By Dr Prashant Pruthi, MD (Paediatrics)
Delays in speech are the most common types of developmental delay. One in five children will show a developmental delay in the speech or language area. Simple speech delays are sometimes temporary. They may resolve on their own or with a little extra help from family. Sometimes formal speech therapy is needed.
It’s important to encourage your baby to ‘talk’ to you with gestures and/or sounds before fulfilling a need. In some cases, your baby will need more help from a trained professional.
Sometimes delays may be a warning sign of a more serious disorder that could include a hearing loss, global developmental delays, or autism. Delays also could be a sign of a possible learning problem you may not notice until the school years. It’s important to have your child evaluated if you are concerned about understanding normal speech and language development
It’s important to discuss early speech and language development, as well as other developmental concerns, with your doctor at every routine clinic visit. It can be difficult to tell whether a child is just immature in his or her ability to communicate or has a problem that requires professional attention. These developmental milestones may provide clues:
Before 12 months
Cooing and babbling are early stages of speech development. As babies get older (often around 9 months), they begin to string sounds together, incorporate the different tones of speech, and say words like ‘mama’ and ‘dada’ (without really understanding what these words mean).
12 to 15 months
Kids this age should have a wide range of speech sounds in their babbling and typically say one or more words (not including ‘mama’ and ‘dada’). Nouns usually come first, like ‘baby’ and ‘ball.’ Your child should also be able to understand and follow simple directions.
18 to 24 months
Though there is a lot of variability, most toddlers are saying about 20 words by 18 months and 50 or more words by the time they turn 2. By age 2, kids are starting to combine two words to make simple sentences, such as ‘baby crying’ or ‘Daddy big.’ A 2-year-old should also be able to follow two-step commands (such as ‘Please pick up the toy and give it to me’).
2 to 3 years
Parents often witness an ‘explosion’ in their child’s speech at this stage. Your toddler’s vocabulary should increase to, too many words to count and he or she should routinely combine three or more words into sentences.
Comprehension should also increase. By 3 years of age, a child should begin to understand what it means to ‘put it on the table’ or ‘put it under the bed.’ Your child should also begin to identify colours and comprehend descriptive concepts.
Signs of a language delay
Language skills begin long before the first spoken words. Your child starts to communicate with you during the first year of life. He/she may respond to you and the world around her with eye gazes, smiles, gestures, or sounds. Later on, you’ll notice more obvious ‘speech’ skills or milestones. While children develop at different rates, they are usually able to do certain things at certain ages.
The difference between language and speech can be understood by considering the relationship between a computer program and an output device like a printer. The software running on the computer (a word processing program, for example) is designed to allow a user to create content that is stored in the computer. In order to actually create a physical copy of the file, the computer requires another device: a printer. The printer takes the file and transforms it into a series of commands which control the movement of a print head, thereby making marks on paper.
If your child seems delayed or shows any of the following signs, tell your paediatrician. Also, tell your paediatrician if your baby stops talking or doing things that he used to do.
● Doesn’t cuddle like other babies.
● Doesn’t return a happy smile back to you.
● Doesn’t seem to notice if you are in the room.
● Doesn’t seem to notice certain noises (for example, seems to hear a car horn or a cat’s meow but not when you call his name).
● Acts as if he is in his own world.
● Prefers to play alone and seems to ‘tune others out.’
● Doesn’t seem interested in toys but likes to play with objects in the house.
● Shows a strange attachment to hard objects (would rather carry around a flashlight or ballpoint pen than a stuffed animal or favourite blanket).
● Can say the ABCs, numbers, or words to TV jingles but can’t ask for things he wants.
● Doesn’t seem to have any fear.
● Doesn’t seem to feel pain.
● Laughs for no reason.
● Uses words or phrases that are inappropriate for the situation.
Seek an evaluation if a child is over 2 years old and
can only imitate speech or actions and doesn’t produce words or phrases spontaneously uses only certain sounds or words repeatedly and can’t use oral language to communicate more than his or her immediate needs.
Can’t follow simple directions.
has an unusual tone of voice (such as raspy or nasal sounding).
Is more difficult to understand than expected for his or her age.
Parents and regular caregivers should understand about half of a child’s speech at 2 years and about three-quarters at 3 years. By 4 years old, a child should be mostly understood, even by people who don’t know the child
What parents can do
Like so many other things, speech development is a mixture of nature and nurture. Genetic make-up will, in part, determine intelligence and speech and language development. However, a lot of it depends on environment. Is a child adequately stimulated at home or at child care? Are there opportunities for communication exchange and participation? What kind of feedback does the child get?
Here are a few general tips you can employ at home
● Spend a lot of time communicating with your child, even during infancy; talk, sing, and encourage imitation of sounds and gestures.
● Read to your child, starting as early as 6 months. You don’t have to finish a whole book, but look for age-appropriate soft or board books or picture books that encourage kids to look while you name the pictures.
● Use everyday situations to reinforce your child’s speech and language. In other words, talk your way through the day. Keep things simple, but never use ‘baby talk.’
Whatever your child’s age, recognizing and treating problems early on is the best approach to help with speech and language delays. With proper therapy and time, your child will likely be better able to communicate with you and the rest of the world.
