Posts Tagged ‘preschool age’

Late Talkers: A Variation of Normal Development? By Michelle MacRoy-Higgins, Ph.D., CCC-SLP

Friday, February 24th, 2012

In adjusting the eligibility criteria for speech only children in Early Intervention, the New York State Health Department frequently stated that “late talkers were a variation of normal development.” The more stringent eligibility was intended to decrease services to “late talkers” because it believed that these children would catch up to their peers over time. The following information reflects research and resources compiled by Michelle MacRoy-Higgins, Ph.D., CCC-SLP, Assistant Professor, Communication Sciences Program, Hunter College-CUNY, who has researched the topic of late talkers and presented at the 2010 ASHA convention on the topic.

Who are Late Talkers?
The late talkers reflect 15% of the toddler population and are identified around two years of age when children produce fewer than 50 words and do not combine words. The late talker also has normal hearing, cognitive, sensory and motor development. A typical child at two years of age would be using over 300 words and putting together 2-4 word sentences.

Why Late Talkers are Not a Variation of Normal Language Development
Language characteristics of the late talkers are not reflective of typical language development in the areas of:

1. Word learning
Receptive language (understanding): Late talkers do not learn (point to) new words as accurately as their peers. (Ellis Weismer & Evans, 2002; MacRoy-Higgins, Schwartz, Shafer & Marton, 2009)
Productive language (expressive vocabulary): Once late talkers say words, they are slow to add more words to their vocabularies; they do not systematically add words to their vocabularies as observed in typically developing toddlers (MacRoy-Higgins et al., 2009).

2. Phonology (sounds)
The sounds in the words that they do say show delays and disordered patterns. For instance, late talkers produce atypical sound errors, atypical sound patterns and show little change in development over time as compared to language-matched peers (Williams & Elbert, 2003)

3. Morphology/syntax (grammar and word combinations)
Once late talkers begin to combine words they show delayed and disordered patterns. For instance, late talkers produce more errors than their language-matched peers (Thal et al., 2004)

4. Social skills
At risk for social/behavioral disorders. Late talkers are less social than their peers; quality of parent-child relationships in late talkers is judged to be more stressful than parent-child relationships in typically developing toddlers (Irwin, Carter & Briggs-Gowan, 2002)

Are there Long-Term Implications for Late Talkers?
The research has indicated that late bloomers show improvement in language skills but that they perform significantly poorer than their peers in reading/literacy, syntax and morphology (word combinations/sentences and grammar) and vocabulary deficits are observed through 17 years of age.
Toddlers with Specific Language Impairment (SLI) demonstrate significant difficulties with all aspect of language (understanding, expression and literacy/reading).

Why is it Important to Provide Speech and Language Services to Late Talkers?
Approximately one-half of toddlers who are late talkers will be labeled as having Specific Language Impairment in preschool/elementary school. Those that show improvement (late bloomers) continue to perform poorer than their peers in language and literacy skills throughout elementary and secondary school.

Late talkers are not a variation of normal development because at age two they show disordered patterns of
• Vocabulary acquisition (understanding and naming)
• Phonology (sound system)
• Grammar
• Social skills

Why is Early Intervention so Important for Late Talkers?
An early foundation in oral language skills is paramount for the development of literacy and reading skills. Late talking toddlers are at significant risk for academic difficulties and therefore would benefit from language intervention as early as their language disorder is identified.

Is Language Intervention for Late Talkers Effective?
Language intervention for late talkers is effective. Late talkers receiving intervention by a Speech-Language Pathologist over a short period of time showed improved language skills (vocabulary, production of sentences, speech sound production) as compared with late talkers who did not receive intervention (Robertson & Weismer, 1999), and these results suggest that if untreated, late talkers will not improve their language at the same rate as their typically developing peers, with the significant risk of lifelong language difficulties impacting academic achievement, reading and literacy.

Ellis Weismer S., & Evans, J.L. (2002). The Role of Processing Limitations in Early Identification of Specific Language Impairment. Topics in Language Disorders, 22(3), 15-29.

