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Speech Therapy for First Grader?

Pediatrics Expert Advice from Shari Nethersole, M.D.

Q: My first grader brought home a note from school requesting that he participate in the speech therapy program, as he has a slight problem with making L and R sounds. I know he sometimes mispronounces certain words beginning with these sounds, but he can also pronounce many words beginning with these sounds accurately. I thought that with maturity, this would improve. Does this sound like a problem that requires enrollment in a speech therapy program? At what age do children master speech sounds? I should also note that he is the oldest child in our family and he was a late talker. He has been read to consistently since he was three months old.

A: Children should have speech that is quite clear by the time they are in first grade. There are certainly some children who will have problems with articulating certain letters and certain sounds, and some of this may be hereditary. While it is true that the problem may get better with maturity, I do not see any harm in initiating speech therapy in order to improve the speech more quickly. For some children the speech does not improve much without specific therapy.

You do want to be careful that your child is not "labeled" and that he is not made to feel bad because of his speech impediment. You want to do whatever you can to bolster his self esteem and let him see that this is just a minor problem that he is getting a little help with. Your child may even feel better once his speech starts to improve because he will be able to communicate more effectively with other children and adults, and not have to repeat or rephrase questions so that people can understand him.

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Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.


Please note: This "Expert Advice" area of FamilyEducation.com should be used for general information purposes only. Advice given here is not intended to provide a basis for action in particular circumstances without consideration by a competent professional. Before using this Expert Advice area, please review our General and Medical Disclaimers.

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