Speech and Language Development and Delay

Speech and Language Development and Delay


What is Speech and Language?
Speech is the use of language to communicate, or express ourselves. Language is used to express ideas and needs in an organized way. It can be spoken, written, sung or expressed using gestures (such as sign language).

The important foundations of language develop in the first three to five years of life. Language development involves both cognitive learning, and motor skill. We use a lot of muscles in our face and mouth to produce speech.

The CanChild Centre for Child Disability Research outlines the ways in which language development can be delayed:

• Semantics – errors in the meaning of words, a limited amount of speech, limited vocabulary, difficulty learning new words, word-finding or vocabulary errors
• Grammar – errors in sentence structure such as shortened sentences, simple grammar structures, limited grammar, leaving out critical parts of sentences, use of unusual word order
• Articulation – errors with speech sounds, unclear or slowed speech, repetition of syllables, difficulty with stress in speech

Speech and Language Milestones
Although children may progress developmentally at different ages, they do follow a consistent sequence for acquiring these skills.

There are some simple, easy-to-identify flags of speech delay, including saying his/her first words after 18 months of age, having a vocabulary of less than 50 expressive words and/or not putting words together at 2 years of age

Here are a list of speech and language milestones to help you understand to progression of speech and language in your child. This list can aid in distinguishing if you need to be concerned about your child’s language and speech development.
(Courtesy of NIDCD Fact Sheet: Speech and Language Developmental Milestones)

Birth to 3 months

• Reacts top loud sounds
• Calms down or smiles when spoken to
• Recognizes your voice and calms down if crying
• When feeding, starts or stops sucking in response to sound
• Has a special way of crying for different needs

4 to 6 months

• Follows sounds with his/her eyes
• Responds to changes in tone of your voice
• Notices toys that make sounds
• Pay attention to music
• Babbles in a speech-like way and uses many different sounds (including sounds that begin with P, B, and M
• Laughs
• Babbles when excited or unhappy
• Makes grunting sounds when alone or playing with you

7 months to 1 year

• Enjoys playing peek-a-boo and pat-a-cake
• Turns and looks in the direction of sounds
• Listens when spoken to
• Understands words for common items such as “cup,” “shoe,” or “juice”
• Responds to requests (“Come here”)
• Babbles using long and short groups of sounds (“tata, upup, bibibi”)
• Babbles to get and keep attention
• Communicates using gestures such as waving or holding up arms
• Imitates different speech sounds
• Has one or two words (“Hi,” “dog,” “Dada,” or “Mama”) by first birthday

1 to 2 years

• Knows a few parts of the body and can point to them when asked
• Follows simple commands (“Roll the ball”) and understands simple questions (“Where’s your shoe?”)
• Enjoys simple stories, songs, and rhymes
• Points to pictures, when named, in books
• Acquires new words on a regular basis
• Uses some one- or two-word questions (“Where kitty?” or “Go bye-bye?”)
• Puts two words together (“More cookie”)
• Uses many different consonant sounds at the beginning of words

2 to 3 years

• Has a word for almost everything
• Uses two- or three-word phrases to talk about and ask for things
• Uses K, G, F, T, D, and n sounds
• Speaks in a way that is understood by family members and
• Names objects to ask for them or to direct attention to them
3 to 4 years
• Hears you when you call from another room
• Hears the television or radio at the same sound level as other family members
• Answers simple “Who?” “What?” “Where?” and “Why?” questions
• Talks about activities at daycare, preschool, or friends’ homes
• Uses sentences with four or more words
• Speaks easily without having to repeat syllables or words

4 to 5 years

• Pays attention to a short story and answers simple questions about it
• Hears and understands most of what is said at home and in school
• Uses sentences that give many details
• Tells stories that stay on topic
• Communicates easily with other children and adults
• Says most sounds correctly except for a few (l, s, r, v, z, ch, sh, and th)
• Uses rhyming words
• Names some letters and numbers
• Uses adult grammar

What causes speech and language delays or problems?

• Anatomical impairments – Notably of the tongue and palate, the muscles that help us produce speech. Examples include cleft lip or palate, and tongue tie.
• Boys – generally boys develop language later than girls
• Prematurity – These infants tend to take longer to meet developmental milestones
• Ear infections – Fluid in the ear from infection can result in poor hearing, and lead to a speech delay, especially if your child tends to have chronic ear infections
• Hearing Loss/Deafness – Hearing should be assessed first to rule out any hearing problems.
• Autism – Speech delay is often one of the first signs of autism.
• Apraxia of Speech – A motor speech disorder where children have problems saying sounds and words.
• Selective Mutism – This child selectively refuses to speak.
• Environmental deprivation – Children not being exposed to language during formative years
• Twins – twins may develop language skills later because they communicate so well with each other in their own language, also called twin talk

What can I do as a parent to help in my child’s speech and language development?
Talking to your children is the best thing you can do for their language development, even during infancy. Respond to their cooing, and babbling sounds, describe what you are doing while going through the day and use gestures along with your words. Play games with your child, sing to them, and read to your child as early as 6 months of age.

As your child gets older and his/her vocabulary increases, add to that vocabulary – instead of “ball”, use “red ball” for example.

When to see your doctor or nurse practitioner?
If you feel that your child is not on track with the above speech and language developmental milestones, or showing some of the flags of language delay, talk about it with your doctor or nurse practitioner.

It can be hard to tell if your child has speech delay or is just a “late bloomer” so it’s best to seek advice. Your doctor may refer you for a hearing test, to a speech and language pathologist, or to an audiologist for further assistance and testing.


– Dr. G Paul Dempsey and Dr. Christina Cesareo

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