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Why can’t my 4-year-old pronounce simple words?
Q: My daughter is nearly 4. She is very smart and knows what you ask her to do. I would like to say there is nothing wrong, but she doesn’t talk. When she says “bye-bye” it comes out like “thy-thy.” I know it’s not her hearing. When she was 2 she would copy songs from movies, and it seemed as though she was on her way to talking. What should I do? I have cousins who didn’t communicate well until they were 5.
A: First of all, I wouldn’t be so sure that her hearing is not part of the problem. We now know that many children develop a slight hearing loss as a consequence of middle ear infections that may seem mild and unlikely to leave any lasting effects. So I would begin by having her pediatrician or family physician test her hearing using ordinary office procedures. If the doctor suspects a hearing loss, a referral can be made to an audiologist or developmental clinic in your area for more precise and refined tests.

Second, I am not entirely clear about the exact nature of your daughter’s problem. You say that she “doesn’t talk” but give as an example a fairly simple pronunciation problem. If it is the latter—if she substitutes one sound for another frequently, as the “th” for “b” example you give—the situation is by no means as serious as it would be if she really did not talk. Again, it would be important to know if she always substituted “th” for “b” – if she also said “thaythe” for “baby” and “thottle” for “bottle,” or it just happens when trying to say “bye-bye.”

Whichever is the case, if you can do it without making her tense about talking—which is far worse than having her mispronounce a few words—sit with her facing you and say you are going to make some words together. Then very slowly and distinctly, make a few “b” words (baby, ball, boy, bed, etc.). Always choose very simple words she is likely to know, and avoid words of more than one syllable or ones that contain consonant blends (brother, bread, blood, etc.).

Exaggerate your lip movements as you make the “b” sound and encourage her to say the word the same way. Praise her for any approximation she makes. Don’t do this for more than a few minutes at a time. You might try the same thing with other sounds that she confuses or does not make properly.

Most importantly, read and talk to her. And encourage her to sing. She may simply be on the same timetable as your cousins and dramatically improve with just a slight boost from you. Or she might need professional help. If things have not changed much by the time she is 5, I would find a good speech and language clinic and arrange for an evaluation and whatever treatment they propose.

Incidentally, if my answer does not quite fit your daughter, don’t hesitate to write again and provide additional information.