School-age

How to know if your child needs speech therapy

What to do if your child points out “pwetty wainbows” or asks for a bowl of “thoup.”

Elizabeth Crisolago Baron’s son, Matteo, was four and a half when she first realized he couldn’t properly make the “s” sound; it came out more like a “th.”

“His junior kindergarten teacher brought it up during our parent-teacher interview, and I kind of scoffed at the idea of him needing therapy, because I could understand him,” she says. But after talking to friends and family, she discovered that they had all at some point had trouble making out his words. Matteo himself was becoming clearly frustrated when his teachers didn’t know what he wanted. So the Toronto mom let the school apply for a speech assessment.

Common speech issues

For the most part, kids should be able to speak fairly clearly by the time they hit elementary school. “By four years old, children should be understood 100 percent of the time, even by strangers,” says Vivian Yau, a speech-language pathologist (SLP) in Toronto. Still, some pronunciation errors could still be hanging around in kindergarten and the early grades—and that’s when parents start to worry.

Sounds that take longer to develop include the “r” and the “s” sounds. Kids may substitute a “w” for the “r” (“wainbow” instead of “rainbow”) or, like Matteo, they’ll use a “th” sound instead of “s,” (“thilly” instead of “silly”). Other kids might use a “t” sound instead of an “s,” or leave the “s” out completely. Maureen Penko, an SLP in Winnipeg, adds that some children may also have difficulty with blended sounds, like “spr” or “br.”

FYI, stuttering is considered a bit different than these other articulation issues. To learn more about kids and stuttering, click here.

When to intervene

When Agnieszka Kosny’s son was around four or five, she noticed his speech wasn’t quite right. “He sounded like he lived in Boston, and he would say ‘wobber’ instead of ‘robber,’” says the Toronto mom. She thought he’d grow out of it and so did his teachers. He didn’t, and at age seven, he had an assessment by an SLP.

In a speech assessment, the therapist will ask your child to say a variety of words and sounds to see if they are having difficulty, and if so, what sounds they are making instead of the correct ones. When it comes to the later-developing sounds, like “r” and “s,” therapists aren’t likely to recommend treatment until age five, and most will hold off until age seven, says Yau. They’re waiting to see if your child will grow out of it, because many do.

Penko, for one, believes in starting therapy as soon as possible. “Early intervention is critical,” she says. “You don’t want the speech difficulties to affect the child’s self-confidence, and you want reading and writing acquisition to keep happening.” When kids begin to spell, she explains, they’ll often spell a word based on how they say it, rather than the correct sound.

Does speech therapy work?

How often your kid sees the SLP will be determined by whether it’s private or through their school and how often your family can commit to attend. But typically your child would have a session once or twice a week and receive instruction on how to properly make the sounds and then play games to practise. They would be sent home with activities to work on with their parents during the week.

Crisolago Baron’s son received his therapy through his school. The therapist pulled him out of class about once a week to play games where he’d really need to articulate his words. “They would also talk in front of mirrors so he could see how her mouth moves versus how his mouth moved when he spoke,” says Crisolago Baron. Matteo’s articulation improved, but his mom says he regressed when his sessions were cancelled due to the pandemic.

Kosny’s son, now nine, still struggles somewhat, despite having had some speech therapy following his assessment. “It was helpful, but it’s difficult to keep on top of it on top of everything else,” says Kosny. “If he could do it at school, or right after school, that would be so helpful.” He was recently assessed through school and put on a waiting list for speech therapy.

Ultimately, the success of therapy depends on your kid’s engagement during the appointments and your family’s commitment to practising throughout the week. “You have to go home and implement it,” says Penko. “But with early interventions with a specialist in the field, the success rate is great.”

Speech therapy from home

Depending on where you live and your community’s COVID-19 infection rates, speech therapy may happen over video chat for now. “The child is in their home, where they are comfortable,” says Maureen Penko, a speech-language pathologist in Winnipeg. “Virtual therapy has been very successful.” It’s pretty convenient, too.