Understanding Speech and Language Delays
As with other skills and milestones, the age at which kids learn language and start talking can vary. Knowing a bit about speech and language development can help parents figure out if there's cause for concern.
Early identification and intervention are crucial for children with speech or language delays. The sooner a delay is recognized and addressed, the better the outcomes for your child's communication development.
Understanding the difference between speech and language, recognizing warning signs, and knowing when to seek help can make a significant difference in your child's development.
How Do Speech and Language Differ?
Speech
Speech is the verbal expression of language and includes articulation (the way we form sounds and words).
Speech Includes:
- • How sounds are produced
- • Pronunciation of words
- • Clarity of speech
- • Voice quality
- • Fluency (stuttering)
Language
Language is giving and getting information. It's understanding and being understood through communication — verbal, nonverbal, and written.
Language Includes:
- • Understanding words and sentences
- • Expressing ideas and thoughts
- • Vocabulary
- • Grammar and syntax
- • Social communication
How They Overlap
Speech and language problems differ, but often overlap. For example:
Language Delay Example:
A child with a language delay might say words well but only be able to put two words together.
Speech Delay Example:
A child with a speech delay might use words and phrases to express ideas but be hard to understand.
What Are the Signs of a Speech or Language Delay?
A baby who doesn't respond to sound or vocalize should be checked by a doctor right away. But often, it's hard for parents to know if their child is taking a bit longer to reach a speech or language milestone, or if there's a problem.
Here are some things to watch for. Call your doctor if your child:
By 12 Months
- • Isn't using gestures, such as pointing or waving bye-bye
- • Doesn't respond to sounds or voices
- • Doesn't vocalize or make sounds
By 18 Months
- • Prefers gestures over vocalizations to communicate
- • Has trouble imitating sounds
- • Has trouble understanding simple verbal requests
- • Not saying any words
By 2 Years
- • Can only imitate speech or actions and doesn't produce words or phrases spontaneously
- • Says only some sounds or words repeatedly and can't use oral language to communicate more than their immediate needs
- • Can't follow simple directions
- • Has an unusual tone of voice (such as raspy or nasal sounding)
- • Speech is harder to understand than expected
Speech Clarity Expectations
Also call the doctor if your child's speech is harder to understand than expected for their age:
By 2 Years:
Parents and regular caregivers should understand about 50% of a child's speech.
By 3 Years:
Parents and regular caregivers should understand about 75% of a child's speech.
By 4 Years:
A child should be mostly understood, even by people who don't know the child.
What Causes Speech or Language Delays?
Oral Impairments
A speech delay might be due to:
Physical Issues:
- • Problems with the tongue
- • Problems with the palate (the roof of the mouth)
- • A short frenulum (the fold beneath the tongue), which can limit tongue movement
- • Cleft lip or palate
Oral-Motor Problems:
- • Problems in areas of the brain responsible for speech
- • Difficulty coordinating lips, tongue, and jaw
- • Trouble making speech sounds
- • May also have feeding problems
Hearing Problems
Hearing problems also can affect speech. So an audiologist should test a child's hearing whenever there's a speech concern.
Impact on Communication:
- • Trouble saying words correctly
- • Difficulty understanding language
- • Problems imitating sounds
- • Challenges using language
Ear Infections:
- • Especially chronic infections can affect hearing
- • As long as there is normal hearing in one ear, speech and language will develop normally
- • Persistent hearing loss in both ears can cause delays
Other Potential Causes
Developmental Factors:
- • Premature birth
- • Low birth weight
- • Family history of speech/language delays
- • Developmental disorders
Environmental Factors:
- • Limited exposure to language
- • Bilingual/multilingual environments (usually temporary)
- • Lack of stimulation
- • Trauma or stress
How Are Speech or Language Delays Diagnosed?
If your child might have a problem, it's important to see a speech-language pathologist (SLP) right away. You can find a speech-language pathologist on your own, or ask your health care provider to refer you to one.
Evaluation Process
The SLP (or speech therapist) will check your child's speech and language skills. The pathologist will do standardized tests and look for milestones in speech and language development.
What Will Be Checked:
- • Receptive language: What your child understands
- • Expressive language: What your child can say
- • Sound development: Speech sound production
- • Clarity of speech: How understandable speech is
- • Oral-motor status: How the mouth, tongue, palate, etc., work together for speech as well as eating and swallowing
Assessment Methods:
- • Standardized tests
- • Observation of communication
- • Parent interviews
- • Play-based assessments
- • Medical history review
Speech Therapy Recommendation
Based on the test results, the speech-language pathologist might recommend speech therapy for your child. This therapy is designed to address specific speech and language needs and help your child develop communication skills.
How Does Speech Therapy Help?
The speech therapist will work with your child to improve speech and language skills, and show you what to do at home to help your child.
