Expressive Language

Expressive Language: What is it?

Speech and language pathologists may use the term “expressive language” when describing the needs of your child. To better understand expressive language it is important to understand its definition and use.  Expressive language is the output of language to communicate a want, need, thought, or idea.

Expressive language is a combination of one or more of the following features:Expressive Language

  1. What words mean: Language is symbolic by nature, therefore, each word represents an idea, item, verb, emotion, etc. Children first need to understand that when they say the word apple, they are representing the actual object of an apple.
  2. How to put words together: Understanding how to put words together is the next step to acquiring expressive language. In order to communicate more extensive or intricate ideas, children often need to combine words. For example, children learn that by saying “more milk” or “all done” they can relay more complex messages.
  3. How to make new words: Understanding that words can be changed to represent a new idea is another feature of expressive language. For example, children often struggle to properly use past tense of verbs. The word friend can be changed to friendly or unfriendly to represent new concepts.
  4. What word combinations are best for different situations: Children learn that in order to effectively communicate, they need to adjust their use of language depending on their surroundings. For example, children may say, “I want a cookie now!” while at home. However, at a birthday party with an unfamiliar adult children may say, “may I please have a cookie?”. This understanding of the social use of language is critical for children and often takes years to fully develop.

Understanding the use of language is extremely complex and can often be difficult for children. A speech and language pathologist can help assess if your child is struggling to properly learn or utilize the features of language.

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NSPT offers speech and language services in BucktownEvanstonHighland ParkLincolnwoodGlenview and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

how early is too early for a speech language evaluation

How Young is Too Young for a Speech Language Evaluation?

If you have concerns about your baby’s ability to listen or communicate, it is never too early for her to be evaluated by a speech-language pathologist.

The first three years of your baby’s life is a critical period for learning language. Rapid growth and change in your baby’s brain makes learning easiest and most efficient during these years. Your baby is listening to you speak, watching you gesture and emote, and learning pre-verbal communication skills that lay the foundation for future speech and language development. Therefore, ensuring that your baby’s development is on-track from the start is very important.

How do I know if my baby needs to be evaluated for a speech or language concern?

  1. Your baby is not meeting speech and language developmental milestones on time:how early is too early for a speech language evaluation

Long before your baby says her first words, she is listening and communicating in a variety of ways:

  • By 3 months, she quiets or smiles when you talk to her and cries differently to express different needs
  • By 6 months, she responds to changes in the tone of your voice, babbles with many different sounds, and vocalizes excitement and displeasure
  • By 1 year, she makes gestures (e.g., waves) to communicate, imitates speech sounds, and says one or two words

These skills, along with other speech and language milestones, generally follow a similar sequence of development in typically developing children. And, though there is variation across all children, these milestones are usually expected at particular ages. The predictability of your baby’s language development allows speech-language pathologists to evaluate your baby’s skills long before she starts saying her first words. Looking at milestone charts and comparing them to your baby’s skills will give you hints about whether your baby might be on track or delayed.

  1. Your baby displays one or more of the following “red flags” for communication disorders*:
  • Does not babble by 9 months
  • Does not say first words by 15 months
  • Does not respond to communication appropriately
  • Does not make eye contact
  • Sudden loss of skills or slowing of development
  • Does not show interest in communication

*Adapted from Please see web site for more information.

  1. Your baby has hearing problems or a previously diagnosed neurodevelopmental disorder:
  • Hearing Problems: 92% of children with hearing loss are born to hearing parents. The ability to hear is essential to your child’s language development, as decreased linguistic input may negatively impact language. Furthermore, otitis media (middle ear infection) is common in children ages birth to 3. It may be harder for children to hear and understand language if sound is dampened by fluid in the middle ear. Therefore, children with frequent ear infections should have their hearing tested to ensure full access to their linguistic environment.
  • Neurodevelopmental Disorder: Neurodevelopmental disorders are disabilities associated with the functioning of the nervous system and brain. Children with these disorders are at higher risk of having speech and language problems.


What Can I do if I see One of These Red Flags?

