Speech and language abilities usually develop in predictable ways. But any one of a number of things can interfere with that development. These can include: delay in the child's development, hearing loss, emotional problems, lack of language stimulation in the child's environment, and neurological conditions. If problems are spotted early, however, children can receive treatment to help prepare them for school. Many children now can be tested as early as age two.

The role of the day care provider is an important one in identifying which children need help. Because you are with the children regularly and for hours at a time, you can watch them as they interact with other children and with adults. then you can alert the parents if help is necessary.

Here are some of the cues to look for that might signal a possible speech, language, or hearing problem:

• Is the child aged two or more not talking or only talking when absolutely necessary and not taking part in social conversation?
• Does a child say "huh?" a lot (indicating he/she hasn't heard)? Or does the child ask to have things repeated?
• Does the child need to watch your face for visual messages, rather than learning from vocal ones?
• Does a youngster have trouble recognizing where sounds are coming from? (By age 1 or 1 ½, this should not be happening.)
• Did the infant babble normally, then suddenly decrease his/her vocalizing after the first 6 to 9 months?
• Does the child indicate an awareness of problems with speaking: "Why is it so hard for me to talk? or "I can't say that."
• At age three or older, does a child leave off the final sounds of words?
• Does the child seem to be behind his/her age group in expressing and understanding language? Does a youngster regularly pull on an ear, poke a finger in an ear, or have ear drainage or excessive ear wax? (CAUTION: Ear wax in the ear canal should be removed medically--NEVER with a cotton swab.)

At 2 to 2 ½ years or older, does a child start repeating words or parts of words more often? (Most children repeat sounds as part of learning to speak. And 80 percent of these kids grow out of it. But if repeating continues or is accompanied by signs of struggle or unusual breathing, it may indicate a speech problem.)

WHEN A CHILD NEEDS SPEECH OR HEARING HELP
If a child you care for shows one or more "cues,"indicating possible speech or hearing problems, mention your observation to the child's parent. Chances are that parent will have already noticed the behavior. (This may not always be the case, however, for a child may not speak the same way at home as in day care.)

Suggest to the parent where he or she could go for help for the child. You can even volunteer to aid the parent by arranging for the help.

One way to schedule a professional evaluation for the child is to call the elementary school principal who can arrange for the services of an audiology or speech pathologist.

Other help is available f rom community speech and hearing clinics and clinics run by colleges, universities, and large hospitals.

Adapted from North Central Regional Publication No.128f. Sponsored by the Extension Services of Illinois, Indiana, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota and Wisconsin. Originally developed by Dorothy Labensohn in cooperation with Elizabeth Perkins and partially funded by the Title V Rural Development Act of 1972.

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