Learning About Speech and Language Delays in Children

What are speech and language delays?

Speech and language delay means that a child is not able to use words or other forms of communication at the expected ages.

Language delays include problems understanding what is heard or read. There can also be problems putting words together to form meaning. Speech delays are problems making the sounds that become words. Some children have both speech and language delays.

Speech and language delays can have many different causes. These causes can include hearing problems, Down syndrome or other genetic conditions, autism spectrum disorder, cerebral palsy, or mental health conditions. Delays can also run in families. Sometimes the cause is not known.

If your child doesn't develop speech and language skills on schedule, it may not mean there is a problem. But if your child is having problems, talk with your doctor. The doctor may suggest testing.

A child can overcome many speech and language problems with treatment such as speech therapy. It helps your child learn speech and language skills.

What are the symptoms?

If your child doesn't reach speech and language milestones as expected, it might not mean that something is wrong. Each child grows and gains skills at their own pace. But not reaching these milestones may mean that a child has a problem with speech or language development.

Signs of a speech or language delay may include:

• No babbling by 9 months.
• No first words by 15 months.
• No consistent words by 18 months.
• No word combinations by age 2.
• Problems following simple directions at age 2.
• Not speaking in complete sentences by age 3.
• Problems using the right words in sentences at age 4.
• Speech that family finds hard to understand when the child is age 2.
• Speech that strangers can't understand when the child is age 3.

How are delays diagnosed?

The doctor will ask about your child's speech and language skills during regular well-child visits. The doctor will do a physical exam and ask questions about your child's past health and development. They will also ask if your child has reached speech and language milestones for their age.

If the doctor thinks your child has a speech or language problem, they will refer your child to a speech-language pathologist (SLP). The SLP will listen to and watch your child talk. They will also ask your child to say certain sounds, words, and sentences.

Tests may be suggested to:

• Look for other conditions. For example, your child may need a hearing test to rule out hearing loss.
• Find out what speech sounds your child can say.
• Find out if your child has trouble putting sounds together to form words and sentences.
• Check how well your child is gaining speech, language, and motor skills.
• Find out if your child is having other problems, such as behavior issues. Problems could also include trouble with common skills, such as sucking, chewing, or swallowing.

How are delays treated?

Therapy depends on the cause and type of problem. To help your child communicate better, the speech-language pathologist may:

• Help your child learn to make all speech sounds and combine them into words. This can help your child produce the sounds more easily.
• Help your child understand the meaning of words and different types of sentences.
• Help your child understand social cues and communicate in various situations.
• Help your child learn sign language or use devices that help children communicate.
• Suggest that your child get a hearing aid, if needed.
• Teach your child how to use special programs on a computer, tablet, or smartphone. Some programs include speech lessons. Others allow your child to communicate through objects or symbols.
• Teach you how to work with your child at home and help your child practice new skills.