At a glance
- Instead of waiting and thinking 'Boys just speak late,' it is crucial to have a speech and language evaluation for a late-talking child.
- Our speech and language therapists separately assess receptive language (understanding) and expressive language (speaking); results are shared with parents through distinct scores and verbal explanations.
- For speech sound issues, the Articulation and Phonology Test (SST) is regularly administered by a speech and language therapist; articulation and phonological issues are differentiated through observation and speech samples.
- When stuttering is suspected, the type, frequency, family history, duration, and severity of the blocks are evaluated; early monitoring and parent guidance are provided.
- Growing up bilingual does not delay speech; unless there is an additional condition noted in the expert evaluation, there is no need to drop to a single language.
- Oral motor and swallowing (dysphagia) evaluations are not conducted at our center; families are referred to appropriate centers for these needs.
Prepared by: Deniz Yıldızı Special Education content team · Scientific review: Psychologist (MSc) Burcu Cebeci Gürel · Last updated: 15 September 2026
What is the difference between language and speech?
Although we often use them interchangeably in daily life, language and speech are different skills. Language is understanding words, forming sentences, and expressing thoughts. Speech, on the other hand, is the ability to produce this language with sounds: articulating sounds correctly, speaking fluently, and adjusting vocal tone.
Language is also divided into two. Receptive language is the child's ability to understand what is said: like knowing what you want when you say, 'Bring your shoes.' Expressive language is the child's ability to express themselves: being able to say what they want using words and sentences. One child may understand most of what is said but speak very little; another may speak a lot but struggle to understand what is said.
Therefore, during an evaluation, we do not just look at a simple 'does they speak or not?' question. Isolating the area where the child struggles is the first step to choosing the right goal.
My child is a late talker: Should I wait, or request an evaluation?
Every child's developmental pace is slightly different; however, delayed speech is sometimes just a gap that closes over time, and sometimes it is a sign of a language disorder that requires support. An evaluation, rather than waiting, makes this distinction. Our answer to parents who say 'Boys just speak late' is clear: Do not wait, an evaluation is essential.
Request an evaluation in these situations
- If they use significantly fewer words than their peers
- If they struggle to combine words into short sentences
- If they seem not to understand simple instructions
- If people outside the family mostly cannot understand their speech
- If they have stopped using words they previously said
- If they frequently stutter, prolong sounds, or cannot get a word out while speaking
- If they get frustrated, give up, or become angry when trying to speak
Common thoughts that lead to waiting
- “Boys speak late”
- “They are still small, it will pass as they grow”
- “Let's send them to kindergarten, they'll open up”
- “Once they start talking, everything will be fine”
- “They are speaking late because we are bilingual, let's switch to one language”
- Making decisions solely by looking at online age-based vocabulary lists
What areas do we support in speech and language therapy?
Language delay and language disorder
For children who lag behind their peers in areas like vocabulary, sentence formation, and understanding, separate goals are set for receptive and expressive language.
Speech sound disorders
For children who cannot say certain sounds or swap them, we determine whether the issue is with producing the sound (articulation) or organizing sound rules (phonological).
Childhood apraxia of speech
In this condition where the brain struggles to plan speech movements, support is provided through frequent repetition, modeling, and tactile cues.
Stuttering and fluency
We differentiate between natural disfluency, which is common in preschool years, and stuttering; early monitoring and parent guidance are provided.
Bilingual children
If multiple languages are spoken at home, the child's proficiency in both languages is evaluated by an expert; unless there is an underlying issue, dropping to a single language is not recommended.
Communication in autism and developmental differences
For children with autism, intellectual disabilities, or Down syndrome, our speech and language therapists work on communication goals together with the rest of the team.
What is looked at during a speech and language evaluation?
Evaluations are conducted by our speech and language therapists. The test chosen depends on the child's age and the reason for the visit.
| Area | How is it evaluated? | How are results shared with parents? |
|---|---|---|
| Receptive and expressive language | Standardized language tests based on need, observation, and parent interviews | Receptive and expressive language are explained verbally with separate scores; needs in both areas are discussed separately |
| Speech sounds (articulation) | The Articulation and Phonology Test (SST) is regularly given, taking 30–60 minutes; additional tests, observations, and speech samples are used if necessary | It is explained which sounds the child makes errors on and whether this is developmental or requires support |
| Speech motor planning | Errors are checked for inconsistency, along with prosody (stress, tone, rhythm of speech) | The characteristics of the condition and how to model at home are shared |
| Fluency (stuttering) | Type of block (repetition, prolongation, block), frequency and percentage, family history, gender, duration, and severity | A monitoring plan and guidance on creating a supportive speaking environment at home |
| Oral motor and swallowing | Not conducted at our institution | Families are referred to appropriate centers for this evaluation |
How do we handle stuttering and speech apraxia?
Many preschool children stumble or repeat words from time to time as their language develops rapidly. This is called natural disfluency. To distinguish it from stuttering, we look at the type of block (syllable repetition, prolonging a sound, or a block where no sound comes out), how often it happens, how long it has been going on, whether there is a family history of stuttering, the child's gender, and the severity of the blocks.
Our early approach is monitoring and providing parent guidance. We work with the family on not completing the child's sentences, avoiding directives like 'speak slowly,' and creating a calm speaking environment. If the blocks change during monitoring, the plan is re-evaluated.
In childhood apraxia of speech, the child knows what they want to say but struggles to plan and sequence their mouth movements. Making a different error on the same word each time and abnormal stress and rhythm in speech are key indicators. For these children, we utilize frequent repetition, modeling, and tactile cues.
Does a bilingual child need to drop to one language, and do screens and pacifiers affect language development?
The most common question from families speaking two languages at home is, “Should we drop to one language?”. Bilingualism alone does not cause delayed speech; in fact, it can expand a child's language capacity. The decision is made through expert evaluation: if no additional language or developmental issue is found, there is no need to switch to one language.
Prolonged use of pacifiers and bottles, excessive screen time, and a reduction in face-to-face conversation, play, and reading time with the child can negatively impact language development. We discuss these issues with every family during parent interviews, looking at that specific child's daily routine. Rather than imposing general bans, we brainstorm small, manageable changes together.
How does the process work for speech and language support?
Scheduling an appointment and Comprehensive Expert Consultation
During the comprehensive expert consultation with Psychologist (MSc) Burcu Cebeci Gürel, your child's developmental history is taken in detail.
Speech and language evaluation
Our speech and language therapist selects tests appropriate for the reason of your visit; these are evaluated alongside observations and speech samples.
Discussing the results
Receptive and expressive language results are presented to you separately with verbal explanations. If swallowing or oral motor evaluation is needed, a referral is made to a suitable center.
Parent education
We talk together about screen time, play, reading, and daily speaking habits to support language development at home.
Program and monitoring
Goals are written into the Individualized Education Program by the team and updated every 3 months; progress is tracked with periodic test repetitions and observation notes.
What do the terms in speech and language reports mean?
- Receptive language
- The child's ability to understand what is said, vocabulary, and instructions.
- Expressive language
- The child's ability to communicate thoughts and desires using words and sentences.
- Articulation
- The accurate production of speech sounds using mouth, tongue, and lip movements.
- Phonological process
- When a child systematically alters or drops sounds; for example, saying 'tup' instead of 'cup'.
- SST (Articulation and Phonology Test)
- A test showing which sounds the child makes errors on and the type of these errors; administered by our speech and language therapist.
- Speech apraxia
- When a child knows what to say but struggles to plan and sequence the speech movements.
- Prosody
- The stress, intonation, and rhythmic qualities of speech.
- Block
- In stuttering, when sound completely stops for a moment, getting stuck at the beginning of a word.
- Dysphagia
- Difficulty swallowing. Evaluations for this are not conducted at our center; families are referred.
Frequently asked questions
Will my child talk?
It is not possible to answer this without an evaluation, and every child's rate of progress is different. A speech and language evaluation reveals how much your child understands and how much they can express. Goals and expectations are discussed with you based on these results.
Boys speak late, shouldn't we just wait?
We do not recommend waiting; an evaluation is vital. Late speaking is sometimes just a gap that closes naturally, but other times it signals a language disorder that needs support. Only an evaluation can make this distinction.
How long does speech and language therapy take?
The duration varies based on the area of difficulty, age, and progress; it is impossible to give an exact timeframe upfront. The program is updated every 3 months, and we evaluate the progress together at each update.
Which language tests do you use?
Our speech and language therapists choose appropriate language tests based on the child's age and the reason for the visit. For speech sounds, the Articulation and Phonology Test (SST) is regularly administered at our center and takes 30–60 minutes.
The receptive and expressive language scores on the report are different, what does this mean?
Your child's ability to understand what is said and their ability to express themselves can be at different levels. The needs of these two areas are distinct and are explained to you separately. The program also sets separate goals for both areas.
My child cannot say certain letters, does this require therapy?
Some sound errors can be part of age-appropriate development, while others require support. Using the Articulation and Phonology Test and a speech sample, we check which sounds your child mispronounces and whether it is developmental or a disorder.
My child stumbles while talking, are they stuttering?
Disfluencies are common in preschool years, and not every block is stuttering. We make the distinction by assessing the type of block, frequency, duration, family history, and severity. We adopt an early monitoring and parent guidance approach.
Is it right to tell a stuttering child to 'speak slowly'?
This is generally not recommended; constantly drawing attention to the child's speech can frustrate them further. Listening without finishing their sentences and creating a calm speaking environment is much more supportive. We will discuss personalized suggestions for your family after the evaluation.
We speak two languages at home, should we drop to one?
Bilingualism alone does not cause delayed speech and can even enhance a child's language capacity. The decision is made through an expert evaluation; if there are no additional issues, there is no need to switch to one language.
Does screen time delay speaking?
Prolonged screen time can negatively affect language development by reducing interactive conversation and play time with the child. Prolonged pacifier and bottle use is also a factor. We discuss these in parent interviews by reviewing your family's daily routine.
Do you evaluate swallowing and chewing issues?
No, oral motor and swallowing (dysphagia) evaluations are not performed at our center. If this is needed, we will refer your family to a specialized center.
What is speech apraxia and how is it treated?
It is a condition where the child knows what they want to say but has difficulty planning speech movements. The evaluation looks at the inconsistency of errors and the prosody/rhythm of speech. Treatment involves frequent repetition, modeling, and tactile cues for support.
What can I do at home to support speech?
Talking at eye level with your child, reading books together, and describing what you are doing in short sentences during play all support language development. We share concrete suggestions suited to your child during parent education and in the brief updates given at the end of each session.
