When and why should parents contact a speech and language therapist?

What age do you consider the most appropriate for intervention?

Parents are the first to notice their child's difficulties. But often, either through ignorance, negligence or fear of the unknown, they let considerable time pass thinking that the difficulties will overcome themselves.

Referring a child to a speech and language therapist can be done for many different reasons.

First, when there is an organic cause that leads to speech and language problems, i.e. when a child has an organic cause in his/her medical history, he/she should be referred to a speech and language therapist from an early age in order to identify his/her difficulties and place the child in a therapeutic programme.

Possible organic causes that may be responsible for speech and language problems are:

• Hearing problems that a child may have and not necessarily be present in their medical history.
  We often tell parents to be careful about ear infections at very young ages because parents may not notice an ear infection or ear infections that their child has had. As a result, we may have a transient loss or alteration of hearing where this will prevent the normal development of oral speech.
• A structural abnormality in the oral cavity (e.g. short bridge, prognathism, malocclusion of the teeth, etc.)
• Also, a fairly common cause is Developmental Anomaly.

As we all know, every child has his or her own rate of development. In some children, neurological maturation occurs at a fairly slow rate, which results in the most delayed development of speech.

Secondly, when children have a large deviation from the developmental stages. Although parents will engage with the child and provide appropriate language stimulation, they do not see any improvement in their child's oral language.

Some indicative features that should worry parents are:

• When their child is two years old and is not yet using words to express themselves.
• When their child is 4 years old and their speech is unintelligible, i.e. only understood by their family.
• When their child is 5 years old and makes syntactical/grammatical errors in oral speech (e.g. omits articles, uses the wrong word endings, misplaces words in a sentence)
• When he has difficulty understanding our spoken language, i.e. carrying out an instruction we have given him (e.g. "Put your shoes under the chair")
• When a child is at the age of 4,5 years old and has difficulty describing something that happened to him/her (e.g. What did you do at school today?) also when he/she has difficulty telling/retelling us a story or a fairy tale that we have read to him/her.
• When the child frequently displays temper, anger, tantrums without a reason or is reluctant to go to school.

The most opportune and the most critical age for intervention where a child can relatively easily overcome their difficulties is the age of 3 - 6 years and this is due to the plasticity of the brain which allows the child to more easily and effectively assimilate the stimuli they receive.

Therefore, by not acting early and proactively, we are not taking advantage of this critical age, and the problem is growing.
Just as, for example, parents will not ignore a cold that their child may have and will not wait for it to develop into pneumonia before visiting the paediatrician, they should act in the same way when they notice a difficulty in his/her expression.

In this way, parents act effectively, proactively and particularly beneficial for their child's future.