Basic prerequisites for language development

In short. Speech does not appear out of thin air. It stands on several supports. If even one is weak, words may not come, even if the child very much wants to speak.

This text is about what should be "under the hood" for speech to start developing.

Why this matters

Many parents focus on "pronouncing words." They buy cards, ask for repetition, take the child to a speech therapist to "set sounds."

The speech therapist meanwhile says, first we need to work on something else. Parents are disappointed. "Why are you not teaching them to speak?"

Because without the prerequisites, words do not take hold. The speech therapist knows this from experience. Here is what these prerequisites are.

Prerequisite 1: hearing

A basic thing. The child must hear and distinguish sounds.

Even mild hearing loss greatly slows speech. With any speech delay, checking hearing is mandatory.

How it is checked. With an audiologist, painlessly. Now there are objective tests that do not require the child's cooperation. Free with a referral from the family doctor.

Prerequisite 2: attention

The ability to focus on another person, an object, an action. Without attention, language passes the child by.

This is not about "an obedient quiet child." It is about the ability to hold focus on something for at least a few seconds.

How we see it. Whether the child looks at you when you address them. Whether they switch their gaze between you and an object you are holding. Whether they react to their name.

If attention is lacking, the priority work is exactly on it. Not on sounds.

Prerequisite 3: joint attention

A separate type of attention that is key for speech. It is when the child and the adult look at the same thing at the same time and share the experience.

An example. You point at a dog on the street. The child shifts their gaze to the dog, then to your face, then back to the dog. This is joint attention.

Why it matters for language. The child hears the word "dog" exactly at the moment when they are looking at this dog, with your facial expression and intonation. Only then does the word attach to its meaning.

Without joint attention, words may sound, but the child does not connect them to objects in the world.

Meta-analyses show. Interventions for the development of joint attention improve this skill itself and the related speech skills in small children with autism.

Prerequisite 4: imitation

Children learn a lot through imitation. First movements, then sounds, then words.

Look. Whether the child copies what you do. You wave "bye," do they wave back? You clap, do they clap too? You say "boom" when a toy falls, do they repeat?

If imitation is weak, this needs to be developed even before setting sounds.

Prerequisite 5: play

Especially "pretend play." When the child feeds a doll. When they pretend to hold a phone. When they "cook soup" from sticks.

This is symbolic play. It is a basic skill for speech. Why. Because a word is also a symbol. "Car" is not the car itself, it is a symbol-substitute. If the child has not developed symbolic thinking, words may sound but not mean what they should.

"Pretend" play usually appears around 18-24 months. If at 2.5-3 years it is not there, this is a reason to talk to a speech therapist.

Prerequisite 6: language comprehension

An often forgotten thing. Before speaking, the child must understand.

Whether the child fulfills simple requests ("give the ball," "come here," "bring an apple"). Whether they react to their name.

You can say many words, but if the child does not understand them, this is not communication. It is a wall of sound.

Comprehension always goes ahead of output. A child can understand 100 words and speak 10. This is normal, not the other way around.

Prerequisite 7: motor skills of the speech organs

A separate big topic. To speak, coordination of the muscles of the mouth, tongue, lips, larynx is needed.

Sometimes the child has everything else, attention, comprehension, motivation, but the sounds themselves are difficult. This may be childhood apraxia of speech. A speech therapist with appropriate training is needed.

Prerequisite 8: sensory regulation

Here is where I (as a sensory therapist) want to make a separate emphasis. Sensory work is not a "pleasant bonus." It is a foundation without which everything else does not work.

If the child is in sensory overload, they cannot communicate. Definitely. An overloaded brain does not process language, does not hold attention, does not learn new things.

This is often confused with "bad behavior" or "does not want to communicate." In reality the child cannot. Their system is overflowing.

What this can look like.

• The child covers their ears in the store.
• Runs from bright light-screens.
• Does not sit still, constantly moves.
• Rebels against certain clothing fabrics.
• Avoids or seeks strong sensations.

If this is present, sensory regulation should go in parallel with communication work. Or even first.

How it looks in practice. Before a speech therapy session, 5 minutes of movement activity ("heavy work" for the muscles, jumping, swings). Then the brain "tunes in" and is ready to receive information.

Sensory strategies are selected by an occupational therapist. This is not "we will figure it out ourselves," but individually for the child.

Prerequisite 9: emotional regulation

Anxiety, fear, overtiredness, all of this blocks speech. A calm child learns. A stressed one does not.

This does not mean "entertain them 24/7." It means do not demand "speaking" in a stressful moment. First regulate, then we will learn.

Prerequisite 10: motivation

The child must have a reason to communicate. If adults anticipate everything, give food before the child has had time to think, the child does not learn to ask.

Not "deliberately create frustration." But create moments when the child needs to ask for something. Hold a favorite toy a little out of reach. Wait until the child shows or says.

What this means in practice

If the child does not speak, the first question is not "how to make them say it." The first question is which of these 10 prerequisites are weak.

A speech therapist, occupational therapist, or developmental psychologist assesses the foundation. Then the work plan becomes clear. If the problem is in joint attention, we work on joint attention. If in sensory work, on sensory work. If in apraxia, on apraxia.

Then "setting sounds" comes as the last stage on a ready foundation, not as the first on an empty place.

What is next

Read "Gestures, pictures, AAC," about how to give the child a way to communicate right now, while the foundation develops.