Therapy Activities:
- • Exercises to improve speech sounds
- • Language-building activities
- • Play-based learning
- • Social communication practice
- • Oral-motor exercises
Parent Involvement:
- • Learn strategies to use at home
- • Practice activities between sessions
- • Support therapy goals
- • Track progress together
- • Communicate with therapist regularly
How Can Parents Help?
Parents are an important part of helping kids who have a speech or language problem. Here are a few ways to encourage speech development at home:
💬Focus on Communication
Talk with your baby, sing, and encourage imitation of sounds and gestures.
Activities:
- • Talk throughout the day
- • Sing songs and nursery rhymes
- • Encourage sound imitation
- • Use gestures and point
- • Make eye contact
Benefits:
- • Builds vocabulary
- • Models communication
- • Encourages interaction
- • Strengthens bonds
- • Supports language learning
📚Read to Your Child
Start reading when your child is a baby. Look for age-appropriate soft or board books or picture books that encourage kids to look while you name the pictures.
Reading Tips:
- • Start reading from birth
- • Choose age-appropriate books
- • Point to and name pictures
- • Make it interactive
- • Read daily, even for short periods
Book Types:
- • Soft or board books for babies
- • Picture books with clear images
- • Books with repetition
- • Books about familiar objects
- • Interactive books
🏠Use Everyday Situations
To build on your child's speech and language, talk your way through the day. Name foods at the grocery store, explain what you're doing as you cook a meal or clean a room, and point out objects around the house. Keep things simple, but avoid "baby talk."
At the Store:
- • Name foods and items
- • Describe what you see
- • Talk about colors and shapes
- • Count items together
At Home:
- • Explain what you're doing
- • Name objects around the house
- • Talk through routines
- • Point out familiar items
Important Reminder:
Keep things simple, but avoid "baby talk." Use real words with correct pronunciation to help your child learn language effectively.
The Importance of Early Intervention
Recognizing and treating speech and language delays early on is the best approach.
Benefits of Early Intervention:
- • Better outcomes for communication development
- • Prevents delays from getting worse
- • Supports academic success
- • Improves social skills
- • Reduces frustration for child and family
What to Do:
- • Trust your instincts
- • Don't wait to see if they "grow out of it"
- • Call your doctor with concerns
- • Seek evaluation if needed
- • Start therapy as soon as recommended
Frequently Asked Questions (FAQs)
Q: How do I know if my child just needs more time or has a real delay?
A: While there's a range of normal development, certain red flags indicate a need for evaluation. If your child isn't meeting milestones by the expected ages (especially by 12, 18, or 24 months), or if you have concerns, it's better to have an evaluation than to wait. Early intervention is more effective than waiting to see if they "catch up." Trust your instincts - if something doesn't seem right, discuss it with your pediatrician.
Q: Will my child outgrow a speech or language delay?
A: Some children do catch up on their own, but many do not. Without intervention, delays can persist and may even worsen. Early intervention gives your child the best chance for success. It's better to have an evaluation and find out everything is fine than to wait and miss valuable intervention time. Speech therapy can help even if your child would have caught up on their own.
Q: How long does speech therapy take?
A: The duration of speech therapy varies widely depending on the child's needs, the type and severity of the delay, how early intervention begins, and how consistently therapy is attended. Some children make significant progress in a few months, while others may need ongoing support. Your speech-language pathologist will discuss goals and expected timelines based on your child's specific situation.
Q: Can bilingualism cause speech delays?
A: Bilingualism itself does not cause speech or language delays. However, bilingual children may have a temporary period where they mix languages or seem to have a smaller vocabulary in each language (though their total vocabulary across both languages is often normal or even advanced). If you're concerned about your bilingual child's development, have them evaluated in both languages. True delays will show up in both languages.
Q: What's the difference between a speech delay and a language delay?
A: The key differences are:
- • Speech delay: Problems with how sounds are made, pronunciation, or clarity - the child may have good language skills but be hard to understand
- • Language delay: Problems understanding or using words, sentences, or grammar - the child may speak clearly but have limited vocabulary or can't put words together
- • Many children have both speech and language delays
- • A speech-language pathologist can determine which areas need support
Q: How can I find a speech-language pathologist?
A: You can find a speech-language pathologist through:
- • Your pediatrician's referral
- • Your local school district (for school-age children)
- • Early intervention programs (for children under 3)
- • Hospitals or medical centers
- • Private therapy clinics
- • Professional organizations like ASHA (American Speech-Language-Hearing Association)
- • Your insurance provider's directory
Key Takeaways
Know the Signs
Recognize warning signs at different ages and don't hesitate to seek evaluation
Early Intervention
The sooner delays are identified and treated, the better the outcomes
Support at Home
Talk, read, and use everyday situations to encourage communication development
⚠️ Important Note
This article provides general information about delayed speech or language development and is not intended to replace professional medical, speech-language pathology, or educational advice. If you have concerns about your child's speech or language development, always consult your pediatrician and consider an evaluation by a speech-language pathologist. Early identification and intervention can make a significant difference in your child's communication development and overall success.