen in his/her classroom, and will do intensive phonemic work with the class. I find your preschool teacher's need to label so many kids ''special ed'' so early repulsive. Every child has special needs and talents. former K teacher
Our, now 4-yr-old, has been in speech therapy through the school district for a year. Yes, it is through the special ed department, and yes it took me a moment to be ok with that. No parent wants their child to be stigmatized with a label. That said, it is very important to address speech issues as soon as they are identified. You always have the choice of going to a private speech therapist, but that could be expensive. By going through the school district, we paid nothing! My son received excellent care, 1 hour per week, and was in a class with other little boys his age, going through the exact same issues. By dealing with his speech issue, and correcting them, before kindergarten, he is less aware that there is anything ''wrong'' with him...he just thinks of the class as yet another fun activity. I'm not sure the same would be true if he was being pulled out of kindergarten to attend a speech class. In my opinion, you should try it out with the school district...speech therapy has to be in some department, just remind yourself that the special education teachers are highly trained and are well qualified to assist your family. Huge Fan of Preschool Speech Therapy
I am a speech/language pathologist in private practice. According to what you described, your son is making unusual sound substitutions. The more unusual the substitution is, the harder it is for other people to understand him. In other words, if a child says ''wabbit'' for ''rabbit,'' everyone understands him because it is a common error. When the errors are unusual, the listener cannot predict what is being said. I am sure a speech pathologist could help him and this would be a fine age to start. I do not think you need to be worried about labeling. Alternatively, you can see a private therapist or check if there are any speech pathology training programs in your area where you might be able to get (discounted) services at their clinics. Joan
Hi, I don't know where you live and things could be radically different there, but I think you're over-reacting about the ''special ed'' label. My son had speeches issues that led us to see a speech therapist when he was four (through the school district)and there was no ''special ed'' stigma attached to it. So, it sounds as if you son also needs a speech therapist and the school district will provide one for him/her once you get the process started. You may need a referral from your child's pediatrician or pre-school/day-care provider or you may not. At any rate, a speech therapist -- either a private one or through the school district -- should be able to solve this issue! Good luck! anon
I used to make a TH for S so thun instead of sun. A speech therapist in elementary school worked with me to fix the speech problem which was caused by improperly placement of my tongue between my teeth when sounding a S. Today they have labels for everything and if you are worried about being labeled perhaps try a different approach to working with your child on the speech development or hire a private speech therapist. The problem could also stem from hearing? If your child does not hear sound at certain frequencies it could cause a problem in his ability to enunciate certain words as they would sound garbled or phonics would all sound CCHH instead of f, sh or s. wise old sage i.e. wiseguy

3 year old's speech unclear

Sept 2008

My son just turned 3 and his speech is very hard to understand. He favors using certain consonants (d and n) and can't use others (s, for example). He gets very frustrated when we don't understand him. Even though I stay home with him, so I listen to him all day, I can't understand about 30 percent of what he is saying. This is the cause of most of his tantrums and is really frustrating for both of us.

When he was a baby, our lactation consultant said he had a very high palate, so maybe that is the problem, I don't know. I don't want to make him feel bad, but I have lost my temper after a year of tantrums and him yelling at me that I don't understand him, and I yelled at him that he needed to speak more clearly if he wanted me to understand (I know--this goes in the annals of terrible motherhood).

Should we try to find a speech pathologist? I have tried slowly mouthing words to him, but it isn't helping much. He is developing normally in all other areas, as far as I can tell. trying hard to understand my boy


This sounds so much like my niece's experience that I had to respond. She, too, was very difficult to understand when she was three. My daughter, who is not quite two years younger, was actually easier for me to understand! It turned out that my niece had really frequent ear infections, and the fluid buildup was interfering with her hearing -- thus, delaying her speech. She was repeating speech as she heard it, which must have sounded like listening to someone talk underwater! Once this was diagnosed, she had shunts put in to drain the fluid, and you would be amazed how quickly her speech improved. She's ten now, and you would never guess there was ever any delay in her speech development. If your son has frequent ear infections, it might be worth investigating whether they're interfering with his hearing. Just one possibility ... Katherine
I would recommend talking with your pediatrician. We had our daughter evaluated for a speech issue, and were eventually able to get her speech therapy for free through the Berkeley Unified School District (they provide services for children age 3 and up). I assume other districts have a similar program, but don't know for sure. Susie
By age three, family and strangers alike should be able to understand a child's speech. But don't worry -- this is the perfect time to get intervention. My daughter also needed speech services. We started her at 3 so she'd have two years of speech therapy before kindergarten. Here's what to do: Talk to your child's pediatrician and ask for a referral for speech and language testing. Your child should be tested to rule out hearing problems, auditory processing issues or physiological problems. Sometimes when a child's speech is unclear, the underlying problem is not comprehension, but articulation, and they just need to strengthen the muscles in their mouths and jaws and practice making sounds correctly. Through your public school district, you can set up an IEP (Individual Learning Plan) for your son even though he is not yet in school. This will save you a ton of money. You can then set up therapy with preschool speech and language specialists. Been there
Wow! I could've wrote this EXACT concern about my son. I just got my son (age 3) evaluated through our school district's early intervention program (WCCUSD). He too had difficulties while breastfeeding with him latching on correctly, can't pronounce certain letters (s,f), and even drooled alot until recently. I'm not sure if there's the same program in other school districts, but all I did was submit a written request with my concerns and he got evaluated within 90 days. They did a quick vision test, hearing test, and then tested his sentence lengths, comprehension, and articulation. His overall assesment is that he's around a year behind in speech and is now qualified for FREE speech therapy each week. I had nothing but good experiences so far with this program and definitely recommend getting evaluated. It doesn't hurt, and only helps your child in the end to build confidence in his speech and communication. Good luck to you both! Danielle
I can't speak specifically to where you live, but start by calling your local school district. In our area, three year olds in need of speech therapy are covered by the school district. Your district can tell you whether they will do the assessment or where to go to get one. If he needs speech therapy, then it probably will be covered. Don't stress about it. My best-friend's three-year-old is in therapy and has been for about six months. It has helped tremendously. Which doesn't mean that she and I (her daughter spends lots of time at my home) don't periodically throw our arms up in complete confusion. And, don't get worry about the battles. Every mom has them. -anon
Have your son get a speech therapy evaluation! He is not purposely speaking unclearly. A speech therapy evaluation will decrease your frustration and his. Jessica Lebe
Children do not learn their speech sounds all at once (''s'' is late developing and r sounds may wait until third grade!) but the communication problems your child is experiencing suggest he should be seen by a speech language pathologist. Public law ensures a free speech screening, and a comprehensive evaluation and therapy if needed. Contact the speech therapist at your local public school and ask who provides these for three year olds. A speech language pathologist who works with young children will tell you if your child's speech is developing normally, if the high palette is a factor, ways to communicate more successfully until he gets his sounds, and how to access free therapy if it is indicated. Best wishes. Pearl
You can have him evaluated through your pediatrician or your public school district. Early intervention is the most successful for speech articulation needs. teacher
Hello, I am the director of Word Works, Speech-Language Pathologists Inc. in Oakland. Our staff specializes in preschool speech and language delays and disorders. I highly recommend bringing your son to us or another clinic soon, to help determine what is going on with his speech.

