Speech and Language Delay

Last Updated October 2023 | This article was created by familydoctor.org editorial staff and reviewed by Kyle Bradford Jones, MD, FAAFP

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.

What is a speech and language delay?

A speech and language delay is when a child isn’t developing speech and language at an expected rate. It’s a common developmental problem that affects as many as 10% of preschool children.

Symptoms of a speech and language delay

Your child may have a speech delay if they aren’t able to do these things:

  • Say simple words (such as “mama” or “dada”) 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

What causes a speech and language delay?

The most common causes of speech delay include:

Other developmental or genetic disorders include:

  • 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)

Living in a bilingual home also may affect a child’s language and speech. The child’s brain has to work harder to interpret and use 2 languages. So, it may take longer for these children to start using one or both languages they’re learning. It’s not unusual for a bilingual child to use one language for a while.

How is a speech and language delay diagnosed?

Your doctor can help you recognize a speech and language delay. They will ask you what you have heard and can listen to your child’s speech and check your child’s mental development.

Your doctor may refer you to other specialists to determine why your child isn’t speaking. For example, if your doctor thinks your child may have trouble hearing, they may refer your child to an audiologist for a hearing test. This is a licensed health care professional who treats hearing problems.

Can a speech and language delay be prevented or avoided?

Depending on the cause of your child’s speech delay, you may not be able to prevent or avoid it.

Speech and language delay treatment

Your child may not need treatment. Some children just take more time to start talking. But if your child needs treatment, the type will depend on the cause of the speech delay. Your doctor will tell you the cause of your child’s issue and talk to you about treatment options. Your doctor may refer you to a speech and language pathologist. 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.

Teaching young babies and children a version of sign language also can help them with their language development. Contrary to what some might think, using sign language with babies and young children does not delay their language development.

Other specialists your doctor may recommend you see include a psychologist (a specialist in behavior problems), an occupational therapist (for help with daily activities), or a social worker (who can help with family problems). Your doctor may also suggest early intervention programs in your area. Many are associated with your local school district

Living with a speech and language delay

If your child’s speech is delayed due to a hearing loss, hearing aids or cochlear implants may help your child hear speech. Once your child has access to sound (and speech), they may be able to develop language and even catch up to their hearing peers.

If your child hears and understands language, you can encourage them to speak by talking as much as you can around them. Describe what you’re doing as you do everyday activities. Keep talking. If your child speaks, confirm what they are saying. Always provide positive feedback.

Speech and language delays can be frustrating for parents and children. Children who can’t express their thoughts and emotions are more likely to act out. They anger easily. They may use unexpected behavior to get your attention. Try to remember your child does want to communicate with you. Read to your child and talk as much as you can. Encourage your child to speak. When they try to speak, praise their efforts.

Questions to ask your doctor

  • Why is my child not talking yet?
  • Should I talk to my child more to help them 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 they have hearing loss?
  • Does my child have a developmental disability?
  • What can I do to help my child speak or understand better?
  • Do you have any materials I can read about speech and language delay?
  • Will my child be able to attend school?
  • Is there an early intervention program available in my area and would it be helpful?
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