Speech and Language Delay

Overview

How do I know if my child has speech delay?

Every child develops at his or her own pace. But if your child doesn’t talk as much as most children of the same age, the problem may be speech delay. Your doctor may think your child has speech delay if he or she isn’t able to do these things:

  • Say simple words (such as "mama") either clearly or unclearly by 12 to 15 months of age

  • Understand simple words (such as "no" or "stop") by 18 months of age

  • Talk in short sentences by 3 years of age

  • Tell a simple story at 4 to 5 years of age

Causes & Risk Factors

What causes speech delay?

Speech delay occurs in up to 10 percent of children. The most common causes of speech delay include:

Other causes include:

  • Hearing loss

  • Slow development

  • Mental retardation

  • Psychosocial deprivation (the child doesn’t spend enough time talking with adults)

  • Being a twin

  • Autism (a developmental disorder)

  • Elective mutism (the child just doesn’t want to talk)

  • Cerebral palsy (a movement disorder caused by brain damage)

Why might living in a bilingual home affect my child’s language and speech?

The brain has to work harder to interpret and use 2 languages, so it may take longer for children to start using either one or both of the languages they’re learning. It’s not unusual for a bilingual child to use just one language for a while.

Diagnosis & Tests

What can my doctor do to find out if speech delay is the problem?

Your doctor can listen to your child’s speech and check your child’s mental development. Your child may also have a hearing test to check for hearing problems.

Treatment

What can be done if my child has speech delay?

Your child may not need any treatment. Some children just take more time to start talking. The way your doctor might treat your child depends on the cause of the speech delay. Your doctor will tell you the cause of your child’s problem and explain any treatments that might fix the problem or make it better. A speech and language pathologist might be helpful in making treatment plans. This person can show you how to help your child talk more and speak better, and also can teach your child how to listen or how to lip read.

Other health care workers who may be able to help you and your child include: an audiologist (a hearing doctor), a psychologist (a specialist in behavior problems), an occupational therapist or a social worker (who can help with family problems). Your family doctor will refer you to these health care workers if your child needs their help.

Questions to Ask Your Doctor

  • Why is my child not talking yet?

  • Should I talk to my child more to help him/her figure out how to talk?

  • Is it normal for my child to not be speaking yet?

  • My child seems to have trouble understanding what I’m saying. Is it possible he/she is deaf or hard of hearing?

  • Does my child have a developmental disability?

  • What can I do to help my child talk or understand better?

  • Is there any material you have that I can read about speech and language delay?

  • Will my child be able to attend school?

Citations

  • Evaluation and Management of the Child with Speech Delay by AKC Leung, M.B.B.S. and C Pion Kao, M.D.( 06/01/99, http://www.aafp.org/afp/990600ap/3121.html)