Typically at age 3 a child should be pretty easy to understand. While there are some sounds that will continue to develop for several years, he should not be as frustrated as you described. It sounds like he is definitely struggling and aware that it is hard to communicate his thoughts, and he could benefit from some intervention.

From age 3 on you can go to your school district for a free evaluation and therapy, however it can take several months to get the process going. Therefore, I recommend going to a clinic such as ours to get the ball rolling faster.

It is often more productive for someone else to work with your child rather than trying to help them yourself, which can cause much frustration. We will help give you ideas and techniques to work with your child at home. All of our therapists work with children in a positive, playful, and productive way. You can look us up at www.wordworkstherpy.com Hope this is helpful! Tamara


I would call your local school district right away and let them know that you would like to schedule a speech assessment for your child. They will do such assessments beginning at age 3 and should be able to provide speech services if your child qualifies. GOod luck! Trish
I would first get his hearing checked and then see a speech therapist. Anon
I think it's perfectly normal to not be able to understand a 3 year old. My daughter is 38 months old and often times, I don't understand what she says. Either because she's not pronouncing it correctly or she's thinking one thing but saying another. And yes because of that she has tantrums. I think the best things to do is if you know which sounds are hard to pronounce try to use words with those sounds more often in your conversation. c.
We have had a similar issue with our son. He is now 4 and begins speech therapy today. It might be worth having him evaluated through the school district or from a referral from your pediatrician. I empathize with the frustration on your part and the part of your son. speech was a huge part of his frustration and later self-consciousness. It doesn't hurt to have it checked out. I have heard that some boys develop speech later and now at 4 my son is much better but there are clearly some sounds that he has great difficulty with. He actually also has a super short frenulum which we are having clipped in a few weeks. That is by an ENT- they call it tongue tied. As for the S sounds- they are said to develop later anyway- but why not have him evaluated. good luck on the road to undertanding
You have two issues: 1.) a potential speech delay and 2.) how to handle temper tantrums.

According to the chart on this website http://www.childdevelopmentinfo.com/development/language_development.shtml at 3-years-old you should understand ninety percent of a child's speech. So it sounds like it's time to get an assessment. After three, your local school district does these assessments for free and if needed provides therapy. You may also qualify for therapy through your health insurance. (Sometimes the school district speech therapy is not enough.) Not only will this help your child's intelligibility with you but it will help him with friendships and academically. My son, too, had this issue and has made great progress with speech therapy.

About the tantrums, improving his speech probably won't make them go away. But working on parenting skills can help you deal with them and keep you from feeling like a frustrated, inadequate parent. A book that has helped me with my preschooler and my middle schooler is ''The Kazdin Method for Parenting the Defiant Child with No Pills, No Therapy, No Contest of Wills'' by Alan Kazdin. I got it from the library. It's a behavior modification approach (which usually turns me off) but it works--primarily by changing the parent to focusing on the desired behavior. Good luck!


I don't think he needs a speech therapist. I think this is really common and I can share my experience. It might help. My son just turned three as well and I was having trouble understanding him about a month ago. After a tantrum (about something unrelated to speech actually), I was just holding him and really feeling a lot of empathy in my heart and maybe he sensed that so he turned to me and said ''Mama, I don't talk weally good.'' I could see how frustrated he was and I just held him a little while and then told him a story. The story was about someone who was still learning how to do something (you could make one up about things he is interested in -- a firefighter or chef for example) and some people in the story said ''You don't do that very good'' but he kept trying and sometimes made mistakes but in the end got a little better every day. After the story my son seemed to feel lighter after that he relaxed a lot more when talking...and I tried extra hard to really listen to him and be patient... not completing sentences for him or correcting him. I remember the first time he said ''Blue'' instead of ''Boo'' and he was so proud of himself. I said, ''I noticed you said Blue. You must have been practicing! Good for you.'' He just beamed. I just think it is important to emphasize the practice and not just give blanket encouragement like ''No, you talk really good!'' when he is obviously frustrated with his speech. He is using a lot more consonants than he did before. He stutters from time to time when he is rushing to get the words out (also really normal for this age) and I am really careful to slow myself down when this happens. Sometimes I say, ''I'm listening'' or ''My ears are open.'' This helps a lot! It is really normal for this age to feel inadequate, and people can be so insensitive sometimes (like parroting back ''cute'' speech to them). We can help them get through it with patience and gently encouraging them to practice. I also point out skateboarders or kids playing soccer (he's really interested in them) and use words like practicing or making mistakes and trying again to emphasize process not product. It must be frustrating for three year olds to hear what ''Great swimmers'' or ''Great dancers'' or ''Great runners'' they are when they are really still learning and growing and they get frustrated with their own performance. When I emphasize process, he seems much more content. I hope this helps. Mama's still learning too!
If he is 3 he qualifies for speech evaluation through the school district and free services if he needs them. Call your school and ask about their early intervention speech screening. My daughter received services through the district for a year from 3.5 to 4.5 and it is amazing how much clearer her speech became from just a one hour a week class. speech therapy mom
Yes, my son had similar problems at the same age. We called the school district and they did a formal assessment and assigned him a speach therapist. He went for perhaps a year with much improvement. The therapist was very skilled at working with a 3 year old. Donna
You should contact your local public school district and request and speech and language assessment. They are required to provide a free assessment to any child over the age of three. good luck! anonymous
You should contact a speech-language pathologist as soon as you can. You should be able to understand 95-100% of what your child is saying by the age of 3 (not content-which can get wacky, but the sounds, how s/he articulates). Call your local school district to get set up with services. However, that can take a while and may not be enough. Private speech therapy is really expensive, but you can get a very thorough program. Look up speech-language pathologists in yahoo yellow pages. You will get a lot of referrals. If you get help now, your child still has a chance of catching up to his peers and it lessens the risk of falling behind in his academic and social development. Don't wait. It won't harm him to meet with a SLP and it may help a lot. local SLP
While it's not all that unusual for three-year-olds to still have some unclear speech, the details of your post gave me pause. Considering his high palate, it is possible that he has some degree of ''tongue tie'' (the tongue shapes the palate, and if the tongue can't elevate enough, the palate remains high rather than broad). This condition isn't always obvious, and the less obvious cases often get missed (or denied) by doctors and speech therapists. Can he stick his tongue all the way out, even with his mouth wide open? Can he touch the top of his mouth with his tongue (with both the tip and the center)? Can he move his tongue over his molars on both sides without it twisting over? If the answer to any of these is no,that may be part of the problem. I also wonder if he has any issues with feeding (picky about textures; difficulty with, or avoids, foods that require a lot of chewing) - - - -
My sister lives in Sacramento and her son had similar speaking difficulties. Here is her advise: Aaron's pediatrician referred us to Alta Regional (Alta California?) for speech therapy. It's totally free, because our tax dollars pay for it. I think it changes after three years old though. I think it's through the school district, but still free. Your BP should ask her doctor or call Alta and ask them. They are SOOO nice and helpful! They will call and then send someone to evaluate the child and take it from there. kelly
hello dear: i think you need speech theraphy for you little one. i have a boy who is going to be 3 1/2 years old. he use to have the same problem. so i look for help. right now he is going to a pre school with the unifed school and he is reciving all the help. hi is speaking much clear now and every day he is learning new words. what they toll me is that he got speech delay, but with help he will be ok. and he is thanks God. Do not worry, just find the right help, your little angel will be ok. you will see. good luck and God bless you. you can write me if you need any information. ed
At 3, your child is entitled to educational evaluations by your school district for free. Contact the special education coordinator and ask for a speech and language evaluation. He can receive services (speech and language therapy) if he is found eligible. ds
My son has speech issues too. Lots of kids have problems annunciating but do not have any other developmental problems. My son gets speech therapy through the school district for free. We live in West Contra Costa county and there is a wonderful program at Cameron School for kids with delays. It can be really frustrating for everyone when your child has trouble communicating. But please try to be patient with him. I know it is hard. It sounds like he is physically unable to make the sounds he wants to. Our son was unintelligible to most people at 2 years old. Now at 3 1/2 he is almost caught up to normal. Definitely talk to your doctor or call the school district about speech therapy. jillian
There are fantastic Early Childhood Intervention programs that you can utilize if you are concerned. Try Cameron School in El Cerrito, the staff there is fantastic and can access your child to see if there is a problem. They can also teach you how to interact with your child (through sign, etc) to help you have a more pleasant interaction. Good luck. anon

