The fact that the child speaks little or needs time to begin to express himself causes concern for many parents. Comparisons with other children around them or feelings of being slower usually fuel worry. Various research in Spain supports the importance of involving families in early language stimulation. One of the most important studies in this sense is the one carried out by professors at the San Vicente Mártir Catholic University of Valencia on the Takes Two To Talk (ITTT) program, an intervention model in which parents are trained to encourage their children’s communication in everyday situations.. The work, entitled Parent-Implemented Hanen Program It takes two to talk: An exploratory study in Spain (Hanen parent-implemented program It Takes Two to Talk: An Exploratory Study in Spain) and published in 2021, observed significant improvements in social communication, assessed through indicators such as gaze and gestures, of the 17 families with children with speech delays who participated. Compared to the seven groups that received doctor-directed therapy, the It Takes Two to Talk group, made up of 10 families, showed better results in social communication, with no differences in vocabulary or syntax. Furthermore, no changes in parental stress were detected but an improvement in the perception of communication difficulties was detected.
The Spanish Association of Pediatrics (AEPed) also identifies the usefulness of timely intervention. In its 2022 Protocol on Speech, Language and Communication Disorders, it highlights that early identification of warning signs and referral to specialized services can improve the prognosis of language development in childhood.
The conclusions of both reports are also reflected in the experiences of many parents. Maripaz, mother of a four-year-old, recalls the months of uncertainty before seeking specialist care. “Until I was almost three years old I almost didn’t say any words. In the park I saw the other children talking non-stop and I felt anxious, thinking that something was wrong. The pediatrician advised us to wait, but I was still uncomfortable and in the end we decided to go to a speech therapist,” she says. Thanks to the sessions and games he learned to play at home, his son began to loosen up: “Now he communicates much better. And I also began to see things differently: there is no need to compare himself with other children, but neither do you have to stand by and watch when you see that something is wrong. The early intervention gave us peace of mind and gave him confidence.”
According to speech therapist Agustín Gómez, communication generally begins before expressing the first words: “They stutter and interact with adults.” He comments that around 12/15 months they produce their first real words (“mom”, “dad”, “water”…), and around 18/24 months it is necessary to take measures and consult a professional if the child expresses few words. He also emphasizes that it is important to pay attention to articulation: “It should improve between 30 and 36 months. If around 3 years of age they are not understood, it is advisable to also consult a speech therapist,” he advises.
Gómez points out some simple activities that can be done at home: “Like reading stories and commenting on images or everyday situations, because they help stimulate language without putting pressure on the child.” And it assures that timely attention to speech therapy usually results in a positive evolution and a better prognosis. “If we are talking about a stable difficulty (a developmental language disorder, for example), early action is fundamental, as it allows us to arrive at the diagnosis sooner and propose more appropriate treatments”.
This early intervention is also based on the maturity of the child’s brain. Neuropsychologist María Dolores Fernández Cros, clinical director of the iPsike psychology, speech therapy and neurodevelopment center in Madrid, says that brain development is essential for language acquisition. This is especially true during the first years of life, when the child’s brain goes through a period of maximum plasticity that facilitates learning.
Fernández talks about different areas that intervene in this period of plasticity: fine and gross motor skills, perception and sensory integration, acquisition of attention and memory skills, communicative interaction: “The early identification of problems in language acquisition makes the difference, because it allows us to exploit the phase of maximum brain plasticity”, he states. Likewise, the expert adds, it helps distinguish simple articulation changes, such as stuttering, wheezing or problems with blocked syllables, from broader disorders that affect the understanding or expression of speech.
Speech therapist Isabel de la Torre Moreno clarifies that the signals that should alert families can be observed in different areas of development: the emission of babbles, the repetition of sounds and words, reactions to one’s name, the execution of simple commands or regression in language or already acquired skills. Furthermore, he adds, hyper or hypo sensory sensitivity, alterations in play development, joint attention or communicative intention, as well as problems in visual and/or auditory processing may occur.
The role of families and schools
Along the same lines, Antonio Clemente, a speech therapist and child psychologist with more than three decades of clinical experience in Bilbao, explains that the two-year mark, when the child is able to put two words together, is very important and serves as a measurement index to see whether the child is developing language well or not. He highlights that mistakes among parents are frequent: speaking to them as they do, with the “rag tongue” and not applying the model (a technique that consists of repeating what the minor says, but well articulated and expanding the sentence to offer a correct model). “The last thing a child’s ear hears, his brain processes,” summarizes the specialist.
Regarding the school environment, he explains that differences can be detected by comparing the monthly evolution of each child, since in the same class there can be large variations in maturity. According to Clemente, language disorders affect approximately between 3% and 7% of the child population, an estimate based on international reference works such as those of Norbury. et al. (2016), therefore detecting it in time allows us to act and improve the prognosis. The expert insists that school professionals refer families to a speech therapist to carry out an assessment and guide stimulation in the child’s environment, with periodic reviews. “We also work with paediatricians; before it was common to hear ‘he’ll talk,’ and that’s terrible advice,” he warns.
Regarding the importance of gestures and non-verbal communication, the speech therapist emphasizes that it is essential to adapt gestures to messages, so that there is coherence. “Children understand intonation before words,” he says. And educate about emotions and autonomy: “You have to respond to what they ask; this way you cultivate trust and develop language and adequate emotional control. Emotion is the gateway to learning”, he explains.
