Children can have delays in understanding and expressing themselves for a variety of reasons.

Sometimes speech and language difficulties are a component of other conditions.

There are some things that are known to be risk factors in a child’s speech and language development such as recurrent ear infections, a family history of speech and language learning difficulties etc.

Delays and difficulties with speech and language can lead to problems with school, social skills as well as behavior issues due to frustration or anxiety at not being understood.

Sometimes it is not immediately clear whether a child has a speech or language delay/disorder alone or whether something else is happening that is contributing the child’s challenges. Depending on their age, children with speech and/or language delays many manifest these challenges differently. In general, children with speech-language delays or disorders may have some of the following characteristics:

  • Trouble following instructions unless simplified or repeated many times
  • Difficulties asking or answering questions accurately or appropriately
  • Problems telling a simple story or retelling an event
  • Difficulties remembering what was just said to them
  • Using sentences that are shorter than those of other children their age and; not expressing ideas as completely as other children
  • Difficulties speaking so that others can understand what they are saying
  • Giving up trying to communicate or getting extremely frustrated because they are not understood
  • Stuttering

Support for Speech and Language Challenges

In Ottawa: First Words

The First Words Preschool Speech and Language Program provides information around early identification, prevention, screening, assessment and intervention for speech, language, stuttering, and voice therapy for children in Ottawa until they are eligible for senior kindergarten.

This website also provides Developmental checklists, screening clinic schedules, online booking, intake information, and general speech and language strategies.

The Hanen Centre

The Hanen Centre in Toronto is a world- recognized leader in early speech, language and literacy intervention. There are excellent information sheets/ resources for families concerned with speech- language delay and autism.

Speech-Language & Audiology Canada

1000-1 Nicholas St.
Ottawa, ON K1N 7B7
613-567-9968; 800-259-8519

American Speech and Hearing Association (ASHA)

2200 Research Boulevard
Rockville, MD 20850-3289
301-296-5700; 800-638-8255

Motor Speech

Childhood Apraxia of Speech Association


For Parents:
  • Childhood Speech, Language, and Listening Problems, by Patricia McAleere Hamaguchi
  • It Takes Two to Talk, by Ayala Manolsen
  • The Parent’s Guide to Speech and Language Problems, by Debbie Feit, with Heidi M. Feldman
For Children:
  • Lilly’s Purple Plastic Purse, by Kevin Henkes (main character has trouble listening)
  • The Mouth with a Mind of Its Own, by Patricia Mervine
  • Talking Is Hard for Me, by Linda Reinert
  • Hooway for Wodney Wat, by Helen Lester

Good hearing is crucial for children to develop clear speech, language, may have implications in reading development and in social interactions. It is a good idea to get a hearing assessment done if :

  • you suspect a speech or language delay
  • your child has difficulty paying attention
  • difficulty following instructions
  • often uses a loud voice
  • often turns up the volume on the TV or stereo
  • has a history of recurrent or long-lasting middle ear infections
  • there is as family history of hearing loss there is a tendency to not respond to your words or noises

Be sure to ask your family doctor for a referral to an audiologist for a hearing assessment if you have concerns.

You may want to consider a complete eye exam to rule out a vision problem if your child:

  • has difficulty paying attention
  • may not make eye contact,
  • was born prematurely,
  • pursues activities on his own agenda or independently,
  • seems to move often from one activity to the next,
  • bumps into things,
  • does not greet familiar people on sight or respond to gestures,
  • has difficulty following along when someone demonstrates what to,
  • has is a family history of visual issues,
  • frequently rubs his eyes

No child would, if able to choose, would want to struggle with connecting with classmates and teachers. As Ross Greene stated in his book The Explosive Child, “Kids do well when they can.”

Many children enter into the school system looking like 4 and 5-year olds, but have social interaction skills of children much younger. This mismatch in development can lead to problems fitting in and making friends.

Some children have trouble figuring out or don’t take the time to read the social scene. Others are noticing what other children are doing, but don’t know how to include themselves. Here is a basic list of some of the ways social skill challenges can present themselves in children from 3 ½ to 7 years:

  • might play beside another child but not really notice what the peer is doing.
  • may appear very self-directed
  • may play the same way, with the same toys
  • may not seem to notice what other children are doing in general (e.g. not tuning in to clues that classmates are putting their papers away)
  • may change activities so frequently, that there is not enough time to establish cooperative play with friends
  • may have real trouble giving toys up to share with a peer or take turns during an activity.
  • may not seem to understand the effect their behavior is having on other children.( e.g. banging on the table is irritating the child beside them) may need things to be their way or played in very specific ways
  • may enter into play destructively (e.g. grabbing the baby and running away hoping a classmate will chase them to include them in play)
  • may appear to not know how to join in play already in progress
  • may not engage in pretend play/dramatic play might be a lot of conflict when engaged with other children
  • may not be able to identify why there is a conflict
  • may not be able to identify how to compromise
  • may get into trouble at school more often than classmates
  • may have difficulty following the routine in class
  • may tantrum more often and more dramatically than other children their age.
  • may not know when someone else is being silly, teasing or joking
  • seems confused at the park or in the school yard about what to do
  • have trouble following the rules of simple games
  • have trouble explaining the rules of simple games

Difficulties with social skills can occur in young children because of something as simple as a need to be exposed to other children more. Sometimes social skills challenges can be related to other issues such as ADHD, Autism, Anxiety etc.

No matter what the source of the challenge skills that need more development can be identified, strengthened and difficulties lessened.

It is important to figure out with a professional and with the input of the important adults in your child’s life what interaction strengths your child may have, what do they need to develop and what next steps would be to build your child abilities.

If you have questions about whether there is an underlying issue that may be contributing to your child’s challenges with making and keeping friends and fitting in to their classroom community, click on the tabs below:

ADHD stands for attention-deficit hyperactivity disorder. There are a variety of subtypes of this. Sometimes the term ADD is used for kids who have attention difficulties but not the hyperactivity. Children are diagnosed with ADHD if they have enough challenges in this area across at least two environments (e.g., at home and at school).

Some possible signs that your child might have an attention deficit disorder include the following:

  • constantly in motion
  • inability to sustain interactions
  • impulsive to the point of not being able to stay and play
  • quick to anger/explosive
  • not attending long enough to listen to other kids;
  • not attending long enough to notice impact of own behavior
  • not paying attention in class; needing instructions repeated
  • not knowing when to stop being silly
  • interrupting a lot
  • dominating interactions
  • possibly destructive tendencies
  • “zoning out”
  • appearing dreamy
  • not initiating interactions
  • perhaps talking too much

Having ADHD/ ADD can impact learning to make and keep friends in young children by:

  • not taking the time to read the body language, facial expressions, or overall climate of the room
  • blurting out thoughts before considering the consequence on the person they are talking to
  • changing activities during play too quickly for their play partner
  • tuning out and not realizing that friends have changed the game or are now talking about something else
  • continuing to talk when friends are finished talking about that subject
  • may be perceived as too rough
  • might enter into play too abruptly
  • may not stay in activities long enough to develop play skills
  • may not take the time to hear what play mates want to do
  • too busy/distracted to notice what playmates are doing
  • may need it be their way/ get more upset and react too strongly for the situation

If you think your child may have ADHD/ADD, here are some resources to explore for more information:


In Ottawa

CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder)

4601 Presidents Dr., Ste. 300
Lanham, MD 20706
800-233-4050; 301-306-7070

CHADD Canada
Box 191
234 - 5149 Country Hills Blvd. NW
Calgary, AB T3A 5K8

LD Online
703-998-2060 (fax)


For Parents:

  • All Dogs have ADHD, by Kathy Hoopmann (kids like it too)
  • The Explosive Child, by Ross Greene
  • Late, Lost, and Unprepared: A Parent’s Guide to Helping Children with Executive Functioning, by Joyce Cooper-Kahn and Laurie Dietzel
  • Lost at School, by Ross Greene
  • Taking Charge of ADHD: The Complete, Authoritative Guide for Parents, by Russell Barkley
  • The Incredible Years, by Carolyn Webster-Stratton

For Kids:

Some excellent books for young kids where the main characters have ADHD/ADD (undiagnosed):

  • Curious George books, by Hans Augusto Rey and Margret Rey
  • No David, by David Shannon
  • 17 Things I Am Not Allowed to Do Anymore, by Jenny Offill
  • Stanley’s Party, by Linda Bailey
  • Winnie the Pooh books (character Tigger the tiger) by A.A. Milne

Autism spectrum disorder or ASD is a general term for a complex disorder with symptoms on a continuum of severity ranging from mild (previously referred to as Asperger’s syndrome) to more severe.