Does my stuttering 4-y-o need speech therapy?

May 2008

My child just turned four a couple of months ago, and I'm having trouble figuring out whether she needs speech therapy or is just experiencing normal speech difficulties for her age. For the past three or four months, she often stutters 4-5 times on the first sound of a word. She is also completely unable to make the ''R'' sound. She loves to talk, and it seems to me that the stutter tends to happen when she's thinking about what she wants to say or changes her mind mid-sentence. There is a history of stuttering on one side of the family, which has prompted my concern. I'm not sure whether to pursue this now or wait, and would really appreciate hearing from others. Also, if you do think I should pursue it, what are your suggestions about how to do that? Not sure if there's a problem


I am not a speech teacher but I have been teaching for 20 years. The 'r' sound (or lack thereof) will not be considered a problem until age 7. Eventhough your child has not entered kindergarten, public school districts do screen for speech/language issues starting at age 3. You can call your local school district office to get more information. teacher mom
The place to start would be to have your child evaluated by a speech-language pathologist associated with a children's hospital.(If you get a referral from your pediatrician, your insurance will pay for the evaluation.) The speech-language pathologists at Oakland's Children's Hospital, for example, are excellent. I have personal experience with them, as my own child had an issue and was evaluated by them. Even though I am a language professional, they picked up on important things that I myself hadn't even noticed. The evaluators will tell you where to go from there - they'll answer all your questions about what is going on, how to address it and roughly what lies ahead for you, and they will recommend speech pathologists in your child's needed area. Regarding age of when to start, I don't know about the stuttering issue (if that is even what it is; my son would do something similar to what you describe though it was clearly because he was thinking and it was not stuttering), but as for the articulatory issue: (a) r's are developmentally one of the harder sounds, it just may mean your daughter has a slower maturation curve, and (b) children respond differently to articulatory speech therapy at different ages. There are a lot of drills and homework practice, and I found my own son at age 7 extremely motivated and able to focus, so he completed his re-training in 4 months. Not sure how focused a younger child will be. Again, the evaluator will be able to tell you much more from their own experience. (One last thing - avoid relying on speech therapy offered by the public schools, go for one associated with a hospital or a reliable private practice. My son's speech therapist (associated with a hospital) said that in her experience working in a school setting, schools are woefully understaffed and underfunded, so that children must meet in group sessions and nothing gets accomplished. Children need the one-on-one.) Anon.
First, I'd ask your pediatrician what he or she thinks about your child's speech - I found that many pediatricians tend to think more ''developmentally'' as our pediatrician thought our son's difficulty with articulation was developmentally/age appropriate though my gut told me that there was more to it. Our pediatrician referred us to Children's Hospital Speech Pathology Clinic for an evaluation when he was about 2 1/2. When he turned 3, we went through our school dsitrict (OUSD) as they will screen a child and provide appropriate speech therapy services if needed. This route worked for us. Good luck! Been there, done that
In the first grade, I couldn't say ''s'' -- it didn't impact my ability to understand or be understood, (which is some school discticts' criteria for speech therapy) but my parents had me ''fixed'' and i'm glad they did. One of my best friends in the world stutters like a champ, and while he's married, two kids, successful career, etc., he's a stutterer, and it's ... annoying for him and others. I'd say that if a speech therapist can help, let them help. Dave
As a teacher with over 10 years experience and a mother of a son with a speech delay, I say call the Regional Center of the East Bay NOW. Their services are free- paid for by our tax dollars. I think the younger a child's speech issues can be addressed the better the hope for the future. Besides your time, what have you got to lose? I was concerned about the social fallout for my son with his speech issues. As you notice your child's stuttering, so do others. Sometimes kids (and adults) can be less than kind and patient. Now at 6 years old his speech is clear, he's an excellent reader and I'm glad he got services. happy mom
My 7 yr old stutters in a similiar pattern. We had him assessed by the school district just before kindergarten (at no cost to our family). He is pulled out of class once or twice a week for about 20 min. by a speech therapist. His stuttering has really improved. On the clinical scale, he has gone from moderate to mild in the 2.5 years since he started the therapy. Also, his attitude towards stuttering is really healthy and positive. The therapist is nice and gives him treats. The stuttering foundation has a good website. Cameron School in EC has some info., as well. Good luck. anon
We began to take notice that our our 5 year old son seemed to be struggling with getting out a number of different words and sounds at around 3. I asked his pediatrician about it and she said that it was common and that he should grow out of it. At his 4 year check up, he was not only still stuttering, but it seemed to be getting worse. She was still unconcerned but by 4 1/2, I was. So I requested a referral to be seen by a specialist. He was assessed by a therapist at Children's Hospital who indeed thought that he could benefit from speech therapy. We then got an approval for 12 sessions with a children's speech therapist at Alta Bates and have been seeing her since February. I also called our school district, Alameda Unified, and have gotten him pre-approved for ongoing therapy once he enters kindergarten in the fall, should he need it. What really drove me to pursue all of this now was that I wanted to get a good headstart on addressing the issue before he entered kindergarten and his stuttering became a social concern for him. We are almost done with our initial 12 sessions, and we are now starting to see noticeable improvement. Feel free to email me directly if you have any other questions. dada

Speech therapy for 4-y-o's mild lisping?

Dec 2007

My 4.5 year old daughter pronounces ''s'' with a slight twist of ''th'', and you can see her tounge protruding from her teeth, when she says anything with ''s'' (so I think hers can be classified as the ''inderdental'' type). It is not very severe, and does not interfere with her intelligibility (everybody can understand what she is saying). She is bilingual and lisping occurs in both languages (whereas in the other language, ''th'' sound does not exist). I am concerned, because if it contiues like this, she might be one of those people with a slight lisp in adulthood. What if she wants to become a singer or something? Is it time to take action yet, or is it too early? If I needed to take her to a speech therapist, do you have any recommendations? I don't even know where to start from to look for a speech therapist. Does Kaiser have them, or can an initial assessment be done in pre-school or when she starts school next year? Thank you for your advice. anon


Your school district will assess your child's speech needs beginning at age 3, I believe. Contact your local school district. Do it now, you are not too early!!!
I recently went through this with my child and so can give you some information:

The place to start is to get your child evaluated by a pediatric speech therapist associated with a hospital. I am familiar with two, Children's Hospital Oakland, via their speech & language center on Claremont Ave., and Herrick/Alta Bates Pediatric Rehabilitation, speech & language center, on Dwight Way in Berkeley. Both of these are excellent. I don't know if your Kaiser insurance will allow you to be referred their by your pediatrician. If there is a Kaiser in-house evaluation process, then do it there I suppose. But starting with this type of evaluation is key. I would start here rather than having her evaluated in the schools.

