Speech delay is a condition in which a child has difficulty producing speech sounds, or in which his or her speech development is significantly slower than that of other children his or her age. Speech delay is a relatively common condition, affecting about 5-10% of preschool children.
There are several possible causes of speech delay in children, including genetic factors, developmental delays, hearing problems and environmental factors such as lack of exposure to language. In some cases, speech delay may be associated with more serious conditions, such as autism or cerebral palsy. Living in a bilingual family environment can also affect a child's speech and language production.
Symptoms of speech delay may vary depending on the child, but may include difficulty forming words, using gestures instead of words to communicate, limited vocabulary, and difficulty following simple instructions.
Fortunately, speech delay can be treated with early intervention and treatment. A speech and language therapist is the responsible person to whom you should turn to in order to assess your child's speech and language development. Speech and language therapy can help children improve their communication skills, develop better language comprehension and increase their vocabulary.
1. At what age do children usually talk?
In general, children with normal development (Tsiantis & Alexandridis, 2008):
- between the 6th and 10th month of age, babbling occurs,
- between the 8th and 10th month, word comprehension develops,
- at the age of 12-13 months the utterance of words begins (beginning of speech)
- between the 12th and 24th months, the combination of words (phrases) develops
- from the age of 2 years, there is a rapid development in grammatical structure (morphology and syntax)
- by the age of 3 years he has mastered the basic morphosyntactic structures of his mother tongue
- by the age of 4 years he has learned and applies the basic grammatical rules
2. What should a 12-24 month old child do?
- Watch a book or a game for about two minutes,
- Follows and understands simple instructions/commands accompanied by gestures such as "give me",
- Responds to simple non-verbal (i.e. pointing) questions, such as Where is your nose?
- Recognizes everyday objects, pictures, and family members,
- Says some words, i.e., names an object or person (pronunciation may not be clear),
- Tries to imitate simple words,
- May ask about a simple item, i.e. cookie or toy,
3. My child is 20 months old and only says "mum, dad, grandpa, ata, nani and a few other words"? Should I be worried?
At this age and approaching 2 years of age, we are quite interested in the child's perception and then we test the language ability.
Therefore the child should:
- walk
- Mimic the behaviour of parents or older children (e.g. pretend to talk on the phone)
- Getting excited in the company of other children (e.g. on the playground or in the playground)
- Pointing to the object or picture you name (e.g., animals, toys)
- Pointing to his body parts and clothes
- Follow simple instructions (e.g. fetch the glass, show the glass)
- Mimic the sounds of animals or other objects
- Trying to imitate syllables or small words
- Turning to his name and listening to you when you talk to him
To talk about speech delay, the child's vocabulary should remain stable (i.e. not enriched) or be less than 15 words at age 2.5-3 years.
4. Is it my fault? Did I not talk to him enough or properly and cause this?
Most research agrees that poor living conditions, poverty, parental psychopathology, inadequate language patterns in the family, lack of quantitative and qualitative stimuli, bilingualism, psycho-emotional deprivation, and child abuse are associated with delayed cognitive and language functions.
Also, about 39% of children with language impairment have a first-degree relative with either the same disorder or a history of language impairment, compared to 3% of the general population.
A child's speech onset, however, is not determined by how much a parent speaks. Besides, this is explained to parents who have two children and one of them is late in speaking. Did the mother or father do anything less to the speech delayed child? The answer is obvious! When a child will start depends on his/her pace and "material". What a Speech and Language Therapist does is to assess the causes of this delay and give the child appropriate stimuli for speech initiation.
5. What causes speech delay? What are its causes?
Although this question is common, it is often not easy to answer. There are multitudes of possible "causes" for a language disorder in children. Some are very obvious, and some are unfortunately still unknown or at least uncertain.
Some common causes are: hearing loss, chronic ear infections, congenital birth defects, brain damage before, during or after birth, traumatic brain injury or stroke, syndromes, mental retardation, language or learning difficulties, impaired auditory discrimination, delayed development associated with prematurity, weakness or impaired articulatory movement, sensory disorders,
Specific Language Impairment. Some children are delayed in speech/communication for no apparent reason. They may develop according to typical development, they are just delayed.
6. Could the speech delay be "hiding" something else?
Speech delay can be a manifestation of numerous disorders (Alexander, 1999) such as:
- Maturational delay (developmental speech delay)
- Expressive language disorder (developmental expressive aphasia)
- (developmental deafness (developmental deafness deprivation of speech)
- Mental retardation
- Bilingualism
- Psychosocial deprivation
- Autism
- Selective salivation
- Recruitment aphasia
- Cerebral palsy
7. My child is 2.5 years old. He says very few words. He was evaluated by a Speech and Language Therapist and referred me to a Developmental Therapist. What is a Developmental Specialist?
Developmental assessment is a process that aims to gain a deeper understanding of the child's motor, social, auditory, language, visual-motor and critical skills and the opportunities provided by the family and educational environment to achieve the child's best developmental potential.
A specialist pediatrician-developmental specialist is the scientist with the appropriate training and experience to diagnose and provide specialized intervention for children with: Developmental delay, learning disabilities, dyslexia, speech delay, language disorders, behavioural disorders, autistic type disorders, attention deficit and/or hyperactivity disorder, mental retardation, intelligence/charismatic children, motor skill disorders, developmental problems of premature children and children with chronic neurological diseases. The developmental specialist also refers for further medical tests, if needed, prior to diagnosis.
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