Children with a speech delay may use words, but you have a hard time understanding them. They could also struggle to speak because they struggle to form words.
A 2-year-old can produce two and three-word sentences and say roughly 50 words. By the age of three, children have a vocabulary of about 1,000 words and can speak in three- and four-word sentences.
Developmental milestones are suggestions that help you monitor your child’s growth. If your child hasn’t reached those developmental milestones, they might be experiencing speech delay. Still, of course, every child grows at their own pace.
A speech delay in your child doesn’t always indicate a medical problem. For example, you might have a slow talker or a child who is still developing and will soon talk nonstop. On the other hand, a hearing impairment, underlying neurological or developmental issues, or both may contribute to speech delay.
The difference between speech and language delay
There are specific differences between a speech and language delay, even though the two are usually confused and referred to as the same thing.
Speech is the active process of uttering words and making sounds. Comprehension or nonverbal communication is not involved in a speech delay. For example, a toddler with a speech delay might make an effort but struggle to make the right sounds to form words.
Understanding and communicating vocally and nonverbally are both impacted by a language delay. For example, a toddler with a language delay may produce the right sounds and correctly pronounce some words. Still, they need help putting words together into coherent phrases or sentences.
Speech and language problems differ, but often overlap. For example:
- A child with a language delay might say words well, but only be able to put two words together.
- A child with a speech delay might use words and phrases to express ideas, but be hard to understand.
The warning signs of speech delay
Each child’s linguistic abilities grow differently, from the earliest cooing sounds to fully formed words. Even siblings have varied speech development. However, their speech should continue improving as your child grows.
Your child should start connecting two words and making small sentences by two. Unfamiliar listeners should be able to understand half of what your child says. At the age of three, most people should be able to understand them.
It would be best to make an appointment with a speech-language pathologist if your child suffers from the following:
- By 12 months, isn’t using gestures, such as pointing or waving bye-bye
- By 18 months, prefers gestures over vocalizations to communicate
- By 18 months, has trouble imitating sounds
- Has difficulty understanding simple verbal requests
- By 2 years, they can only imitate speech or actions and don’t produce words or phrases spontaneously
- By 2 years, says only some sounds or words repeatedly and can’t use oral language to communicate more than their immediate needs
- By 2 years, can’t follow simple directions
- By 2 years, has an unusual tone of voice (such as raspy or nasal sounding)
It is essential to watch out for all these signs to prevent any possible conditions from worsening or being irreversible.
Causes of speech delay
Physical impairments
A speech delay might be due to an oral impairment, like problems with the tongue or palate (the roof of the mouth) or a short frenulum (the fold beneath the tongue), which can limit tongue movement.
Many children with speech delays have oral-motor problems. These happen when there’s a problem in the areas of the brain responsible for speech. This makes it hard to coordinate the lips, tongue, and jaw to produce speech sounds. These children also might have other oral-motor problems, such as feeding problems.
Hearing problems also can affect speech. So an audiologist should test a child’s hearing whenever there’s a speech concern. For example, children who have trouble hearing may have trouble saying, understanding, imitating, and using language.
Ear infections, especially chronic infections, can affect hearing. But as long as one ear has normal hearing, speech and language will develop normally.
Environmental factors
Your child develops communication skills through interaction. If a caregiver does not expose the child enough to various conversations, language skills will grow slower, making it difficult to comprehend.
This environment dramatically influences a child’s speech and language development. Moreover, the child’s ability to meet developmental milestones may be hindered by abuse, neglect, or a lack of verbal stimulation.
Autism spectrum disorder
Autism spectrum disorders frequently present with speech and language issues. Indications are:
- Using sentences again rather than forming new phrases (echolalia)
- Repeating patterns
- Communication problems (verbal and nonverbal)
- Social contact is compromised
- Regression in language and speech
- Issues with speech and language
A 2-year-old who communicates verbally and nonverbally, but struggles to speak, may have a speech delay, while working to talk in complete sentences may be a sign of language delay.
What to expect during speech therapy
When your child begins speech treatment, a speech-language pathologist will assess them. Then, each course of treatment will be built around your child’s unique treatment plan.
The language exercises your child’s therapist uses may include play, conversation, reading, and good modeling. As required, they may also use feeding and swallowing treatment or articulation therapy, which involves teaching your child how to pronounce particular sounds.
The next step to take
A child with a speech delay struggles to attain the speaking milestone appropriate for their age, and sometimes an underlying ailment that requires treatment is the cause. In these situations, speech or language therapy may be combined with other forms of treatment.
Speaking earlier or later than usual is common among toddlers, so it’s not always a cause for alarm. But do not hesitate to consult a pediatrician if you have concerns about your child’s speech or language development.
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