The evaluator will then tell you how to proceed and where best to sign up for speech therapy. They will tell you if this is something to be concerned about at 4.5 years or if she'll outgrow it, if there is an anatomical issue, exactly which sound contexts she lisps in (i.e. it may be only when S is before/after certain sounds) and if there are any other issues in addition.

I can recommended extremely highly the speech therapists at Herrick Speech & Language, Angela Korpela and Meredith Trowbridge. They do evaluation as well as the therapy itself. They are both fantastic, work extremely well with children, very knowledgeable. Their scheduler Cathy 204-6729 can put you in touch with them. You may want to initially ask to talk to Angela as she has been practicing there for 18 years and can inform you about your daughter based on much prior experience. I spoke to her myself initially and was so impressed I was willing to be on her waiting list just to get a chance to work with her. My son actually wound up with Meredith Trowbridge, who joined the group this June (we didn't want to wait any longer) - Meredith was fantastic. We were told that 6 months would be extremely speedy progress on my son's issue, and Meredith helped my son finish in 4 months.

Some advice:

1) Insurance approval is difficult to get. Speech therapy is expensive to pay out of pocket, but that's what we did and I am so glad, my son's speech is beautiful. 2) Your child will be assigned daily excercises by the speech therapy. Do these diligently. This is where the real progress is made. The weekly 45 minute sessions are for progress diagnostics, assigning and introducing new techniques and drills, and teaching the child how to focus in on the issue and be aware of it and be able to hear not good/good sounds. But don't expect progress just by the therapy sessions, in my experience everything hinges on teaching the tongue muscle new skills by daily repetition at home.

Good luck! Believer in speech therapy


I posted just above about Herrick Speech and just wanted to add one more thing: while speech therapy is expensive, paying out of pocket is less expensive than it could be. If you are denied by your insurance, then Herrick/Alta Bates can set you up with an uninsured discount, which was something like 40 or 50%, I don't recall the exact figure, and then if you pay your bill within 30 days you can call a special phone number on the bill to receive a prompt payment further 20% discount.

Also, age may make a difference in the speed of the progress, talk to Angela or Meredith about this. My child was highly motivated at 7 to be able to finally speak clearly, I don't know if he would have been as focused at a younger age...maybe..I just don't have any experience of this sort. Believer in speech therapy


I am a Speech-Language Pathologist. What you are describing is not developmentally wrong. In the scheme of possible speech issues, it is relatively minor. Correcting an ''s'' takes quite a bit of self-discipline and I find it is often hard for 4-year-olds to follow through, although many 4 year olds can fix it if they are into it. If it is not affecting her intelligibility and she is not being teased or doesn't feel bad about it, then it isn't imperative that you take care of it now. It won't necessarily get harder for her to fix later if it persists (and it may be easier to fix when she is older and more mature and can tolerate the repetitive exercises). Really, unless she will be a professional speaker when she grows up, there is nothing super horrible about having a tiny lisp. SLP

3 year old lisping

Oct 2007

At what age is lisping not OK anymore? My daughter's tounge sticks out between her teeth when trying to make an ''S'' sound. If I show her my mouth, and ask her to do it properly, she can after some trying. But, she doesn't normally. Her ''tch'' sounds are a bit off as well. It's very cute, actually, and doesn't bother me, but I have no idea at what age it's necessary to intervene in order for her not to be an adult with a lisp. Lithping daughter


We have gone through some similar concerns with our son. Your local school district should be able to test your child to see whether she's on track. We had our son tested by the school district as well as privately -- the private speech therapist gave us a flier with information on appropriate ages for certain sounds, and the ''s'' sound is listed at 7 -- meaning that they should have mastered the sound by 7. However, if you would feel better, try to pursue at least an assessment through the school district! been there, unconcerned now
My step-mother is a speech therapist and special ed teacher in S. CA. From her, I have learned that you can get free speech therapy from your school district BEFORE your child enters kindergarten. Call your school district and find out what the requirements are. Usually, you begin with an evaluation. My neice had the same issue at age three, and my sister got her into the school speech therapy program at age 3 or 4. She progressed well, but continued until she was about 8. Good luck! Susan B
Try contacting your local public school. She may be eligible to receive speech therapy at about this age. I beleive that by law the school districts can give services such as speech therapy even before beginning school. It is something worth looking into. Anon
3 is still early, many children -especially boys- have articulatory issues that don't resolve until 1st grade even, and all children have different articulatory developmental curves so don't necessarily go by what other girls her age are doing. But if it will ease your mind, I'd suggested having her evaluated by one of the speech pathologists associated with Children's Hospital in Oakland, get a referreal from your pediatrician. Don't go to one of the independent speech therapists in the area. I've actually been down this road for my child, and Children's Hosptial were excellent. The independent ones I felt didn't know their stufff. Good luck! anon
I'm not speech-language pathologist, but I do know that I lisped as a child. And around first grade-second grade I went to an SLP, and she fixed me, easy. a

3-year-old is not verbal at all

Oct 2006

This is my question; my child is not verbal at all. he likes to talk but is totally non-understandable. the doctor says it is up to him to make it happen i.e. certain constanants etc. are vacant from his speech. the doctor says it's developmental. he has to develope it on his own. we read to him, he loves books. he likes to learn and seems like he wants to talk but just can't find the words. literally. has anyone ever been in this situation? what happens at ''speech therapy'' clases. is it necessary to get them? he is developing normal, does it even matter? he is just three in November? he will catch up adventualy? concerned parent


when my boy was almost 3, he started speech therapy for articulation issues (just couldn't undertsand him!) it was free through the school district, call the special ed office. I brought him in once a week, it's not a ''class'' it was 1-on-1 game playing with a teacher. he loved it! and he got much clearer christine
My now 4 year old daughter is well understood by all. She has had speech therapy for a year (with the summer off). She was getting frustrated because it was hard to understand her. She goes to the Cameron School. It's early childhood prevention through the West Contra Costa School District. You have to live in the District to go. If you do, call them, get your child assesed and go. She loves it, can't wait for her 2x a week sessions. There's four children and they meet for 45 mintues and is great. They do fun things, projects, art etc. It's THE hidden jewel in the district. She's so happy. Even this morning the preschool teacher commented how great her speech is. Much luck! cheers for speech
Here in Oakland (you will need to check with your school dist) your child is eligible for speech, lang and occupational therapy starting at age 3 if s/he qualfies. The diagnostic evaluation is free, why not have your child tested? My daughter was not a severe case, but she did qualify and the past 6 months of speech and OT have done wonders for her (she is almost 4 now). She gets free services at our local elem school and they have been great. Montclair Mommy
At 3, the schoool system becomes responsible through early intervention programs. Contact your local school district about having your child evaluated once he turns 3, and they will determine if he is eligible for services through the school district.

