The question
My five-year old still can't pronounce the letter L (he pronounces it as Y or TH). Does he need speech therapy?
The answer
If that's your only concern, he doesn't need to see a speech therapist. It's not uncommon for a child this age to struggle with his or her pronunciation, and the vast majority of children eventually get through this stage and do not need to see a registered speech and language therapist.
It's important that you watch him carefully, though, to be sure all his other developmental markers are on time.
At age five, a child should have speech that is completely intelligible in spite of articulation problems. He should have the ability to pronounce all vowels, and consonants such as M, P, B, H, W, K, G, T, D, N, NG and Y.
In terms of other milestones, he should be able to repeat sentences as long as nine words and be able to follow three commands given without interruptions. He should also know his age and grasp simple time concepts such as morning, afternoon, night, day, later, after and while.
By this age, he should also know common opposites such as big-little, hard-soft and heavy-light and be able to define common objects in terms of use, such as hat, shoe and chair.
Many speech and language pathologists remind us that although there are ages-and-stages charts for normal speech development and intelligibility, they should not be interpreted too rigidly. Children vary considerably with regard to the rate at which they reach various milestones. Having said that, if a parent remains concerned over time, it's never a bad idea to see a certified therapist for more reassurance (see www.speech-language-therapy.com).
One of the best activities you can engage in with your child to help develop normal speech is reading to him. The Canadian Pediatric Society ( www.cps.caringforkids.ca) has excellent ideas on how to do this age appropriately.
Childdevelopmentinfo.com is an excellent resource where you can find more information about language development and children.
Send pediatrician Peter Nieman your questions at pediatrician@globeandmail.com. He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.
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