Speech and Language Delay
How Do Speech and Language Differ?
Speech is the verbal expression of language and includes articulation (the way we form sounds and words).
Language is giving and getting information. It’s understanding and being understood through communication — verbal, nonverbal, and written.
What Are Speech or Language Delays?
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.
What Are the Signs of a Speech or Language Delay?
A baby who doesn’t respond to sound or vocalize should be checked by a doctor right away. But often, it’s hard for parents to know if their child is taking a bit longer to reach a speech or language milestone, or if there’s a problem.
- 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 trouble understanding simple verbal requests
- by 2 years: can only imitate speech or actions and doesn’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)
What Causes Speech or Language Delays?
A speech delay might be due to:
an oral impairment, like problems with the tongue or palate (the roof of the mouth)
a short frenulum (the fold beneath the tongue), which can limit tongue movement
Many kids 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 make speech sounds. These kids 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. Kids who have trouble hearing may have trouble saying, understanding, imitating, and using language.