If you want to do something immediately, or if he is deemed ineligible by the school district, you could have an evaluation done by a private speech therapist. Treatment will depend on his diagnosis.

My son underwent therapy through the school system and with a private therapist starting at age 3. He was having problems socializing at preschool because the other kids couldn't understand him. His was an articulation issue, and the sessions primarily consisted of playing games that involved making specific sounds that he had trouble with. We also had homework to practice at home. My son might have outgrown it on his own, but I think the therapy helped him improve more quickly Speech Therapy Graduate


at three I believe they are supposed to be putting two words together, my son has a speech problem but he has CP. he is now 5 and his speech is not clear, he does alot of mumbling, I would say, get him evaluated, when it comes to your childs development dont listen to people/doctors that tell you to ''lets wait and see'' that does not work, my son started speech therapy at 2, you should push to get him evaluated the school district can do that for you. They start them at 3, they can also do the eval if your doctor refuses to do anything, and is telling you ''lets wait and see'' go with your mommy instinct... good luck..and I hope all is well claudia
Pediatricians can tend to be too conservative about child development, particularly if you have a boy. ''He'll grow out of it'' is not always the right answer. I recommend having your child evaluated by a developmental pediatrician or by the Regional Center. If there is a problem, you absolutely need to find out sooner rather than later Jill
Your son's doctor might be right (2- and 3-year-olds are often hard to understand). Since you are worried, check out this website to make sure your child is meeting developmental milestones in his speech. http://www.asha.org/public/speech/development/child_hear_talk.htm If not, show your doctor the list, and ask for a referral for a speech language evaluation. A speech language pathologist can assess his communication development to tell you whether or not your child needs speech language therapy. Once your child turns 3, you could also contact your local school district for an assessment. (Then you won't need the pediatrician's referral) A speech language pathologist (and mother)
If your child is close to three (as in less than 3 months until his 3rd b-day) contact your local school district and have him assessed by the speech therapist. If he qualifies for speech therapy, the school district will cover it. You could pay privately, but the assessments are expensive and hourly therapy ranges from $80 to $120 per hour. You can contact the Regional Center of the East Bay 510-383-1200 as well (ask for the assessment intake worker for kids under three years of age). But they will only cover services until your child is 3 years old. It takes a while to go through the assessment process...so the District might be a better bet. Good luck, Anonymous
My son also had no understandable words but used a lot of imaginary conversational sounds at 2-1/2, too. People kept telling me not to worry because boys develop speech later than girls, Albert Einstein didn't speak until he was seven, their uncle/son/whoever was just like my child and now holds a Ph.D., etc., etc., etc. Suffice it to say, now at 3 years old my son should have 900-1,000 vocabularly words, be speaking in 3 word sentences, and have 90% of his words be understandable. None of which is close to the case. (For language development milestones see www.childdevelopmentinfo.com/development/ language_development.shtml)

Call your school district for a speech assesment. They start providing services at 3 years old and will assess children who are near that age. Even if you choose not to use the district's free services (paid for by your tax dollars), at least you'll know where your child's language development stands. My son's assessment helped me understand his particular issues and his speech therapy (twice a week for 45 minutes each) gives me techniques for helping him produce sounds that increasingly make his speech more understandable (along with increasing his vocabulary).

I don't care if he would have ''grown out of this'' someday. My child deserves to use words to make friends, use words instead of screams or fists to resolve conflicts, use words to talk about his feelings, ideas, dreams, fears--just like other children his age. So why wait this out when speech therapy can help him do this now? What I really don't understand--especially since speech delays are easier to resolve earlier rather than later--is why so many people encouraged me to chance it and just wait and see. Susan


You should contact a speech therapist. A speech therapist will evaluate your child's speech, or lack there of, and ability to understand language. Speech therapy will help you child use language and it's usually fun. There are lots of speech therapists in the area - here is the practice that evaluated my child when he was young (3.5yrs) Amy Faltz and associates 510-654-3381 they have an office on Piedmont ave and one on Solano ave. Laura
You might wait until he turns 3, then contact your school district for an evaluation. It is free, and if they find that he is in need of speech therapy, that is free as well. I suggest waiting until he turns 3, because prior to age 3 he would fall under the jurisdiction of the regional center, but once he turns 3 he would start receiving services through the school district. The transfer over can be kind of a hassle, so you might as well wait until he actually is 3. Good luck! been there!
You have every right to have your child evaluated if you believe he has speech issues. Since he is almost three, contact your city's school district and explain your concerns. They will perform the evaluation and decide whether or not he qualifies for speech therapy. Your child is entitled to this by law through the Individuals with Disabilities Education Act. As a teacher and a mother of a child who received speech therapy, my advice to you is to trust your instincts and have your child evaluated. P.S. Your son should have his hearing tested, too. EGW
Insist on a speech evaluation. All children develop at different rates, some do speak later than others. Most children are intelligible by age 3. Your child should also have a hearing evaluation and any good speech pathologist will require one prior to the speech evaluation. They might find that there is nothing wrong, but if your child is truly having problems, therapy is needed. Not being able to communicate becomes very frustrating, particularly as children start preschool. Insist on an evaluation Elizabeth

Speech therapist for 3 1/2 year old

Oct 2006

I'm looking for speech therapist recommendations for my 3 1/2 year old son. I'd like to find someone who is mostly play based and not too structured...someone that my son will look forward to seeing once or twice/week! We're looking to find someone in the Berkeley/Oakland/Albany area. Thanks!


Our pediatrician recommended that we try our local school district for speech therapy. My son sees a therapist two times a week for 30 - 45 minutes. He has made vast improvements and there was no fee to me. Please request an evaluation from your school district! Pinole Mom of 4 year old
Louise Fender (655-2175) helped my daughter with her speech. She played games--something different every time--gave little treats, and was very effective. My daughter really looked forward to seeing her. She also came to our house in North Berkeley, which was great. I found her through a BPN listing and am happy to second the recommendation Mary

Assessment for 3-y-o's pronunciation problems

Feb 2005

I am really worried about my sons speech language development. He has good vocabulary, but for example he transposes words/letters. His articulation of words is at times hard to understand (it is cute - still like baby talk), though his vocabulary is broad. Like he can't pronounce the letters: f or s at the beginning of a word. Snake is ''nake'', frog is ''wog''. I'm wondering where do I get him tested? What is available for assessing preschoolers and where do I start? Also is it covered by healthcare? Are there pediatricians who can do testing? other resources? preschools and schools for children with language learning issues, any information at all. I've researched online and also in the archives but the information is not recent, and most is for older children. thank you in advance for any advice. desperately worried mom


