Identifying Speech Delays in Multiples

Should you be concerned when your toddler multiples say “love you” and it sounds like “lub ou”? Do your twins jabber to each other in a language that no one understands except them? Are your multiples’ communication skills worrying you?

Overview

As a parent, it is often difficult to discern when language skills are developing normally and when a child might need some outside help. Multiples tend to experience a higher rate of speech and language development delays. Many factors contribute to a speech and/or language delay in multiples.

Benchmarks

According to a study published in 2019, most twins outgrow these language issues by 5 years of age. However, these general guidelines can help you determine if your child could be experiencing a delay:

Between 12-24 months, your children should:

• Combine two simple words
• Respond to simple questions
• Can use sounds of p, b, m, h, and w
• Point to pictures in books
• Start to name pictures in books

Between 24-36 months, your children should:

• Ask simple “why” questions
• Use the sounds of k, g, f, t, d, and n
• Understand opposites like big and little
• Be understood by people who know them
• Be able to talk about things that are not in the room

Between 3-4 years your children should:

• Ask how and when questions
• Understand words for family members
• Begin to name colors
• Be able to tell a story
• Be understood by most people
• Start to use plurals

Between 4-5 years, your children should: 

• Use all speech sounds
• Understand words for time
• Understand most of what they hear at home or school
• Name numbers and letters
• Retell a story in their own words

Though speech/language delays may be common in multiples, they can have a profound effect on their success in school. Proper speech and language development are building blocks for good reading and writing skills. So what do you do if one or all of your multiples are not meeting these guidelines?

When to Seek Help

If you suspect a delay in language development, contact your pediatrician. You can also pursue an evaluation on your own through a private speech therapist (verify coverage with your insurance carrier) or through your local Early Intervention Program or school district. The Individuals with Disabilities Act (IDEA) ensures that every child is guaranteed to receive free and appropriate education, including speech and language therapy.

The Evaluation Process

Your pediatrician should refer your child to the proper agency for evaluation. However, a pediatrician’s referral is not required. As a parent, you have the right to request an evaluation.

After you make the initial contact, an evaluation will be scheduled. Normally, this means a team of qualified people will come to your home for the assessment. In-home evaluations allow the children to interact in a familiar environment. The evaluations are normally play-based and are enjoyable.

For older multiples, the evaluation process will be arranged through the school district. After your children are referred for an assessment, an appointment will be made for an evaluation. The evaluation normally takes place in a play-based environment full of toys, puzzles, blocks, and other stimulants.

Usually, the parent stays in the room while a team of qualified people interacts with the children, recording their verbalizations. A screening may be performed to determine if any of the children have hearing loss.

Speech Therapy

Children under age 3 will probably benefit from receiving therapy in the home during visits from a degreed speech pathologist. Local school districts should provide therapy opportunities for children over 3.

Programs vary and are based on need; some children may only require a weekly 30-minute session focusing on articulation. Others may qualify for preschool programs that emphasize speech and language development; these children attend two to five times a week for 2 to 3 hours per day.

Most speech therapy is play-based, encouraging children to talk about and build on subjects of interest. Therapy for older children focuses in large part on language development, increasing their vocabulary and word combinations as well as speech (articulation skills). For example, at snack time a child must verbalize what they want, rather than pointing or grunting, in order to receive the snack.

Children are always encouraged to talk and provided many opportunities and stimulants to create conversation through toys, games, circle time, etc. If articulation problems exist, the therapist will play games with the child to strengthen the tongue and lips so the child is able to form them correctly when speaking.

Whether your multiples are in an Early Intervention program or receiving therapy through the school district, their development is measured by how well they meet goals and objectives. Once they show measurable progress and meet or exceed those goals and objectives, they will be phased out of the program.

How to Help at Home

To help prevent speech delays, or if you are concerned that your multiples may be experiencing a delay, there are some things you can do to help. Aside from seeking professional help, there are some strategies you can employ at home.

1. Read. Read out loud to your multiples every single day. It's a great opportunity to encourage language. Point and talk about pictures and words on each page. Ask them, "What do you think happens next?" and other questions. The more conversation there is between parent and child, the more opportunities exist for language skills to develop. Limit the amount of television your children watch. Those moments may provide a parent with much-needed breaks, but they do little to encourage language development.
2. Repeat. When your multiples speak to you, show each child that you understand what they said by repeating back their words and expanding on the information given. For example, if Jack asks for milk by saying “milk,” respond with “Jack would like some milk. Look, Jack, we have a green cup for your milk.”
3. Talk. Talk often with each of your twins or multiples. Turn off the radio in the car and talk about where you are going and what you will do when you get there. For example, on the way to the zoo talk about all the animals you will see there and the sounds that each animal makes. At home, describe the different ingredients you are using as you cook. As you pick up around the house, talk about the toys you are putting away.
4. Respond appropriately. If your toddler points or grunts at items, do not reward their lack of language by giving them what they want. Instead, only respond when an effort to verbalize the request has been made. Any attempt to verbalize should be rewarded and praised. Don't frustrate the child by correcting or demanding that they “say it like this.” Instead, model the correct way, such as, “Cookie? Do you want a cookie? Here is your cookie.”
5. Take turns. If you have children who try to “talk” for their siblings, speak to them about the importance of letting their siblings ask for things. For example, if Jill's twin is trying to do all the talking for her, encourage the twin to “let Jill have a turn to talk.”