Speech Delay: What You Need To Know

While the joys of parenthood are endless, raising kids comes with its fair share of concerns, especially regarding development. Speech delay and language development in the first few years of life can feel like an overwhelming topic. Questions like, “Why isn’t she clapping yet like the other babies?” or “Shouldn’t he have more words by now?” are a nonstop stream of anxiety-inducing thoughts wracking our brains to make sure our babies are on the right track.

As a speech-language pathologist (SLP) and a new mama, I am hyper-focused on my son’s communication milestones. Having a clear understanding of speech and language delays, how to identify them, and what to do when we suspect our child may have one are essential to have in your mama toolbelt.

What’s the Difference Between Speech and Language?

The domains of speech and language are often confused and misunderstood. Children can have a problem with speech, language, or both. Speech is how we say sounds and words.¹

This includes:

• Articulation: This is the pronunciation of speech sounds in words, like “it’s waining” instead of “it’s raining.
• Voice: This is how we use our vocal cords and breath to make sounds. Our voice can be characterized as raspy, breathy, nasal, etc.
• Fluency: This is the rhythm of our speech, also known as stuttering.

Language is defined as the words we use and how we use them to share ideas and comprehend information. Language skills include vocabulary, grammar, comprehension, and social skills. We separate language skills into two categories: receptive and expressive.¹

• Receptive language is how we understand the world around us.
• Expressive language is how we use words in sentences and form our thoughts.

Together, speech and language skills allow our children to interact effectively with others and understand the world around them.

What is a Speech or Language Delay?

A speech delay or language delay occurs when a child is not meeting their communication milestones compared to other children of the same age. Children are expected to make certain sounds by a specific age. If they cannot, we identify them as having a speech delay.²

For example, the “k” sound is typically pronounced correctly in words and sentences between 3 to 3 ½ years old. Speech delays are relatively common in older toddlers and elementary school-aged children.

Like speech, we expect children to meet specific language milestones throughout typical stages of development. In babies and toddlers, such milestones include clapping, using gestures like waving, or even as basic as responding to their name. As children grow, how they use words and understand spoken language changes constantly. Once they enter toddlerhood, we expect children to start using more words, answering yes-and-no questions, and following basic directions. Children who do not display such skills by the expected age of development may demonstrate a language delay.

What are the Signs of a Speech or Language Delay?

The signs of a speech or language delay could change depending on your child’s development stage. Speech delays can emerge as early as 2-3 years old. Signs of a speech delay include incorrect pronunciation of sounds, you or other adults having difficulty understanding your child, and signs of frustration, such as crying, tantrums, or biting when misunderstood.^1,2

Common speech sound errors include making the “t” for “k” (“tite” for “kite”), making “w” or “y” for “r” and “l” (“yoyi-pop” for “lollipop”), and the infamous lisp, when a child sticks their tongue out to make the “s” sound (“thmile” for “smile”).

What Causes a Speech or Language Delay?

There are a wide variety of causes for speech and language delays. Speech delays can be caused by problems with oral-motor function, which occur when the brain has difficulty coordinating the movements of the lips, tongue, and jaw to make speech sounds. Children with a history of oral restrictions, such as lip and tongue ties, are more susceptible to speech delays. Frequent ear infections and hearing problems may also lead to speech delays.²

The exact causes of language delays are a bit more challenging to define. Sometimes, language delays can be caused by a lack of exposure to adult interaction or appropriate play. Some children develop at their own pace and need extra help to catch up to their peers. Children born prematurely, have low birth weight, have hearing loss, and have poor nutrition or feeding difficulties may also be predisposed to language delays. Lastly, underlying diagnoses, including autism, Down syndrome, traumatic brain injury, and cerebral palsy, are often associated with language delays.³

I want to reiterate that there may not be one specific cause for your child’s speech or language delay – it just happens. Parents should never feel guilt or shame if their child presents signs of a communication delay. But you are now equipped with the knowledge and resources to help your kids!

How Do Doctors Diagnose a Speech or Language Delay?

If your child displays signs of a speech delay or language delay, it is vital to seek an evaluation from a speech-language pathologist (SLP) as soon as possible. Research shows that the earlier a child receives interventions to promote communication skills, the more likely those interventions are to be effective. Speak to your pediatrician about your concerns as soon as possible. If your child is under two, they may qualify for state-funded intervention services. You can also ask your pediatrician to refer you to speech and language therapy at a clinic or private practice.⁴

At your child’s evaluation, the SLP will use a combination of formal assessments, clinical observations, and your input to help diagnose them with a speech or language delay. Depending on their age and your concerns, they will likely include the following factors in their evaluation:

• Receptive language (how information is understood)
• Expressive (the words we use to form sentences)
• Speech sounds
• Oral motor exam

The SLP will examine all the data to determine the type and severity of the delay. For example, if your child demonstrates age-appropriate comprehension skills but shows a speech delay, they may be diagnosed with a “mild expressive language delay.” During your child’s evaluation, don’t be afraid to ask questions about their diagnosis. The more you understand your child’s strengths and weaknesses, the more equipped you will be to help them work on their communication skills at home.

What Can You Do If Your Child Has a Speech or Language Delay?

After your child’s diagnosis, they will begin speech or language therapy. The SLP will create therapy goals for your child based on strengths and weaknesses demonstrated in their evaluation. Additionally, their goals will align with appropriate communication milestones for children their age. Remember the importance of early intervention — the earlier you start, the better!

Speech and language therapy helps your child by directly targeting their goals with evidence-based intervention methods. SLPs have an arsenal of sophisticated techniques obtained through their education and experience, all designed to reach positive outcomes and steady progress in therapy. Their unique training incorporates these intervention strategies into play-based activities, interactive book reading, games, and more to keep your child enthusiastic and happy during treatment. The repetition and consistency of therapy are essential for your child to make continuous progress toward their communication goals.

You Have the Key

While SLPs are trained professionals, parents are the key to making therapy the most successful it can be. Research indicates that parental involvement in speech and language therapy is the key to long-term success. Collaborate with your SLP on creatively targeting your child’s goals at home. They can provide you with training and tips on using their techniques in your child’s daily routines and natural environment.⁵

Some ideas include narrating your activities at the grocery store, bath time, and meal times. Read many books and use the pictures to target sounds and label the images. Find 5-10 minutes daily to sit on the floor with your child and play with their toys, indirectly working on their goals in a way they won’t even realize!

Any developmental delay, including speech or language delays, can cause guilt and worry. I understand first-hand how mom guilt feels and how difficult it is to overcome, especially when your child is struggling. Please remember that if your child seems to have a speech or language delay, it is not because of anything you did! Trust that you are the best mom for your child and are doing everything you can to support them. Now you are more prepared to look for signs of delays and how to start intervening as early as possible.

Resources

1. https://www.asha.org/1-2

2. https://kidshealth.org/

3. https://www.asha.org/3

4. https://www.cdc.gov/

5. https://www.hanen.org/