I am currently taking my 3 year old son to the Cameron School in El Cerrito for speech/language therapy. I'm not sure where you are located or what their policy is as far as treating children in Berkeley/Oakland since they are part of the West Contra Costa school district, but it's worth calling and checking out. The number is 233-1955 and since it is state funded, there is no cost to us. taylorsmama
From what you describe, it sounds like your child may have a phonological disorder (sound system problems for speech production). Speech Language Pathologists are the professionals, who assess and treat speech & language problems. You may find these professionals listed in the Yellow Pages or by visiting the American Speech, Language and Hearing Association website. However, there aren't many professionals in private practice and they are typically quite expensive. You may consider contacting your local school district, because as a parent of a child over 36 months, you may request that your child be assessed. He may not qualify for services because the districts have strigent criteria. California State University East Bay (AKA Hayward) has a university clinic, where I am the Clinic Director. You can seek info about our clinical services on the University Website or by calling 885-3233. SFSU also has a training clinic. Lastly, you may want to discuss your concerns with your pediatrician to seek out his/her advice. I hope this cursory response is helpful. Shelley Simrin
Call your local school system and ask for an appointment for your child to evaluated by the preschool speech/language therapist. They may refer you to a SELPA (Special education local plan area) for the appoinment. It is a free service and you can get your questions answered by a qualified therapist. If you have amazing insurance, an evaluation may be a covered benefit. Ask your child's primary care doctor for their referral. anon
Call the school district, and ask them where to address a request for an evaluation. The school district provides these services, even before your son enters school (and yes, it's free).Then, put your request in writing, and send it certified mail. You may also want to talk with your pediatrician about normal development,what to expect when, etc. Many kids are saved a great deal of trouble by getting early intervention with speech and/or hearing so you are absolutely doing the right thing to follow up. Good luck. You can find information also at ''LD Online'' Carrie
You don't say where you live, but school districts are usually the ones that carry out the Federal and State (I believe) mandate to offer free speech therapy/testing (and other learning disorders) to kids 3 and over (see the California Department of Health Services Early Start program website: www.dds.ca.gov/earlystart). My daughter is 3 and currently in speech therapy through the Oakland Unified School District. I was very impressed with the speed with which they did the testing (one nurse visit followed by one speech evaluation) and then the therapy started (w/in one week of the evaluation). Granted, I had to follow up and push a bit, but it was great. And its free.If you are in Oakland, call the OUSD Diagnostic Center and say you want to get your child tested. If not, I don't have a number for you but maybe the OUSD Diagnostic Center could direct you, or check the website above.

You can also do it privately, and during the summer break we will be doing this through Children's Hospital. For us it all started with the pediatrician who sent us to an ENT who got her hearing tested, which found a deficit, which lead to surgery, which fixed the problem, and in there he ''prescribed'' a speech evaluation. She has articulation problems like your child. This was all paid through via insurance. Then once she turned 3 we went to OUSD who as I've said we've been very happy with and will stick with for now. Good luck. Hilary


Start with your pediatrician. Depending on your health insurance, initial testing may be covered. My son's testing was covered by Kaiser. Depending on the results, you will then probably be referred to your local school district. School districts in California provide free therapy and/or preschool for a variety of problems that can be considered learning disabilities, for kids aged 3 to 18. Speech problems definitely fall under that category! My son was enrolled in the county early intervention program for speech delay, and is now transitioning to our local school district. The good news is, therapy works! Fear not, I am sure they can help your son! anonymous
My daughter had the same problem until a bit older. Pre-schools pressured me to take her to a speech therapist to get tested. I consulted a linguist who is a specialist in language acquisition and was told that the only reason to get speech therapy is psychological. Kids can tease at school. Otherwise, as children develop, they become able to pronounce the letters without the need for therapy. The inability to pronounce letters correctly does not interfere with the child's ability to perceive differences in sounds, and therefore will not affect how the child learns to read and write (if I imitated my daughter's wrong pronunciation she would point out my mistake). Thus, we do not see older children, teens or adults with this problem. My daughter is 10 and has been speaking perfectly since she was about 5. At that time, again under school pressure, I asked her whether she wanted to go to a special teacher (speech therapist). She said she wanted me to teach her. I chose a letter at a time, showed her first how to position her mouth, teeth and tongue to make the sound, and drilled her and corrected her for about two days. As she got a letter, we moved on to the next. We did this for all but one, which she got on her own. She never had speech therapy and this never affected her performance in school. I am sure speech therapists will provide you with many reasons to seek their professional help, but I am personally very invested in demedicalizing our differences, so I was happy to learn from a specialist with no financial interest in promoting therapy that this is an issue which does not need ''treatment''. Been there
The pronunciation you described (''nake'' for snake and ''wog'' for frog)is not that unusual for a 3-year-old. I studied Speech Language Pathology and checked the norms after reading your post. Though half of 3-year-olds pronounce /f/, most (90%) can by age 4. /s/ takes longer with half pronouncing by age 4.5 and most by school-age. Nevertheless, if your son's speech is markedly different than his peers, I'd have him assessed. He'll probably have fun during the process and it should ease your worries. Also, if there is a problem, you won't feel guilty about ignoring it. Start with your local school district. Put your request in writing and follow-up with a phone call. I think they have 60 days to do the assessment. You could also check to see if the Scottish Rite in Oakland can help you. Cal State Hayward's Dept. of Comm. Sciences and Disorders could also assess him (510-885-3233). Please feel free to email me if you have more questions. Paula Crosatto
Call your local Regional center and tell them you would like your child tested for speech issues. Be persistent, it may take a while. This will be free. After your child turns 4 the school district is responsible for testing/treating your child for free. You can also ask your pediatrician to a referral for speech/language testing. Where you go will probably be determined by your insurance plan. Both Alta Bates and Children's have speech testing. The first thing your pediatrician should do is order a hearing test. If you're worried you should go with your gut and get reassurance but I have to say that what you've described does not sound at all unusual or worrisome to me (a special education parent whose child has serious language/learning/attention problems). I think it is way too soon to tell about dyslexia and that you need to look at the whole picture of your son's langauge development. Does he understand what is going on around him? Does he understand what he is supposed to do in different situations? Does he communicate with you? With other children? Experts say the best way to help any child develop is to get down on the floor with them and do one on one pretend play. please try not to worry
It sounds like your son has a problem with what is called phonology. I know that the Oakland Unified School District offers classes for preschool children with phonological speech issues, and I would imagine that other school districts would as well. The first thing you should do is to contact the diagnostic center for your local school district to request a speech/language assessment (no cost to you), and see what services they have to offer (also no cost to you). Charlotte
I don't know if this will be of any help at all to you, but I'll post it anyway. My friend has a little girl with (It sounds like from your discription anyway) the same issues your son does. She has been doing speech therapy, I think it is a group class, since she was 3, and now she is 4 and a half. She is making great progress. The state pays for it through the school district, so there is no finanical problem for you. I'm not sure if you need a doctors referrel or not. They also tested her hearing through the same program. I have heard about it before through this site, so you might want to check the archives. The good news is that I can almost always understand my friend's child now, and I think that makes everyone feel great. ( I was also going to look into this, as my son's speech was difficult to understand, but suddenly it all came together right around his 3rd birthday) Good Luck. Your son is lucky to have a proacitve Mom. annon

Worried my 3 yr old has speech problems/dyslexia

Feb 2005

My lovely 3 1/2 year old son is a wonderful boy in all ways. Lately I've been getting really worried about his speech. Lately I've noticed that the clarity of his speech is sounding less and less clear than that of his peers. He's very bright, seems ahead in gross and fine motor development, very active, artistic, communicative, social, friendly and an 'easy', happy child. Everyone keeps saying it is too soon to tell, but I want to catch anything now before he starts feeling self esteem issues when people don't understand him. I'm wondering how other parents have handled these issues and how they have prepared their child for what is ahead without scaring them or leaving them in the dark.

