When to See a Speech Pathologist: Signs in Children and Adults
The short answer: when something about communication or swallowing seems different, or does not seem right. You know yourself and your family best. You do not need a referral, and you do not need to be certain there is a problem before you ask.
The longer answer depends on age.
Signs in children
Consider a speech pathology assessment if your child:
- Is not meeting speech and language milestones
- Is hard for other people to understand
- Has a limited vocabulary for their age
- Has trouble following instructions
- Has difficulty eating or drinking safely
- Stutters
Milestones to check against
Speech Pathology Australia publishes communication milestones for children aged 12 months to five years. Children develop at different rates, so treat these as a guide.
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Age
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Understanding
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Speaking
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12 months
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Understands about 10 words, responds to their name
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Uses sounds and gestures, says a few words
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18 months
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Understands up to 50 words and some short phrases
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Says 6 to 20 single words, copies words and noises
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2 years
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Follows simple two-part instructions
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Says more than 50 words, puts two words together
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3 years
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Follows more complex two-part instructions, understands simple “what”, “where” and “who” questions
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Uses four to five words in a sentence, asks questions
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4 years
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Answers most questions about daily tasks
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Uses “and”, “but” and “because” to make longer sentences
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5 years
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Follows three-part instructions, understands time-related words
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Uses well-formed sentences most people understand, tells short stories
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Healthdirect advises speaking to your doctor or child health nurse if, by 12 months, your child is not trying to communicate using sounds, gestures or words, or if, by two years, your child is not saying about 50 words or has not started putting words together.
Signs in school-age children
Some difficulties only show once school starts. Look for:
- Trouble following classroom instructions
- Difficulty with reading, spelling or written work
- Struggling to tell a story or explain an idea
- Finding it hard to make friends or manage conversations
Signs in adults
Speech pathology is not only for children. Adults should consider an assessment for:
- Changes in speech after illness or injury
- Difficulty swallowing food or liquids safely
- Communication difficulties that affect work or relationships
- Memory or thinking problems that affect communication
Stroke, brain injury and progressive neurological conditions can cause aphasia (difficulty understanding or expressing language) and dysarthria (slurred or slow speech from weak or uncoordinated speech muscles). Adults who stutter, or who have a voice disorder, can also benefit.
Swallowing problems
Difficulty swallowing is called dysphagia. It can occur at any age and affects nutrition, hydration and quality of life. A speech pathologist assesses swallowing and recommends strategies for safe eating and drinking.
“Wait and see” or book now?
If the concern has lasted more than a few weeks, or other people such as a teacher, educator or GP have raised it too, book. An assessment either confirms that things are on track or gives you a plan. Both outcomes are useful.
Rule out hearing first
Hearing difficulties can significantly affect communication development. We recommend a hearing assessment before a speech pathology assessment. RT Speech and Hearing has an audiologist in the same practice, and assesses hearing in adults and in children aged four and over.
What happens at an assessment
- A discussion of your concerns and goals
- Formal and informal testing of speech, language or swallowing
- Observation of communication in natural settings
- Input from family, carers or other professionals where helpful
- Recommendations and a treatment plan
Bring any previous reports, a list of current medications, your Medicare and health fund details, your NDIS plan if you have one, and any communication device already in use.
Do I need a referral to see a speech pathologist?
No. A GP referral may help you access Medicare rebates, and most private health funds with extras cover speech pathology. RT Speech and Hearing is a registered NDIS provider.
When choosing a clinician, look for a member of Speech Pathology Australia who holds Certified Practising Speech Pathologist (CPSP) status like those at RT Speech and Hearing.
Book with us: call 0411 104 190 or 0411 192 218, or book online. Find us: Wesley Quarter, Shop 7, 93 William Street, Perth WA 6000