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Not talking at all and other problems

What causes it?

'Your child might have problems paying attention or listening, which in turn can affect their ability to understand and therefore develop their speech,' says Sarah Hulme, principal speech and language therapist for Early Years at Camden and Islington Community Health Services. 'It might also be caused by something simple such as glue ear, or more serious, such as autism.'

When to worry and what to do

If children around the age of two are babbling instead of making whole words, ask your doctor to refer you to a speech and language therapist. Don't ask your child loads of questions to try and prompt her to talk, it will only frustrate a child who can't. Instead, let her babble and try to understand her.

Other problems

Muddling up words in sentences

This is usually caused by a difficulty in understanding. See your GP or speech and language therapist if your child is still muddled after the age of two. The treatment will involve intense one-to-one sessions to help your child understand through the use of repetition and games.

Dyspraxia

This affects how your child sounds words. The words will tend to be confused and will sound unrecognisable. It's not really known why a child may suffer from dyspraxia but, if your child has problems after the age of two, see your GP, speech therapist or specialist dyspraxic centre. The sooner it can be treated, the faster the rate of recovery. Therapists usually practise a particular sound such as 'p' again and again and then add a vowel such as 'po', followed by a consonant such as ' pop', gradually building up sounds.

Difficulties in understanding

Sometimes referred to as receptive language difficulties, your child may find it difficult to understand you when you talk to him. This could be because of glue ear, with this complaint, children tune out the outside world because they don't hear it properly. Or it could be because of a general language problem or an unexplained difficulty. If your child is still finding it hard understanding language after the age of two, see your GP, health visitor or speech or language therapist.

'A therapist will help improve understanding by using play-based treatment where words are associated with objects, pictures and visual clues,' explains Louisa Reeves, service development officer and speech and language therapist for I CAN, the educational charity for children suffering from speech and language problems.

It's easier for a young child to pronounce sounds using the front of the mouth, like 't', than sounds from the back, like 'c'. That's why little ones might say 'tar' instead of 'car'. It's also normal for a child to have problems with two consonants together, such as 'sp' in spoon which might come out as ' poon', or 'th' in ' thank you' which might sound like 'fank you'. 'S', 'f' and 'ch' are also the latest sounds to develop.
This is very common in small children.

Only think about getting advice from your GP if your child is still mixing some sounds by four or five. At that age you might be referred to a therapist who will check that your child can actually hear the sound correctly when someone else says it to her. At home, don't criticise your child's pronunciation. Instead, just repeat the word correctly.

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