He has good vocabulary, sentences seem fine most of the time but for example he transposes words/letters. (Like he'll say: ''I don't want you to go TA all'' instead of ''...I don't want you to go AT all.'' He sometimes repeats himself till he gets a verbal response to make sure he's been heard or understood. When he is very tired sometimes he stutters slightly - finding it hard to get the words out. His articulation of words is at times hard to understand (it is cute - still like baby talk), though his vocabulary is broad. Like he can't pronounce the letters: f or s at the beginning of a word. Snake is ''nake'', frog is ''wog'' or ''pog'', dog is ''gog'', socks are ''kocks'', cornflakes is ''compakes'', Jeremy is ''Je-emy'', and so on...I'm now almost sure he has something going on - like maybe dyslexia. He is such a charming and adorable child and so communicative that he can still get people engaged with him with ease. I want him to continue with that ease and am worried I may not catch whatever it is in time to assist him fully.

If you or someone you know has experience with anything like this, would you please give me some information? Where do I get him tested? What is available for assessing preschoolers and where do I start?

At first I thought he just needed regular exposure to other kids, as he was home with me till four months ago. Now he is in preschool part-time the overall difference is not hugely significant. He's been exposed to a lot of activities and experiences as I took him to lots of places so is quite knowledgeable, observant and creative.

I'm a single mom and with meager resources. If anyone knows ANYTHING about learning disorders, please can you write something - assessment centers? is it covered by healthcare? pediatricians who can do testing? other resources? preschools and schools for children with language learning issues, any information at all.

I am just beginning this journey and desperate to learn all I can to support him to realize his best potential. I've researched online and also in the archives but the information is not recent, and most is for older children. thank you in advance for any advice. desperately worried mom


I'm so sorry that your son's speech is worrying you. My son also had trouble with articulation at age 3, and I spoke to my pediatrician about it. He referred us to the wonderful Speech Therapists at Alta Bates Herrick, who did very thorough speech and language testing. As it turned out, his articulation was at about 18th percentile for his age; they said he would have needed to have articulation at less than 15th percentile to qualify for speech therapy (at least the free therapy paid for by public schools; this sort of free speech therapy is available to children as young as 3 through your local school system, I think). But because his language and cognitive abilities were so much higher than his articulation, he did qualify for speech therapy, paid for by our HealthNet HMO. I was so glad, since he had such great ideas he wanted to communicate, but even his preschool teacher didn't always understand him. He qualified for speech therapy at Alta Bates Herrick once a week for about 6 months. In that time his articulation of 'w', 's' and 'l' sounds improved dramatically, and his 'r' sounds are much better.

I would encourage you to talk to your pediatrician and have your son tested now, and not wait. The sooner you can do it, the better, as children at 3 don't mind repeating things over and over as much as children at 6, when speech problems are normally picked up. Good luck!


I'm sorry that you are so desparately worried that your son who sounds wonderful in most respects may have a learning disability. As a parent of a child with severe learning disabilities I was offended by your tone of horror at the idea that your son may have learning differences. If your son really is dyslexic it is not going to be the end of the world or even something you would have to prepare him for at the age of 3.5. Although language based, dyslexia specifically refers to problems with reading and since your son is only 3 and has not yet started reading you have plenty of time to address any problems he may have. I think the best way for you to help your son maintain his current ease with the world is for you to try to relax a little about his pronunciation. You can't prepare him or any child for what is ahead because no one can tell how any child will fulfill their academic potential. Do you really want to start telling him he might have to learn differently from other kids before he is even in school? Go to schwablearning.org for information. good luck
I am a speech-language pathologist working with pre-schoolers. It sounds by your description that some of the things that your son is doing may be developmentally appropriate. To have a speech-language evaluation, the best place to start is with your school district. Each district has a preschool program where they do evaluations and therapy, if indicated. Unfortunatly, it usually takes a long time to get an appointment. The department that you contact is usually called Special Services. I would be more than happy to answer any more of your questions- you can email me directly. Good luck. loren
Your school district should provide free testing and evaluation for all 3 year olds and above. Once a child is in Kindergarten they need to be in the public school system otherwise you will need to go and have your child tested privately (very expensive).

I'm not sure what district you are in but we are in the Contra Costa School District where this testing is readily available. Depending on what your child is eligible for, therapy is available weekly, or several times per week (my friends son went 4x per week for 20 min sessions). My child attended once per week for a 60 min speech therapy class. All this paid for by your tax dollars. We went through all this when my daughter was 3 years old. She stayed in the program for over 2 years.

All preschools should have this information posted on the bulletin board. The school district sends out flyers to all preschools. You do not need a referral.

As I stated previously, this service is paid by your tax dollars. If you have any misgivings about your childs speech development (and it's sounds like you do), you have everything to gain and nothing to lose by having them tested.

My advice is to call your district office now and have your child tested, esp. if you intend to have he/she go to a private elementary school. They won't be eligible then. As in all these situations you need to be your child's strong advocate. Good Luck


My now 16 year old son could barely talk at that age, but many of the words he did say were exactly the pronouncement you say your son has. He found his way on his own and his speech was fine by kindergarten. Speech delays are not uncommon in boys. However, in retrospect, I might have had him tested, he has struggled some with school although there have been other, non learning disability factors involved. If you're worried, I believe your local school district is legally obligated to provide you with educational testing if you ask for it, even if your child is preschool age. I think they also must provide you with speech therapy if necessary. You may have to wait awhile, but they are generally very good, they've seen a million kids & know their stuff, and it's free! Call the district and find your way around. I'm sure others will post having been through this process. Good luck. Jenny
Call your local school district. They are obligated to assess him and provide services, if they determine there is a need. If you live in Oakland I am happy to get you phone #'s and email addresses of the people to get you started, but unfortunately don't have contact info for other districts. Good luck.

Speech therapy for apraxic 4-year-old

July 2004

We want to pay privately for extra speech therapy to supplement what my son receives in school. He is going on four and is diagnosed with childhood apraxia of speech. (We have Kaiser health insurance and it isn't looking like they will pay for it). We just scheduled him to see Patricia Dodd with Faltz Associates on Solano Ave. Is anyone familiar with her, and would you recommend her for a child of his age and/or diagnosis? Or does anyone recommend any other private speech therapist? Any relevant information would be much appreciated! Jessica


Angela Korpela or Michelle Gibson at Herrick Pediatric Rehab. are quite experienced with apraxia - 510-204-4599, though you would be paying out-of-pocket. Also if you don't already know about the website www.apraxia-kids.org, it has some helpful resources. Good luck! parent of apraxic toddler
My son saw both Sarah Thompson and Martha Wagele at Faltz Associates from age 5 till about 7. (From 4-5 he worked with Kris Baines at Children's, but he hit the wall with her so we needed to change.) He worked better with both of them than he did with Patricia, who did his assessment. Martha left Faltz and was in private practice last I knew. The contact number I have for her is 510 525 6649. - Nancy
I'd like to share our experience with Patricia with just a few disclaimers at the end. We actually used Patricia Dodd at Faltz for a few months this past spring. Our daughter was 3.5 at the time and had/has severe speech and language delays. We actually stopped the speech therapy sessions for a few different reasons. Although Patricia is an extremely sweet person (my daughter liked her a lot) as a parent I didn't find her to be very personable at all. Extremely formal, not really into chatting about or learning about how our daughter behaved outside the office walls. To me this is good information for the therapist. It didn't seem like she felt a strong need to collaborate so I didn't feel like it was a joint effort. Also, to me she seemed very ''by the book''...very straight forward, not too much innovation or creativity. And given all this, very expensive (I know all private practices will be).

