Key takeaways:
A child with a speech or language delay doesn’t use words or communicate like their peers.
You can help your child’s speech and language development by reading, singing, and talking to them.
With early intervention, most children with speech and language delays catch up to their peers.
Babies are always learning and developing new skills. But some moments stand out — like your baby’s first smile, first steps, and first words.
While each baby develops at their own pace, most children hit certain milestones by a certain age. Early language milestones are all about nonverbal communication — like smiling, pointing, and waving. But between their first and second birthdays, toddlers start expressing themselves by talking. Some toddlers are very verbal, while others may only have a handful of words.
How can you know if your child is a “late talker” or has a speech delay? Let’s take a closer look at the signs of speech delays and what you can do to help your child “turn on” their voice.
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What’s the difference between speech and language delays?
When we talk about “speech” and “language,” the words themselves can be confusing. Think of “language” as everything that a child uses to communicate. Words are part of that, but so are gestures and facial expressions. Language involves understanding ideas people are trying to share with you (receptive language) and sharing your own thoughts with others (expressive language). Speech is one part of expressive language.
A child who can form words perfectly but cannot put them together to make a sentence has a language delay with normal speech. A child with a condition like cleft palate may have difficulty making themselves understood by others even when their language development is fine.
These two things might look the same to an outsider: a child who isn’t speaking. But the conditions are treated differently.
What are signs that my toddler may be a late talker?
Many parents grow concerned when they notice that their child doesn’t talk or understand as much as a sibling, cousin, or friend did at the same age. Speech and language development vary from one child to the next. That said, language milestones can help you determine if your child's speech and language are generally on track:
By their first birthday, your child should make gestures like wave “bye-bye” or point to an object they want.
By 18 months, your child should imitate sounds, understand simple one-step requests, and use words more often than gestures. They should be able to say about 15-20 words.
By their second birthday, your child should know at least 50-100 words and use two-to-three-word phrases. They should reliably follow simple directions.
By their third birthday, your child should have more words than you can count. They should use three or more words together and follow more complex instructions.
If your child hasn’t met these milestones, talk to your child’s healthcare provider.
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How are speech and language delays diagnosed?
Diagnosing speech and language delays involves several steps.
Two important parts are a screening for autism spectrum disorder and a hearing test. If there is a concern for autism spectrum disorder, your child will need specialized autism evaluations and therapy. If your child has hearing loss, they will need evaluation by an audiologist and ear-nose-and-throat doctor (ENT) as well as speech therapy.
If there are no concerns on your child’s autism screen or hearing test, the next step is an evaluation by a speech-language pathologist (speech therapist).
A speech-language pathologist will go through questionnaires with you. They will also engage with your child using toys and play to assess your child’s speech and language. The speech-language pathologist will be able to determine how your child is developing compared to their peers using standardized evaluations.
How are speech and language delays treated?
Healthcare professionals trained to work with young children will develop a treatment plan for your child. This plan will include early intervention services like speech therapy. Insurance covers early intervention services, but there may be copays and deductibles.
As a parent, you will have an important role in making sure these services are a success. You’ll attend services with your toddler and reinforce the skills at home.
Other things you can do to help your child’s speech and language development include:
Read to your child: It’s never too early to start reading to your child. You can visit your local library and borrow books and get recommendations.
Sing to your child: Singing is another fun way to help your child with language development. Young children love music, and they love parents, so a parent making music doubles the joy.
Talk to your child: Narrate your day. Whatever you’re doing — pouring milk, folding the laundry, petting the cat — talk about it. Use sentences that are at least five words long. Use walks, drives — even trips to the grocery store — to name things and point out new items and actions. You may never again have such an attentive audience!
Can a toddler outgrow a speech delay?
Approximately 70% to 80% of children with expressive language delays will outgrow their delay and catch up to their peers. Children who receive early intervention services are more likely to catch up to their peers.
What does a diagnosis of a speech delay mean for my child long term?
Children who don’t catch up are more likely to have trouble with reading or writing in school. Children with speech and language delays are at higher risk of developing a learning disability and attention-deficit hyperactivity disorder (ADHD).
There’s no way to predict which children are more likely to develop these issues. But studies show that children who get early intervention services do better in the long term.
If you’re worried about your child’s language or speech, don’t wait. Ask your child’s healthcare provider about an evaluation. If your child has a speech or language delay, get started with early intervention services.
The bottom line
Speech and language delays are common in toddlers, but it’s hard to know which children are “late talkers.” If you’re worried about your child’s speech or language skills, talk to your child’s healthcare provider. Early intervention services available for children younger than 3 years old. These services can help your toddler catch up to their peers and set them up for long-term success.
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References
American Academy of Pediatrics. (2021). Language delays in toddlers: Information for parents.
American Speech-Language-Hearing Association. (n.d.). Spoken Language Disorders.
American Speech-Language-Hearing Association. (n.d.). Written Language Disorders.
Dale, P. S., et al. (2003). Outcomes of early language delay: I. Predicting persistent and transient language difficulties at 3 and 4 years. Journal of Speech, Language, and Hearing Research: JSLHR.
Ellis, E. M., et al. (2008). Early language delay and risk for language impairment. Perspectives.
Fuller, D. (2006). What is the difference between a speech therapist and a speech pathologist? Speech Pathology.com.
Gellner, C. (2015). My little one isn't talking—should I be worried? University of Utah Health.
Sharma, M., et al. (2009). Comorbidity of auditory processing, language, and reading disorders. Journal of Speech, Language, and Hearing Research: JSLHR.
