At times parents question whether their child’s speech and language development is on track.
In this video I’m going to mention some of the more common signs of how speech and
language delays could present themselves.
I’m also going to mention when you should talk to your child’s healthcare provider
about speech and language development concerns you may notice.
Babies start communicating with us long before saying a single word.
Your child’s cry, smile, and reactions are ways they communicate with you.
All children develop at their own individual pace, but there are guidelines we follow that
give us an indication whether the child’s speech and language development is progressing
as expected.
A child can have a delay in the development of speech, language, or both.
Speech is the verbal expression of language and includes the way we say sounds and words.
Whereas language is how we understand and are understood by others through our verbal
and nonverbal communication.
One of the quickest ways that parents notice a speech delay is that their child is not
saying as many words as other children their age.
It’s not until 12 months that we really expect the baby to be able to say a few words.
Most babies will be saying mama, dada, and at least one other word.
But before that, by the end of 3 months, the baby’s speech development includes making
cooing sounds like, “ahh,” “ooh” and “ah-gooh”.
And by the end of 6 months babbling using recognizable syllables such as “ba, da,
ga, and ma.”
By 15 months most toddlers are saying at least 3 to 5 words, and by 18 months between 6 and
20 words.
At this age they will typically say single words, instead of putting them together in
sentences.
By 2 years of age, most children can say at least 50 words.
Between 2 and 3 years of age children have a huge jump in language skills.
They expand their vocabulary and start putting together at least two word sentences.
By 3 years of age, many children are putting together at least three word sentences.
If a child is not saying as many words for their age as the guidelines recommend, it’s
an indication for us to look further into whether a delay is present.
Another sign of speech delay is when a child can’t pronounce words clearly, or can’t
pronounce certain sounds, _ leading to communication difficulties.
Of course when they’re just starting to speak, most of what children say is hard to
understand and they will mispronounce words.
But at 2 years of age, we expect that about 50% of what the child says should be understood.
Around 75% of what the child says should be understood at 3 years of age.
And most of what the child says should be understood at 4 years of age, even by people
who don’t know the child.
Some ways that this type of delay may present itself is that the child will omit part of
the word, such as saying “bo” instead of “boat.”
Or the child may have difficulty pronouncing certain sounds, commonly the r and s sounds.
An example would be a child who says “wabbit” instead of “rabbit.”
This can also involve the child adding extra sounds in a word or repeating sounds, such
as saying “b-b-b-ball.”
If a child uses gestures instead of words to communicate, or speaks with an unusual
pitch or volume, these also may be indications that they have a speech impediment.
One of the signs of language delay is when a child struggles to understand and process
what is being said to them by others.
In this type of situation the child has difficulty comprehending words and connecting them with
ideas.
Therefore the child may have a hard time giving answers to questions or may give answers that
seem off.
In addition the child may have trouble following directions that are spoken to them.
By 18 months most children can follow a simple one step direction, for example sitting down
when told to sit down.
At 2 years of age children should be able to follow simple two step directions, such
as “pick up the ball, and bring it to me.”
When children struggle to achieve this skill-set, it may be an indication that there is an underlying
language delay.
Another sign of language delay is when the child has difficulty using words to communicate
needs and ideas.
Some of the ways that this can present is that the child struggles to put words together
to form sentences.
Also the child may leave words out of sentences, or use the past, present and future tenses
incorrectly.
In addition, because of having a hard time finding the right words to say, the child
may use a lot of placeholder words such as “ah” and “um.”
Another potential sign of delay is that the child doesn’t engage with others as much
as other children their age.
By one year of age it’s expected that children will look up at someone when they enter the
room.
They will wave goodbye when people are leaving.
By two year of age children will make eye contact with others to try to get their attention,
or point to things they’re interested in and want others to look at those things as
well.
In addition, the child will bring toys and other things to show them to others.
Some of the ways that this delay may present itself is that the child shows a lack of interest
in others, or is not making good eye contact.
The child will prefer to play alone, and seems to tune others out.
These children tend to get labeled as shy, but it’s important to get them evaluated
to make sure that a delay isn’t overlooked.
Now let’s talk about when you should raise a concern about your child’s development.
If at the following age marks you notice the red flags that I mention, you should speak
with a healthcare provider about your child’s speech and language development to see if
further evaluation is needed.
In the first several weeks of life, your baby doesn’t get startled by loud sounds.
By 3 months your baby doesn’t seem to recognize and turn towards your voice.
By 6 months your baby is not turning the eyes or head towards different sounds in their
environment, or your child is not babbling.
By 12 months your baby is not saying “mama,” “dada,” and at least one other word.
Or the child does not wave bye or make other gestures when interacting with others.
By 18 months, your child has trouble understanding and following simple directions, prefers to
use gestures to communicate over vocalizations, or is not saying at least 6 words.
Or your child doesn’t seem to notice when you’re in the room and seems to tune others
out.
By 2 years your child doesn’t say at least 50 words, only says several sounds or words
repeatedly, and can’t use language to communicate more than immediate needs.
Or if your child can’t follow simple directions or has an unusual tone of voice that sounds
raspy or nasal sounding.
By 3 years if your child is not putting together at least three word sentences or others can’t
understand at least 75% of what the child says.
By 4 years of age if people don’t understand most of what your child says, or your child
struggles to understand questions or give appropriate responses to questions.
Keep in mind that each child develops at an individual pace, and some children do take
a little longer to meet certain developmental milestones.
However if you notice any of the things that I mention in this video, it may be a sign
that the child has a delay.
By discussing it with your child’s healthcare provider, it will allow them to decide if
further evaluation is needed, or if it’s something they can follow more closely, and
give the child more time to develop.
See you in the next video.