With that said, we have never had a formal diagnosis for our daughter so we aren't quite sure ourselves if the way, for instance, to tackle the speech delay is speech therapy. My point is, I may not have been completely convinced it was the right route in the first place, so opinions could be tainted. I guess I would like to pass on the information but give ALL the information so that I'm being fair about it as well. anonymous


My son, who is now 6 yrs old, has been seeing Patricia Dodd for about 2 years. My Son's diagnosis is PDD/language delay. He also receives speach from his school. We continue with the private speach therapy because we feel that she challenges him more than the school therapist does. She has a good relationship with him and is able to keep him focused. If you have any other questions please feel free to contact me at my e- mail. Sandy

Twins, 4 yrs, delayed speech, behavior

March 2004

I have soon to be 4 year old twin girls. I am somewhat concerned about their speech and development. They were born 6 weeks premature, and were in the NICU for a couple weeks because of difficulty feeding, but were basically okay. They are doing well in preschool, but are behind almost all the other kids as far as speech and behavior. One twin, for example, will not answer ''yes'' to a question. If I say, do you want some ice cream?'', she'll say ''Want some ice cream!'' If I say ''Say 'Yes. I want some ice cream.' '', she'll respond with ''Say yes! I want some ice cream!'' The other twin is just beginning to use ''Yes'' appropriately, but she did the same thing for a long time. If they have any distraction at all, they seem unable to focus on what I'm saying to them. They both have low frustration levels, and have temper tantrums and crying jags when they don't get their way, or are tired. They have a hard time sitting still, and we are just now to the point where we can go out to a restaurant and expect them to sit for 30 minutes in a chair. All the other kids their age are so much more articulate. We have had behavioralist specialists see them, and all they say is that they are behind, but they don't know why. They have said that they are not autistic, or on the auitistic spectrum. One specialist recommended a special ed classroom, but I did not like the classroom or the teacher's methods. We are working on some speech therapy at home with recommendations given by a speech therapist. I am just wondering if anyone with twins has had a similar experience, or should I be more worried? Signed: twin mom Signed: twin mom


I was really taken by your posting and suggest you talk with my local HANDLE practitioner, Sindy Wilkinson, who specializes in children with neurological development remediation through short- term, non-drug, movement exercises. I have been seeing her myself this year after my daughter had such fantastic results. Sounds like the delays you are describing seem to be based on neurological systems that need nurturing and practice to do their jobs efficiently. In this context, with what you relayed, your girls' difficulties actually make sense . From what I know, ''Echolalia'' - or the repeating of words - is part of learning speech, and that one of the twins has demonstrated that by her moving on to more appropriate ''yes'' responses after mastering the repeating behavior. I encourage you to talk with Sindy. She has a really accessible nature, is a parent of two girls herself, both of whom prospered from HANDLE and that is why she became a student of and now a certified full practioner of HANDLE. Sindy can describe how this all makes sense from the HANDLE perspective. My daughter and I have learned that there are simple and fun ways to do little games/play exercises, which will assist even 4 year olds' neurological systems to mature and ''catch them up.'' My 14 year old progressed much, much faster than I did, with my being 53!
Sindy Wilkinson, MA 
HANDLE Practioner and Licensed Marriage and FAmily Therapist 
(and she knows about parenting!) 
Lafayette 925-962-9506 
Wishing you well. Having a context of understanding helps so much. A fellow loving MOM

Developmental Language Disorder: Appropriate School?

Feb. 2004

My son, who is 2.9 months old was diagnosed with a developmental language disorder(mixed receptive and expressive).He is at a pre school right now, but the teacher has no experience with kids with language disorders, so I am looking for a new school for him. Does anyone know of a good school that has experience with this disorder? I would also like to talk with someone that knows about this disorder and have been trough what I am going right now. He is being seen by a speech therapist once a week,trough Regional Center, and is making progress, but I need more resources. I called Scottish Rite Temple and the waiting list is a year long. I am pretty sure that he is going to be eligible for OUSD in September, but he is turning 3 in May and I need to get him in a different pre school ASAP. Can someone help?? Thanks a lot.


Recommendations received:
  • The Lake School near Lake Merritt

    Other advice:

    Do you need just a few hours of preschool, or do you need full days?

    For just a few hours:
    --Small Voices is an early-intervention program at the Alta Bates Herrick campus in Berkeley. Usually kids go there for free because they are Regional Center of the East Bay clients (call 383-1200 and ask for an intake coordinator to get your boy evaluated).
    --Similarly, CEID (in Berkeley; see www.ceid.org) has a preschool program that accepts kids with language delays, 527-5244.
    --Finally, if your son turns 3 in May, you might think about having an IEP with the Oakland diagnotic team (870-1760) in the spring--perhaps they'd let your son go to one of the Tilden preschool classes for a month before school lets out in June.

    BUT for full days:

    In my experience, private preschools tend not to go out of their way to deal with speech-delayed children. I'm sure there are exceptions; for example, I've heard positive stories about Duck's Nest, Chatham School, some of the Jewish synagogue preschools, and the Berkeley JCC. You might try the Merritt College lab preschool or the Mills College lab preschool, too, since they have a more educational focus. Good luck. Been There


    There was a preschool program called ''First Step'' at Broadway and Fairmount in Oakland that took kids with various kinds of special needs. It was for babies/kids 6 weeks old to kindergarten, and 4 hours per day were somehow subsidized. I never checked it out, but the contact info I have is Donna Wolf at 238-0880.

    Speech therapist for 3-year-old

    September 2002

    Hi - I am wondering if anyone has a speech therapist they can recommend to me? My son will be 3 in Oct. He is talking great. I just think he could be talking clearer and could benefit from a therapist. I don't think insurance would cover it. I also don't think he would qualify for therapy under any program. He really isn't delayed, just fuzzy. Any suggestions?


    If you live in Oakland you can call the school district and ask to have your son evaluated, even though he's not elementary age yet (we had our 3-year-old evaluated last year). If the evaluator agrees that there's cause for concern, you can start free speech therapy through the school district, which is mandated to provide this service to preschool- and school-age children who need it. The quality of the therapy obviously depends on the therapist. We've been reasonably happy with our daughter's speech therapist, Linda Wyman, who works out of Redwood Heights and a few other area schools. Good luck! Leah
    Our son has had speech/language therapy since he was less than three years old. There are some very good therapists in the area. Mary Gage-Hermann used to or still does work through Childrens' Hospital in Oakland. She's terrific with little kids. Debbie McCloskey is wonderful, as well. I would recommend both without reservation. Tobie
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