Everyone with ASD has difficulty in three broad, general areas:

  • social interaction
  • social communication
  • repetitive or restricted interests

Here are some specific ways these difficulties in social skills may be shown in a young child with autism:

  • difficulties with joint attention and eye contact
  • failing to seek out social interactions with others; often on his own agenda, in his own world
  • difficulty understanding why other kids act the way they do
  • difficulty knowing what to do with other kids
  • seeking out much younger or much older kids or adults for interaction
  • difficulties staying on topic
  • literal interpretation of jokes, teasing
  • talking excessively about a personal interest without the insight that listeners are bored or disinterested
  • seeking sensory stimulating activities such as repeating the same activity over and over (e.g., lining up toys, hand flapping)
  • needing things to be “just so”; inflexible
  • really grooving on the rules for games
  • not engaging in much pretend play or following a rigid format when pretending

If you have concerns that your child may be struggling with social connections due to autism, here are some resources to find out more and get support:


In Ottawa:

Autism Society Canada
Box 22017, 1670 Heron Rd.
Ottawa, ON K1V 0W2
866-476-8440; 519-695-5858

Autism Speaks

Autism Speaks Canada
2450 Victoria Park Avenue, Unit 120
Toronto, ON M2J 4A2
416-362-6227; 888-362-6227


For Parents:

  • More Than Words by, Fern Sussman
  • The Complete Guide to Asperger’s Syndrome, by Tony Attwood
  • Early Start for your Child with Autism, by Sally Rogers, Geraldine Dawson, and Laurie Vismara
  • Essential First Steps for Parents of Children with Autism, by Lara Delmolino and Sandra L. Harris
  • Talkability: People Skills for Verbal Children on the Autism Spectrum, by Fern Sussman

For Kids:

  • All Cats Have Asperger’s, by Kathy Hoopmann
  • The Survival Guide for Kids with Autism and Their Parents, by Elizabeth Verdick and Elizabeth Reeve
  • All My Stripes: A Story for Children with Autism, Shaina Rudolph and Danielle Royer Amelia Bedelia books by Peggy Parish

Sensory integration refers to how a person’s ability to perceive sensory information aligns with the sensations in the environment.

For example, someone with good sensory integration is able to tune in to useful visual, auditory, tactile and other input from the environment and tune out background sensations. (e.g. ignore the buzzing light while finishing their worksheet) Different people perceive sensory input differently.

A child dealing with sensory integration issues may be oversensitive (hypersensitive) to conditions such as noise, touch, sight, movement or under sensitive (hyposensitive) to some or all sensations or a combination of both.

Busy classrooms or daycares can be a nightmare for children with hypersensitivities. At young ages, classrooms often have a lot of children moving around and making a lot of noise. Not to mention other background sources of potential irritation such as buzzing fluorescent lights, sudden announcements made on the PA, recess bells, fire drills and scratchy tags on sweaters.

A child with these struggles may be so busy trying to deal with being bombarded with unpleasant sensations, they may be chronically irritated or distracted and simply not freed up to enjoy themselves with other children.

For hyposensitive kids needing extra sensations, the need to move, crash and make noise may cause classmates and teachers to react in annoyance.

