Dangers of Using Speech & Language Milestones Online

Hello. So we're going to talk about milestones in this video. So milestones is something that us therapists, we look at and use every day. And parents do go online and check milestones. If, you know, like if you go down the Google rabbit hole, you will see that people will type something like, oh, milestone, what? What should a 2 year old be saying? Whatever, right? So there are general guidelines and there are also very, very detailed milestones on the Internet. And sometimes it's not the best idea for parents to look into it and drill into it. So I have parents coming at me and asking me, ming, my child can do this, can do that, and they already know how to turn around or whatever. Inside of this website it says this and that and I get like a whole wall of text right, coming at me. So to answer you this question, I'll just tell you what has been working for us as an online parent coaching company. And I'll tell you that first of all, any child below 2 years of age, you should wait until 2 to do a full speech and language assessment. Any time your child is not yet at 2 years old and you see that there's a delay, what a lot of parents will do. And like, as I told you, when I hop onto calls, the best thing that you can do is to do a lot of language facilitation techniques of which go on YouTube and listen to other speech therapists. Doesn't need to be me. Learn about what language facilitation is. Okay? And other than that, let's talk about the milestones and why it's actually a little bit dangerous. Okay? So the thing is, milestones can go all the way up here with very high expectations or very down low here. And recently there was not recently, a year ago there was drama with the CDC in America where the language milestones were lowballed out of like it's very low. So a lot of people were actually, they're like, oh, it's permissible, we don't need to see therapists or whatnot. Right? But at the same time there are other countries that have their standards a lot higher. So like Asian countries such as Singapore, like Hong Kong, we have a slightly higher standard for that. And that's because there are cultural differences, which I'll talk about that later. But what I'm trying to say is if you are currently thinking about looking at milestones, I want you to take it with a grain of salt. The reason why is because if you just look at it at a face value, right? And without the context Your child is in right now, it's very difficult for you to have a good judgment about it. So below to wait until 2, right? And not telling you to stop doing anything. Look at language facilitation techniques that I can do at home, okay? A good resource is the hand and center. We also have some, some videos about that and on our channel, by all means, be my guest. Watch other therapists talk about it. It's at this point in time, it's pretty much common knowledge about what and how to follow child's lead and so on. Very common practice on the Internet, if you go inside the rabbit hole, right? So the second thing is cultural and country differences that milestones have. And not only just milestones, but like in general, how much a child should talk, use language and so on. So let me give you examples. For example, the S sound as a speech goal, as a speech milestone, in like Western countries, it's permissible to acquire that sound later, right? Whereas for Asian people, for me, for instance, in Hong Kong, we speak Cantonese, the S sound is a lot more frequent, meaning there are a lot more words that require the S sound. And that the S sound by itself, I'm giving you an example as a little caveat, right? So is used in single syllable words a lot more, right? So therefore it's easier to acquire. Okay? So given that what we just heard, right? For the S sound to acquire earlier for Chinese kids is a lot more likely than Western children, right? And it's a simple fact that the S sound is used more frequently. And that's a cultural difference and the language difference. So I need to put that onto you first. Because a lot of countries around the world, for instance Indonesia, Malaysia, Southeast Asian countries, maybe Latin America is getting better. Like these kind of places, they really do not have their own standards just yet. And therefore a lot of times, even for Hong Kong, back in the day where I got my education, we're also leaning towards using Australian UK standards to help us to generate something. But those are English based, right? So you need to have that grain of salt, okay? You have to be careful about that. All right? So given what I just said, right? That being said, you need to understand that those milestones online may not apply to your child 100%. So you're saying, ming, dude, get to the point. So here's the point, all right? When you think that your child has a delay or disorder, you need to think about it from a functional perspective. What I mean by functional? Functional perspective, okay? So for instance, if your child is required to Go to kindergarten by law, Right. Then obviously you need to look at if your child can function within the classroom or not, okay. Or culturally speaking or within the family even. Like you have children who have siblings or whatnot and they're playing together and your child cannot function within that environment, then of course you need to do something about it. Right? So you don't need actually need an assessment to tell you these things, because you can see it already, Right. And if you see that your child has problems with playing with other children speaking properly, speech intelligibility, meaning how much you can understand your child's speech is low, you know, by all means, you have to do something about it. And usually it starts off with an assessment. An assessment is always better because a speech therapist or a language therapist or whatever therapists there are, they are a lot more understanding towards what the cultural differences are. Right. And they can if, like, the difference between you and a professional as a parent is that professionals can see through, can read at the very least, I guess giving me some benefit of the doubt here, is that I know a little bit more than you do. Right. And I can siphon through and think about what resources will apply to your child, which approaches apply to your child. Right. It's not that following a child's lead or that makes sense in a lot of settings, but in a lot of Asian schools, they don't have inside of school, everything is very structured. So why would you try and do a totally naturalistic approach? Right. How about we think about how to make it more