Speech and Language Development Delay

Speech and language development delay: Communication difficulties can pose challenges for children, making it tough for them to understand others or articulate speech sounds. These issues are quite common, affecting around one in 12 children and teenagers in the United States.

Children experiencing these disorders often encounter obstacles in learning to read and write, as well as in socializing and forming friendships. However, most children show improvement with treatment, particularly if intervention begins early.

It’s important to note that adults can also grapple with these disorders, whether stemming from childhood or arising due to other factors like brain injuries, stroke, cancer, or dementia.

Signs of speech and language development delay

“Speech disorders can pose challenges for children, making it difficult for them to articulate sounds or construct sentences. Signs of a speech disorder may include:

1. Difficulty with sounds like ‘p,’ ‘b,’ ‘m,’ ‘h,’ and ‘w’ between the ages of 1 and 2.
2. Problems with sounds like ‘k,’ ‘g,’ ‘f,’ ‘t,’ ‘d,’ and ‘n’ between the ages of 2 and 3.
3. Difficulty being understood by people who know the child well.

Causes of Speech and language development delay

The exact causes of most speech disorders remain unknown. However, there are three primary types:

1. Articulation: Difficulty pronouncing words correctly, which may involve dropping sounds or substituting one sound for another (e.g., saying “wabbit” instead of “rabbit”). While sounds like ‘p,’ ‘b,’ and ‘m’ are typically mastered by age 2, sounds like ‘r,’ ‘l,’ and ‘th’ may take longer to develop.
2. Fluency: Challenges with the flow of words and sentences, often characterized by stuttering, where a child repeats words, parts of words, or experiences unusual pauses. Stuttering is common as children near 3 years of age, as their thoughts may outpace their speech. However, if stuttering persists beyond 6 months or if the child is older than 3.5 years, seeking professional help is advisable.
3. Voice: Issues with the quality of the child’s voice, such as speaking too loudly, softly, or experiencing hoarseness. This can result from speaking with excessive force or the presence of growths like nodules or polyps on the vocal cords, often due to vocal strain.”

Is your child using fewer words and simpler sentences compared to their peers?

These could be signs of a language disorder, where it’s challenging for them to find the right words or speak in complete sentences. Understanding what others say may also be difficult for them. Your child might have this disorder if they exhibit the following:

1. Lack of babbling by 7 months.
2. Speaking only a few words by 17 months.
3. Inability to combine two words by 2 years.
4. Difficulty interacting and communicating with other kids between the ages of 2 and 3.

Types of language disorder

There are two primary types of language disorders, and a child may have both:

1. Receptive: Difficulty understanding speech, leading to challenges in following directions, answering questions, or identifying objects when asked.
2. Expressive: Trouble finding the right words to express themselves, making it tough to ask questions, form sentences, or engage in conversations.

Risk Factors

Language disorders can have various causes, including physical factors like head injuries, illnesses, or ear infections, which are sometimes referred to as acquired language disorders. Other factors that may increase the likelihood of these disorders include:

• Family history of language problems.
• Premature birth.
• Autism.
• Down syndrome.
• Poor nutrition.

Identifying the exact cause of language disorders isn’t always possible. It’s essential to understand that these disorders are not indicative of a child’s intelligence; often, children with language disorders are as smart as their peers or even above average.”

Diagnosis

Speech and language disorders are considered legal disabilities. Children can undergo testing and receive treatment through their state’s early intervention program or local public schools, with some services available for free.

Treatment

A speech-language pathologist (SLP) may assess your child’s abilities to follow directions, name common objects, play with toys, and handle books correctly. Initially, the SLP will conduct a hearing test. If hearing is normal, further tests will determine the type and severity of the disorder, whether it requires short-term intervention or ongoing treatment, and develop a suitable treatment plan.

Supporting Your Child

Children develop skills at their own pace, and mistakes are common, especially at a young age. It’s important to be aware of developmental milestones and what your child should achieve at each stage.

To assist your child with their speech and language skills:

1. Engage in conversation with your child from infancy.
2. Point out objects and name them.
3. When they’re ready, ask questions to encourage interaction.
4. Respond to their speech without correcting errors.
5. Read to your child for at least 15 minutes daily.

It’s crucial not to assume that speech or language disorders will resolve on their own. However, treatment can significantly improve outcomes for most children, especially when initiated early.

Should I be concerned that my 2-year-old doesn’t say many words and is hard to understand?

Talk to your child’s healthcare provider if you’re having difficulty understanding only a few or none of your 2-year-old’s words. A delay in using words or speaking can potentially signal underlying issues. Your toddler’s provider can offer referrals to professionals who specialize in testing children for such concerns.

While every child develops at their own pace, there are typical milestones for toddler speech development. By age 2, most children can:

• Use simple two-word phrases like “more milk.”
• Ask one- or two-word questions such as “Go bye-bye?”
• Follow simple commands and understand basic questions.
• Speak around 50 to 100 words.
• Be understood at least half the time by unfamiliar adults.

Between ages 2 and 3, most children:

• Speak in two- or three-word phrases or sentences.
• Have a vocabulary of at least 200 words, possibly up to 1,000 words.
• Ask questions using words like who, what, where, or why.
• Say their own name when asked.
• Use pronouns to refer to themselves.
• Can be understood by familiar listeners most of the time.

If there’s a concern about a potential condition causing a speech delay, your child’s healthcare provider may recommend evaluation by specialists such as an audiologist for hearing issues or a speech-language pathologist for communication problems. If your child is bilingual, seeing a bilingual speech-language pathologist for testing in both languages may be advised.

In the United States, government-funded early intervention programs are available for testing and support for children with developmental delays or disabilities. Each state and territory operates its own early intervention program, some of which include speech therapy.

Treatment for speech delay in toddlers varies based on the cause. Early intervention often leads to improvement over time for both the delays and their underlying causes.”

Sources

1. Understood.org: “Understanding Language Disorders”
2. Mayo Clinic: Jay L. Hoecker, M.D.
3. Diane Paul, PhD, American Speech-Language-Hearing Association, Washington, D.C.
4. National Institute on Deafness and Other Communication Disorders:
5. UpToDate: “Etiology of speech and language disorders in children”
6. Stanford Children’s Health: “Fluency Disorder”
7. American Speech-Language-Hearing Association: