Speech and Language Delay

What are the common causes of delay in a child beginning to talk?

It could we one of the following or may simply be normal for that child. You must remember that the normal age of attaining a milestone is not for ALL children. A small percentage of children may be slightly delayed in attaining that particular milestone.

  • Hearing deficit (If the child can’t hear he can not talk)
  • Overall developmental delay
  • Oral motor planning problems (dyspraxia)
  • Autism
  • Environmental / emotional deprivation
  • Primary language disorder


Diagnosis and Evaluation:

  • All children with language delay should have their hearing formally evaluated. This can be done at any age, in places having audiometry facilities.
  • If language delay is regarded as part of overall delay in development, Developmental evaluation is done by age-appropriate tools like DDST.
Age in monthsIndicators
12Limited babbling; quiet child
18Does not understand specific words, his name, and names of common objects; cannot follow simple commands such as ” come here”, “sit down”.
24Uses few single words; is not imitating words.
30Does not know names of common objects or simple body parts; cannot point on command to familiar objects or get an object on request not directly in visual field; no true two word combinations such as ” no cookie”, “more milk”; child is often misunderstood.
36No simple sentences (subject, verb, object); does not seem to understand simple explanations or discussions of events in past or future.
  • Observe how does the child communicate his needs without language. Those with a hearing problem and primary language disorders will be able to act out their needs properly, whereas children with developmental delay will not be able to.
  • Your consultant will compare between levels of understanding and spoken language.
  • While giving history, be sure to involve a description of the home environment and how does the child interact.
  • Caution while testing – many children will not show their best language skills with strangers.
  • After the initial workup referral to an audiologist for hearing problems is often appropriate. If hearing is normal a speech pathologist should be approached.
  • Mild delays in speech can be treated in most cases by educating and encouraging parents to use language more pervasively in a play context, with frequent modeling of words.
  • Early intervention (under 3 years) or language centered classrooms in public schools (over 3 years ) may be helpful for these children.

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