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    Speech and Language Delay in Children - Reasons, Types and Treatment

    • 4.5   (1 Votes)
    Medically Reviewed by Dr. Deepika Tiwari - MBBS on 11 Dec 2018 - Written by Dr. Astha Dayal - MBBS - Grammatically Approved by Dr. Kavita Jaggi Agrawal - MBBS

    Speech and Language delay is caused when a child is unable to express his/her feelings through words. The reasons for language delay in toddlers such as Oral Apraxia, Ear infections, Prenatal nutrition, Dysarthria, and Hearing problems. The various types of speech errors are Omissions, Distortions, and Substitutions.

    Many young children have difficulty in communicating with others. Most children eventually catch up while some continue to have problems like speech and language disorders. The development of speech and language skills may vary from one child to another. A child with a speech disorder may have difficulty with fluency, articulation, voice and resonance. They may have trouble understanding what others say, hesitate, or stutter when talking as compared to children of the same age. Hearing loss can also be one of the reasons for speech or language disorder. All these factors can create a sense of suppression among children with such an abnormality.

    Signs of a Speech or Language Delay

    When a child does not respond to sound or does not vocalizes, it is important to consult a doctor right away. However, often, it is hard for parents to understand the likeliness of a problem with the child that needs medical attention. Here are some of the common signs to detect if a child is suffering from speech and language abnormality:

    By 12 months

    • If a child is not using gestures, such as pointing or waving like bye- bye.

    By 18 months

    • If a child has trouble imitating sounds
    • Trouble understanding simple verbal requests
    • If a child prefers gestures over vocalizations to communicate
    • If the child does not babble using consonant sounds (particularly b, d, m, and n)

    By 2 years or above

    • When a child does not produce words or phrases spontaneously and can only imitate speech or actions 
    • Repeats only certain words and sounds
    • unable to use oral language to communicate 
    • Finds it difficult to follow simple directions
    • If a child is still not able to produce most speech sounds by the age of four
    • If a child is distorting sounds such as /s/ and /r/ after the age of five or six
    • If a child is embarrassed to speak or worried about their speech at any age 
    • Develops an unusual tone which is (raspy or nasal sounding) difficult to understand than expected for their age

    sign of a speech or language delay

    It is important for parents and regular caregivers to understand their child's speech at two or three years.

    Cause of Speech and Language Delay

    For most children, the cause of the speech or language delay can be linked to problems with the teeth, hearing loss, or difficulty controlling the movements of the mouth. Factors associated with speech or language delay include:

    Oral Apraxia: Many children with speech delays have oral-motor problems that are difficulty in making voluntary movements of the tongue and lips.
    As a result, a child’s may have a problem to make a speech and there are often many inconsistent articulation errors in connected speech. These problems occur when there is a problem in the areas of the brain responsible for speech, making it hard to coordinate the lips, tongue, and jaw to produce speech sounds.

    oral apraxia

    Dysarthria: Dysarthria occurs when a child shows symptoms such as numbness, paralysis, weakness, or poor coordination of the muscles in the mouth. This can make the child’s speech slow, inaccurate, slurred or hypernasal (too much sound from the nose)

    Hearing problems: Hearing problems also aid delayed speech. Children who have trouble hearing may have trouble in understanding, articulating as well as imitating and using language.

    Ear infections: Ear infections, if severe, can affect speech. Speech and language develop normally as long as there is normal hearing in at least one ear.
    Genes and heredity: According to a study it is found that about 20 to 40 percent of children with a family history of speech and language impairment have the condition themselves, compared with about five percent of those with no family history of speech and language delay.

    Prenatal nutrition: If a woman takes prenatal folic acid supplements during pregnancy, her baby is less likely to have severe language issues. 

    Sometimes extreme environmental deprivation can cause speech and language delay. When a child is abused or neglected and does not hear others speaking, he does not learn to speak. Prematurity can also lead to many kinds of health issues and developmental delays, including speech/language problems. Neurological problems such as muscular dystrophy, cerebral palsy and traumatic brain injury can affect the muscles needed for speaking. Other conditions include Downs syndrome, autism spectrum disorder, intellectual disabilities and premature birth.

    Types of Speech and Language Errors

    Omissions: When a child may leave out sounds in sentences and words.

    Substitutions: When a child uses an incorrect sound instead of the correct one.

    Distortions: When a child cannot pronounce clearly.

    Treatment for Delayed Speech and Language

    Early intervention is very important for children with speech and language disorders. Preschool years are a critical period for normal speech and language development. If there is a problem with the child’s communication skills at any age, it should first be discussed with the child’s doctor. The doctor may refer the child to a speech-language pathologist for evaluation and treatment. A speech-language pathologist evaluates a child's speech and language skills within the context of total development. The pathologist conducts a standardized test and looks for milestones in speech and language development.

    treatment for delayed speech and language

    What Can Parents Do?

    Parental involvement plays an important role in helping children who have a speech or language problem. Children often learn a speech and develop language skills when they listen to the speech of others. Parents are the most important teachers for children in their early years. Here are a few ways what parents can do to encourage speech development at home:

    • Parents can talk, sing and encourage imitation of sounds and gestures to the child throughout the day, especially during daily routines and favorite activities. 
    • Read age-appropriate soft or board books or picture books that encourage kids to look, for example, Pat the Bunny, in which the child can imitate the patting motion. Let the child point to recognizable pictures and try to name them. 
    • Ask questions and listen to their answers.
    • Parents can progress to predictable books that can let them anticipate what happens.

    In this way, children may even start memorizing their favorite stories.

    Parents can sing songs; play music and share nursery rhymes along with the child. This is a great way to build speech and language while having fun with the child.

    With help and understanding, a child can learn to manage a language disorder and make the most of their strengths and talents. Healthcare providers can also contribute to collaborating with schools to help a child with speech or language disorders and delay or other disabilities get the special services they need. A healthy and peaceful environment is the key to a child’s overall mental and physical development. 

    If you have concerns related to childbirth or pregnancy, you can consult Ela at the given number +917899912611. Ela also provides efficient assistance in selecting and arranging infertility treatments including IVF, IUI and surrogacy.

    Dr. Astha Dayal

    Written by

    Infertility Specialist, Obstetrician

    Dr. Astha Dayal is an infertility specialist who has been practising for many years to help women conceive naturally as well as with the help of assisted techniques. Her extensive knowledge in Dysmenorrhea Treatment, High-Risk Pregnancy, Intrauterine Insemination (IUI) and Abortion and Infertility Treatments makes her one of the most preferred Gynecologists in Gurgaon.

    She completed MBBS and MD in Obstetrics and Gynaecology from G B Pant Hospital and Maulana Azad Medical College, New Delhi in 2003 and 2008 respectively. Following this, she pursued MRCOG from Royal College of Obstetricians and Gynaecologists in London in 2011. She is also a member of World Association of Laparoscopic Surgeons (WALS), Royal College of Obstetricians and Gynaecologists (RCOG), London and Federation of Obstetric and Gynecological Societies of India (FOGSI). You can get the contact details of Dr. Astha Dayal at


    • Ivf - ivf procedure steps, costs, ivf success rates, types, and faq's  IVF, Elawoman - 2018
    • Male infertility - signs of infertility, male infertility treatment  IUI, Elawoman - 2017
    • What is surrogacy and what are the international laws around surrogacy?  surrogacy, Elawoman - 2018

    1 Comment


    Hemant Pavi

    Dec. 11, 2018, 12:44 p.m. 4.5

    Leave a Comment



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