structured so that we can bring it into the school setting? Yeah. So it really is dependent on what? Where you are, how old is your child, what language you speak, what are the needs right now, what are they functionally speaking? You know, like some children are legally, you know, legally bounded to go to school. Right. And if you don't want to homeschool or whatever, then by all means, you have to do something to make them functional. Some parents want to bring their children to go to preschool. It's not must, but like some people do. And if that's the case, then you have to think about, okay, once I have that educational need, that need of them being able to function in that environment, then you need to take steps to start doing and start helping your child to go towards there. So the last point I want to take here before I end this video is, how do you even know if your child is hitting the milestones or not? So let me just explain milestones real quick. Maybe I should have done this in the earlier in the video. But anyways, so milestones just mean, if you see like there's 70% and 90%, it just means that by this age, 90% of children should have these skills. Should, right? And it's a loose guideline. And most of the time, for instance, in a western country, the, the population size might be a little bigger, right? In a smaller country or a smaller city, the population size to create these milestones must be smaller. If you read some of the guidelines and some of the results and methods of making these milestones and doing the standardized test, so to speak, you can see that the population sometimes is only just 80 kids. How it works is that you take the data from 80 kids or like 80 to 200, depending on the size, right? But it's a lot of work. Take that data, extrapolate it and put it upon the whole population of the country, okay? And you have to understand that this is not a perfect standard. It's not perfect. It's a lot of times when a therapist, right, A person like me versus a younger therap, a therapist who just came out of school versus a very senior therapist, we all have different standards, right? And that's because I've seen children at my age and at this, like at, at a certain time frame, right, between, I don't know, 2014 till now, that's me, right? Whereas a senior therapist, they started in like 1980 something. And until now, the children, they see the, you know, like back in the day, ABC was apple, banana, carrot, right? Not right now, it's alligator, I don't know, beef binoculars or something, right? So it's very different. And nowadays the therapists who have just graduated, they have learned a new set of standardized tools and tests and whatever as well. And there's also like trilingualism, bilingualism is on the rise. So all of us have very different standards. So again, other than understanding that milestones we have, it's all over the place. You know, like one random university can come up with it. One random country, even like America, the CDC can come up with a milestone that most of the speech and language, the population pathologist, they don't agree on, right? Milestones are everywhere on the Internet. And there's no one good perfect standard where we say, yo, listen up, this is what works. This is not whatever, right? But maybe in the future we can gather language data a lot better with AI and we can like have a bigger size and so on and have all cultural differences input into the data points. And we don't have to have so many caveats and so on. But what I'm trying to say is always think about what you're trying to achieve with your child. Okay. Treatment is always thinking about, your child cannot do something. Why cannot they do something? Okay, well, the underlying deficits. Can we solve underlying set underlying deficits? Right. If we cannot, then why is it we keep on trying, trying, trying. Assessment is only the first part. Hitting milestones doesn't mean anything. If you're thinking about, like, treating the milestones by milestone, like, oh, my child doesn't, like, respond to their name or whatever, then you are not treating the underlying deficit. Right. You are treating things symptom by symptom. And what I mean by symptom by symptom is, for instance, if your feet hurts and then you try to, like, take painkillers, you're treating the symptoms, but the underlying problem is that there's tendonitis, but you didn't treat the tendonitis. You only had painkillers. So therefore, the symptoms will always come out and you're always trying to relieve the symptoms. And it's the same as speech and language delays and disorders. Understand why that there was a delay in the very first place. Was there not enough language input at home? Was it that parent child interaction wasn't as good as it should be? Right. That's also something you need to be careful about. Is it that the child doesn't understand why they have to communicate. Okay. And that they're on the spectrum, they have a different understanding of the world than we do. Right. All these things you have to take into account. And don't just think about, like, treating milestones. I need to hit this. I need to hit this. This is my goal. I want them to do this. No child ever put their hand up and like, when they're born, and it's like, oh, I'm gonna be delayed. Right. I'm gonna not hit milestones and stuff. And milestones are what people set anyways. And it should. If you read the fine prints, 90% of children should attain these skills by age. Whatever. It's a should, not must. And those skills are what we deem important in the world. Okay? But a lot of treatment plans and when you're teaching a child is very individualized. There's a reason why we do things. Okay. If we only think about how to teach a child to say three word sentences, then you will only get three word sentences. Right. You're not thinking about whether you're increasing the number of vocab. You're not thinking about whether they understand the grammar, the sentence structures, you're not thinking about that, then if you treat symptoms, all you get is better symptoms. Okay, so that's it. I went on a rant a little bit. But at the same time, if you have any questions about milestones and so on, please put it in the comment section below. We'll try our best to answer the questions. Right. And if you need anything else, please just put it in the comment section. All right. Other than that, before we go, if you haven't, Please go to agentsofspeech.com checklist to grab list of tools and toys that we recommend you to get when you start home therapy. All right, so that's it for this week's video. Hope you enjoyed it. I'll see you next week. Bye. Bye.