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Does your child have a hard time following directions, pointing to pictures, or answering questions? They may have a receptive or expressive language difficulty. A receptive language difficulty is trouble understanding spoken language. An expressive language difficulty is trouble using language, such as finding words, putting them in the correct order, forming sentences, or using correct grammar. 

A receptive language difficulty is trouble understanding spoken language. Your child may be showing signs of receptive language difficulty if they:

  • Do not follow directions (e.g., go to the door and get your shoes on to go outside).

  • Are unable to answer questions. These questions can be related to events happening in the present, or questions about past events or related to a book.

  • Are unable to point to pictures or show you familiar objects in their day-to-day interactions.


Your child may be showing signs of an expressive language delay if they:

  • Have trouble asking questions.

  • Do not label or name objects, toys or pictures around them.

  • Use gestures to communicate their everyday needs and wants.

  • Have difficulty putting words together to form sentences.

  • Are struggling to learn songs and rhymes.

  • Have difficulty using certain grammatical forms or grammar endings such as knowing when to use the correct pronoun “she” vs. “he” or knowing to include –ING ending as in “running”.

  • Have difficulty starting a conversation and knowing how to keep the conversation going.

  • Are having trouble adjusting their voice or changing the way they speak to different people in different environments or situations. For example, knowing when to use a quiet “inside voice” vs. a louder voice.


Often children can have difficulties in both understanding and using language.

You can find more information on speech and language milestones here:


What does an assessment look like?

For your older baby or toddler, their assessment is most often informal in nature. We will play and interact with your child on the floor in the most natural and comfortable way possible. Assessment also involves observing how you and your child interact to determine your style of communication as a parent. Early language is also assessed through parent questionnaires, as often therapists are not able to observe every aspect of your child’s language.

What does therapy look like?


Speech therapy for early language learners often involves more parent-coaching, with the use of strategies adapted from the Hanen parent training programs including It Takes Two to Talk, Target Word and More Than Words.  Speech therapy will also include one on one interaction with your child where we will model effective language learning strategies to you or your child’s caregivers. And as always, therapy is meant to be enjoyable and fun, including your child’s interest and strengths.  

Early Language Development: Services
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