If your baby is not meeting developmental milestones, displays any “red flags,” or has hearing difficulties or a neurodevelopmental disorder, you can take action by finding a speech-language pathologist in your area and scheduling an evaluation. Click here more information about how to select a speech-language pathologist, as well as what happens during a speech-language evaluation.

Baby with a pacifier

Pacifiers – Time to Give it Up?

Pacifier. Binky. Paci. Buppy. Ga ga. Dee dee. Whatever you call it, many moms know it as Mommy’s best friend. Those little rubber plugs are miracle workers, they help to calm a fussy baby, soothe a sleepy baby, and relax a restless one. But when is it time to give it up? And why? And most importantly, how?


12 months. This is when your baby should be transitioning away from bottle to sippy cup or open cup drinking as well.


12 months marks the beginning of a dramatic increase in speech development. With frequent pacifier use, your child:

  • May be less likely to produce the beginning stages of speech and language development, like babbling and first words.
  • Will have his mouth in an unnatural position, potentially affecting the way his tongue and lip muscles develop for proper Baby with a pacifierspeech production.
  • May develop an unnatural tongue position at rest as the tongue is pushed forward between the teeth. This can lead to the development of a lisped production of “s” and “z” sounds.
  • May have more frequent ear infections. One study showed that children who did not use pacifiers had 33 percent fewer middle ear infections.
  • May develop an abnormal unnatural arc to their front teeth causing their upper teeth to tip forward toward the lip. There’s no evidence that pacifiers can cause damage to baby teeth, but permanent teeth is a different story.


  • Sooner rather than later

o   Taking away the pacifier when your child is still young (think 3-5 months) can make the transition easier for you and for him as he hasn’t developed the habit as deeply yet and he doesn’t have the ability to express his displeasure or negotiate with words.

  • Going Cold Turkey

o   You are the parent. You have the power! The transition may be rocky at first, but stick with it for a few days and your child is likely to find another way to calm himself.

o   Some creative ideas on how to go cold turkey:

  • Lose it; whether intentional or not. Play dumb and say you have no idea where they possibly could have gone.
  • Pick a day and reason why the pacifier is going away. For example, “It’s your third birthday and you’re going to be a big boy. Big boys don’t use binkies!”
  • Cut off the tip and say the pacifier is broken.
  • Leave it for Santa/Easter Bunny/Binky Fairy.
  • Give it away. For example, tell your child that the “new babies” need the pacifiers. Package them up and drop them off at the doctors office or day care.

*These ideas are best for older children, 2-3 years old.

  • Gradual

o   A slow, gradual weaning process may work best for you and your child. Restrict the pacifier use to certain times (i.e. bedtime only) or places (i.e. in the crib or in his room).

  • Read about it

o   Kids love a good bedtime story, so why not make it one about getting rid of the binky? Here are some recommendations:

  • Bye-bye Binky” by Brigitte Weninger
  • “Bye-Bye, Pacifier” (A Muppet Babies book), by Louise Gikow
  • “No More Pacifier” by Ricki Booker
  • “Pacifiers Are Not Forever” by Elizabeth Verdick

Developmental Milestones | Concepts

Children’s first words are generally composed of nouns: the people and things in their lives.  Children start to understand and use verbs more frequently as their vocabularies build.  They then begin to use modifiers and adjectives.  Concepts are among these early modifiers and adjectives.  Children acquire these concepts at different stages in their development.  Read on for conceptual milestones for children ages 1 through 6.

Conceptual milestones for children ages 1 through 6:

Ages 1-2

  • Follows simple commands using spatial terms in or on
  • Uses a few spatial terms such as in or on
  • Uses simple directional terms such as up or down

Ages 2-3

  • Understands number concepts such as 1 or 2
  • Understanding of spatial terms become mastered with in, on, off, under, out
  • Begins to understand same/different
  • Time concepts begin to emerge, specifically with soon, later, wait
  • Begins to use color and size vocabulary

Ages 3-4

  • Advances spatial terms to understanding next to, besides, between
  • Uses spatial terms behind, in front, around
  • Begins to follow quantity directions such as a lot and empty
  • Identifies colors
  • Identifies what is different Read more