Speech delay in children

As with every developmental milestone, children acquire and understand language at different rates, but most follow a general timeline (though if your baby is a preemie he may lag slightly behind his full-term peers in both verbal, physical and social development).

Having an idea of what to expect and when will help you figure out if your child is on schedule or whether he might have a speech delay…

9-12 months

What’s normal
Your baby should be babbling – basically long strings of meaningless sounds that are her first attempt at proper speech. You’ll notice that although it’s nonsense, it incorporates all the intonation of speech, so you’ll be able to tell if she’s amused, interested or cranky! Your baby should also notice sounds. Hearing is closely tied to speech so if you notice your child doesn’t react to sound it’s important to mention this to your pediatrician.

What’s not

Doesn’t use gestures, for example waving bye-bye or shaking her head to mean “no”.
Isn’t using at least two consonants (p, b, etc) when babbling.
Isn’t somehow communicating when she needs help to do something.

12 to 15 months

What’s normal
As well as babbling your child should be able to say at least one proper word by now (not including mama and dada). Ball or dog are often first words. She should also follow simple directions, such as “give me the ball”.

What’s not

Doesn’t understand and respond to words such as “no” and “bye-bye”.
Can’t say at least one to three words.
Doesn’t say “mama” or “dada”.

18 to 24 months

What’s normal
Your child’s vocabulary should continue to expand: by the time she’s 18 months she should ideally be able to say around 20 words and by the time she’s two she should say 50 or so words. Her comprehension goes being what she can say: she should know the meaning of around 200 words by two years of age. At this point she should also be using two-word phrases such as “all gone” or “cow moo”.

What’s not

Doesn’t say at least six to 10 words.
Doesn’t point to things that interest her, such as animals, a school bus or firetruck driving by, or an airplane flying overhead.
Doesn’t make at least six consonant sounds.
Doesn’t respond to simple directions or requests.
Doesn’t mimic your actions or words.
Can’t point to pictures in a book when you say their name – for example, “where is the dog?”
Can’t join two words together

Two to three years

What’s normal
Expect to see a language explosion this year – by the end of it you can expect your child to know more words than you can count, to be able to combine three or four words into simple sentences, and to understand more complicated directions, such as “pick up your cup and put it on the table”. She should also know colors and understand concepts like big and small, short and long, fast and slow.

What’s not

Isn’t able to form the sounds of consonants – for example, instead of “cat” she may say “ca”.
Can’t form simple two-word sentences.
Can’t name at least three body parts or common household objects such as “cup”.
Speech that is difficult to understand (by age three a stranger should be able to understand around 80 percent of what your child is saying).
Doesn’t ask questions.
Still relies mainly on gestures to communicate – for example, pointing to what she wants or reaching up her arms to you if she wants to be lifted.
Can’t speak in short phrases or understand simple instructions by age three.

What causes speech delays?

If your child is otherwise healthy, delayed speech could be caused by a problem with her hearing. Speech development is closely tied to the ability to hear clearly so if your child has had frequent ear infections and isn’t acquiring language as fast as she should, ask your pediatrician to refer you to an audiologist. It’s also possible for oral problems, such as tongue-tie or cleft lip and palate, to interfere with speech development. Low muscle tone can also be an issue, as this can affect the muscles of your baby’s mouth and tongue.

If your baby was born early and had to spend time in a neonatal intensive care unit it’s possible that medical procedures such as a tracheotomy may affect later speech development.

Getting help

Early evaluation is vital if you suspect your child has a speech and language problem, as your child’s capacity for learning certain elements of language is fixed by age three. Up to then, your child’s brain has twice as many nerve connections as yours and these need to be repeatedly stimulated so they will become permanent. Speech and language problems can also be an early sign of autism.

Your pediatrician can refer you to a licensed speech-language pathologist if your child is slow to speak, or you can contact your county’s early intervention program to arrange to have your child evaluated. They will assess what your child can both understand and say, and can identify if your child is attempting to communicate I other ways, such as with gestures. They can also check how your child’s mouth, tongue and palate my be impacting on her speech development.

There is a lot you can do to help your child develop and improve her speech. Read to her often, pointing to things she sees in her books and labeling them so that she associates the word sound with the image. And talk to her as much as you can, keeping up a running commentary of what you and she are doing throughout your day, asking her questions and pausing so that she can answer you and say what she wants to.

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.

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Last Modified: 25/10/2008

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