Irwin, J.R., Carter, A.S., & Briggs-Gowan, M.J. (2002). The Social-Emotional Development of ‘Late-Talking’ Toddlers.Journal of the American Academy of Child & Adolescent Psychiatry. 41(11), 1324-1233.

Leonard, L.B. (2000). Children with Specific Language Impairment. Cambridge, MA: MIT Press.

MacRoy-Higgins, M. Schwartz R.G., Shafer, V.L., & Marton, K. (2009). Word learning and phonological representations in children who are late talkers. (Doctoral Dissertation), Graduate Center, CUNY, New York, NY.

Rescorla, L. (1989). The Language Development Survey: A screening tool for delayed language in toddlers. Journal of Speech and Hearing Disorders, 54, 587-599. 22.

Rescorla, L. (2009). Age 17 Language and Reading Outcomes in Late-Talking Toddlers: Support for a Dimensional Perspective on Language Delay. Journal of Speech, Language, and Hearing Research. 52, 16–30.

Robertson S.B. & Ellis Weismer, S. (1999). Effects of Treatment on Linguistic and Social Skills in Toddlers With Delayed Language Development. Journal of Speech, Language, Hearing Research. 42, 1234-1248.

Thal, D.J., Reilly, J., Seibert, L., Jeffries, R., & Fenson, J. (2004). Language Development in children at risk for language impairment: Cross-population comparisons. Brain and Language, 88, 167-179.

Williams, A.L., & Elbert, M. (2003). A Prospective Longitudinal Study of Phonological Development in Late Talkers. Language, Speech and Hearing Services in Schools, 34, 138-153.

Dr. Michelle MacRoy-Higgins has worked as a Speech-Language Pathologist for nearly 15 years. In addition to being a private practitioner, Michelle is an Assistant Professor in the Communication Sciences program at Hunter College (CUNY) and teaches graduate students in the areas of language development, language, phonological, articulation, motor speech and swallowing disorders in children. Michelle has worked clinically in a variety of settings including home-based, preschool, elementary school and private practice clinics; and has enjoyed working with a variety of children presenting with language, phonological, articulation, and feeding disorders ranging in age from birth through adolescents. Michelle’s clinical and research expertise is with children who are late talkers. She enjoys working with children and their families to develop individualized and evidenced-based treatment, while having fun and encouraging communication success.

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Medication Study for Young Autistic Children

Friday, February 24th, 2012

NYU is the site of an NIH-funded study of the effect of a medication that increases serotonin in 2 to 6-year-old autistic children. Studies show that brain levels of serotonin are low in many young children with autism, but by age 6, serotonin levels increase to the point where they are similar to typically developing children. We hypothesize that if we replace serotonin during the critical 2 to 6-year-old period we will improve outcome. The serotonin will direct brain cells to wire up in a more typical fashion.

The Study:
We are using a medication called BuSpar, that acts like serotonin. It is a medicine that has been around for many years given to treat anxiety in children and adults. Children are randomly assigned to receive placebo, low-dose BuSpar, or higher dose BuSpar.

Children are followed for six months. They are seen once a month and there is phone contact once a month. At the beginning of the study, we do a full evaluation for autism and IQ, and interview parents. Parents are given the results of that evaluation for their records. At the end of the six-month study, the autism diagnostic observation schedule is repeated to see if improvement has occurred.

The study is free, including initial evaluations, and transportation is covered.

If BuSpar proves to be effective, it will likely become a standard therapy for children diagnosed with autism. If you are interested in finding out more about the study, contact Dr. Ruth Nass, Pediatric Neurology at NYU, (212) 263-7753,

Dr. Ruth Nass, M.D., Professor of Child Neurology, Child & Adolescent Psychiatry, and Pediatrics at NYU Langone Medical Center, has over 30 years of medical experience and practices in Pediatrics and Neurology. Her research interests include pediatric neurology, learning and developmental disabilities, hemiplegic CP, and autism.

