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Learning About Speech and Language Delays in Children

What are speech and language delays?

Speech and language delay means that a child is not able to use words or other forms of communication at the expected ages.

Language delays include problems understanding what is heard or read. There can also be problems putting words together to form meaning. Speech delays are problems making the sounds that become words. This is the physical act of talking. Some children have both speech and language delays.

Speech and language delays can have many different causes. These causes can include hearing problems, Down syndrome or other genetic conditions, autism spectrum disorder, cerebral palsy, or mental health conditions. Delays can also run in families. Sometimes the cause is not known.

If your child doesn't develop speech and language skills on schedule, it may not mean there is a problem. But if your child is having problems, talk with your doctor. The doctor may suggest testing.

A child can overcome many speech and language problems with treatment such as speech therapy. It helps your child learn speech and language skills.

What are the symptoms?

Speech and language problems include:

  • No babbling by 9 months.
  • No first words by 15 months.
  • No consistent words by 18 months.
  • No word combinations by age 2.
  • Problems following directions at age 2.
  • Not speaking in complete sentences by age 3.
  • Problems using the right words in sentences at age 4.
  • Speech that family finds hard to understand when the child is age 2.
  • Speech that strangers can't understand when the child is age 3.

Other problems that affect your child's speech could include:

  • Lots of drooling, or problems sucking, chewing, or swallowing.
  • Problems coordinating the lips, tongue, and jaw.
  • Not responding when spoken to, or not reacting to loud noises.

How are delays diagnosed?

Diagnosis starts with your child's doctor. He or she will ask about your child's speech and language skills during regular routine checkups. In some areas, your child may see a public health nurse for routine checkups. The doctor will do a physical exam and ask questions about your child's past health and development.

The doctor will also ask you questions about whether your child has reached speech and language milestones for his or her age. If it looks like your child has a speech or language problem, the doctor will refer your child to a speech-language pathologist (SLP).

Your doctor or SLP may suggest tests to:

  • Look for other conditions. For example, your child may need a hearing test to rule out hearing loss.
  • Find out what speech sounds your child can say.
  • See if your child has problems putting speech sounds together to form words and sentences.
  • Review how your child is gaining speech, language, and motor skills.
  • Find out if your child is having other problems. These could include behaviour problems. They could also include trouble doing some of the common skills for your child's age, such as sucking, chewing, or swallowing.

To test your child's speech, the SLP will listen to your child talk. He or she will ask your child to say certain sounds, words, and sentences.

How are delays treated?

Therapy depends on the cause and type of problem. To help your child communicate better, the speech-language pathologist may:

  • Help your child learn to make all speech sounds and combine them into words. This can help your child produce the sounds more easily.
  • Help your child understand the meaning of words and different types of sentences.
  • Help your child understand social cues and communicate in various situations.
  • Help your child learn sign language or use devices that help children communicate.
  • Suggest that your child get a hearing aid, if needed.
  • Teach your child how to use special programs on a computer, tablet, or smartphone. Some programs include speech lessons. Others allow your child to communicate through objects or symbols.
  • Teach you how to work with your child at home and help your child practice new skills.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

Where can you learn more?

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