Here are some examples of behaviors that may be due to sensory integration problems:

  • covering ears or crying at loud sounds (like fire alarms) or sounds that are not overly loud like songs in a minor key
  • being distracted or bothered by very slight sounds (like fluorescent lights humming)
  • crashing into things on purpose to get more touch input (if hyposensitive)
  • flinching or crying as if in pain when bathing in warm water
  • being enormously bothered by clothing tags
  • craving movement sensations such as swinging or spinning
  • closing eyes or not making eye contact when feeling visually overloaded
  • turning the lights on and off repetitively to experience the shadows

Support for children with sensory issues:

Sensory Processing Disorder Resource Center
Sensory Processing Disorder Foundation
5420 S. Quebec Street, Ste. 135
Greenwood Village, CO 80111


For Parents:

  • The Out of Sync Child, by Carol Stock Kranowitz
  • The Sensory Child Gets Organized: Proven Systems for Rigid, Anxious, or Distracted Kids, by Carolyn Dagliesh

For Kids:

  • The Loud Book by, Deborah Underwood
  • The Very Itchy Bear by, Nick Bland

Some signs of an anxiety disorder include the following:

  • avoiding interaction
  • clinging to parents
  • hanging around adults mostly
  • whispering responses
  • insisting that things be “just so”
  • feeling compelled to repeat the same action (e.g., checking things, washing hands)

Selective mutism in young children might look like a child who talks a lot at home, but is silent around other people or in other environments. These children may not speak at all at school, may not even speak to relatives despite being chatty with their parents.

Young children experiencing significant anxiety in social situations may miss opportunities to experience all of the learning that happens with other children around developing social perspective taking in a variety of situations, learning to resolve conflicts, how to join in play and when to leave play etc.

Pre school and kindergarten years lay a foundation of social interaction and play skills that kids need to be part of to be equipped with social tools when interactions become more complex and subtle as they get older.

If you have concerns that your young child may have social anxiety here are some resources to explore:

In Ottawa:

Kids’ Mental Health Ontario
40 St. Clair Avenue East, Ste. 309
Toronto, ON M4T 1M9

Mood Disorders Association of Ontario
36 Eglinton Ave. West, Suite 602
Toronto, ON M4R 1A1

The Selective Mutism Foundation
P.O. Box 450632
Sunrise, FL 33345-0632


For Parents:

  • Freeing your Child from Anxiety, by Tamar Chansky.
  • Helping Your Anxious Child, by Vanessa Cobham, Ronald M. Rapee, and Sue Spence
  • Helping Your Child With Selective Mutism: Steps to Overcome a Fear of Speaking by, Angela McHolm

For Kids:

Books for young children where the main character leans toward an anxious disposition:

  • Scaredy Squirrel books, by Melanie Watts
  • Frog and Toad books, by Arnold Lobel (it’s Toad who works through his worry brain)
  • Stella books, by Marie-Louise Gay (Stella’s little brother Sam is often anxious)
  • Let’s Talk about Feeling Worried by, Joy Berry
  • Mr. Worry by, Roger Hargreaves
  • Wallace’s Lists by, Barbara Bottner Understanding Katie by, Elisa Shipon-Blum

Non-verbal learning disability refers to children whose verbal skills are much stronger than their visual spatial abilities, social skills and motor skills. NVLD presents as all other challenges in that it is on a continuum meaning that features of NVLD may be mild or severe and impacted in one or more areas.

Socially, these children:

  • might not notice or have trouble understanding non-verbal communication (e.g. changing facial expressions, body language).
  • have challenges ”reading the room” figuring out what is happening around them and responding appropriately.
  • may not pick up on things like personal space and may stand too close a friend.
  • may have trouble with flexibility and need to play the same way to help them manage their lack of being able to follow the frequent shifts and changes that happen when young children play together.
  • may be more literal and rules-based than classmates and have real trouble with “going with the flow.”
  • may be more intense outbursts as a result of the stress of having to interpret a busy classroom when it is such a challenge.
  • may have trouble knowing when friends are joking, teasing in a nice way or being sarcastic.
  • may be more literal and struggle with slang terms.
  • may be more “black and white” in their thinking and not come up with alternatives on their own.
  • Might finding understanding the main point difficult in stories, shows or movies.
  • May really enjoy and want to play with other children, but are overwhelmed with how to keep play going once they’ve started.
  • May really want to join in and play with other children but are awkward in their attempts or remain on the sidelines anxiously.
  • May over rely on teachers/ adults at school during recess or outdoor time.

Support for Non-Verbal Learning Disability:

Raising NLD Superstars: What Families with Nonverbal Learning Disabilities Need to Know about Nurturing Confident, Competent Kids. By, Marcia Brown Rubenstein.