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Speech Language Therapy Updates

Saturday, March 12th, 2011

Our speech language pathology department is passionate about our work: We are caring, supportive, and creative; the payoff- the children and students we work with are very excited to see us and they are proud of their accomplishments!

We are now offering speech and language services in the convenience of your Brooklyn, Queens, and Manhattan home in the following areas:

Brooklyn- Park Slope, Windsor Terrace, Carrol Gardens, Cobble & Boerum Hill, Fort Greene, Brooklyn Heights, Red Hook, Bay Ridge, Dyker Park, Dyker Heights, Bensonhurst, Williamsburg, Greenpoint, Bushwick, Kensington, Sunset Park, Ditmas Park, & Flatbush.

Queens- Sunnyside, Woodside, Long Island City, Astoria, Jamaica Estates, Hollis Hills, Fresh Meadows, Kew Gardens, Forest Hills, Bellerose

Manhattan Upper West Side, Gramercy Park, Midtown, Murray Hill, Flatiron District, Chelsea, Nolita, Soho, Greenwich Village, West Village, Battery Park City, Financial District, Lower East Side, East Village,

If you do not live in these neighborhoods and you are interested in speech language services, I am currently reserving spots for my Park Slope office (15th Street and 8th Ave) for the summer of 2011. Contact me at

We treat a wide variety of delays and learning needs, including children and students with the following: articulation/enunciation difficulties (e.g lisp, tongue thrust, and/or difficulty saying sounds, cleft, tongue tie), speech delay (including apraxia, oral motor difficulties, cleft palate), late talkers/language delay (including multilingual homes), expressive and receptive language disorders (language processing), autism spectrum, e.g. Asperger’s, pervasive developmental disorder (PDD), social language delays, central auditory processing disorder, language based learning disabilities (e.g. dyslexia), SEIT services, disfluency (stuttering), cluttering, and feeding delays (including picky eaters, oral motor delays, medically fragile), reading & writing disorders, and SAT preparation for struggling learners, including students with earning disabilities, and resonance disorders. We provide a unique reading intervention/remediation program that is specific to your child’s learning needs!

We provide:

* Auditory Processing Therapy
* Bilingual and Spanish/French Evaluation & Therapy
* Feeding Evaluation/Consultation and Therapy
* Fluency Assessment and Therapy
* Language (Early Childhood)- Evaluation, Therapy & Remediation
* Language (School Age)- Evaluation, Therapy, & Remediation
* Literacy (Reading & Writing) Treatment
* Literacy Circle Group (4th-6th Grade)
* Parent Training (toddlers and preschoolers)
* Private Special Education Itinerant Services (SEIT)
* Social Skills Training
* Speech- Articulation/ Oral Motor / Phonology- Evaluation & Therapy
* Transition Planning (High School to College) for Students with Learning Disabilities

Our therapy is eclectic and we tailor it towards your child’s need. We have experience with Floortime, ABA, RDI, PECS, and experience with several communicative devices.

We are now offering SAT tutoring for students with learning needs. It’s time to start planning for the SATs! If your child has difficulty with test-taking, the SATs can be very stressful. Jocelyn Wood, speech language pathologist, has been working with children with speech and language disabilities and learning disabilities to help them feel more confident and prepared for college entrance tests. Together, we create goals and formulate a plan for achieving that goal. My work takes the child’s individual learning style into account and makes test prep fun and exciting! We use creative methods to introduce and learn vocabulary words, discover how to find grammatical errors on the writing section and create a fool-proof plan to have a high scoring essay. Your child will go into the test feeling much stronger and will achieve his/her goals!

Contact me for more information:

Finally, welcome Lynn-Marie Herlihy, MS, OTR/L, Occupational Therapist. Lynn provides occupational therapy evaluations, individual treatment sessions, parent and/or classroom consultations. She is an expert on sensory integration treatment, fine motor development, visual-motor and visual-perceptual deficits, and handwriting/pre-writing skills.
Contact her at

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