When to Worry About Your Child's Speech Delay

Portrait of a small boy
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Question: Is it ok that my child doesn't talk as well as the other kids his age?

My 2-year-old's speech seems much less clear than other children his age. His daycare provider suggested I get him evaluated by a speech pathologist. Could something be wrong or could he just be a late bloomer?

Answer: There is a wide range of normal for language development in toddlers and 2-year-olds. Comparing one child to another isn't necessary or helpful since children hit milestones at different times and many factors can influence how much or how well a child speaks.

For instance, children who live in a bilingual home may take a little longer to become fluent in either language (but in the long run may have significantly better verbal skills than their peers). Toddlers in a family with many siblings sometimes speak later because brothers and sisters "talk for them" in some regard. Research also shows that girls speak earlier than boys.

Sometimes, though, speaking late or speech that is unclear can be red flags for a developmental delay or a physical problem. In those cases, your child may benefit from speech therapy. The first step, of course, is determining whether your child's speech is really off target for his age.

Speech Milestones

Around your child's first birthday, baby babble starts to change. As your little one tries harder to imitate the sounds he hears around him, the string of noises start to take the shape of actual words. In subsequent months, words begin to get strung together into toddler sentences, and after your child's second birthday, there is usually an explosion in vocabulary and the use of more complex sentences.

You can use this list of specific milestones and signs of possible delay when considering whether your little one's speech is progressing normally.

12 to 18 months:

Around your child's first birthday, toddlers have a wide range of speech sounds. You’ll probably be able to recognize at least one or two common words such as "baba" (bottle) or "mama." Nouns that are, in his view, essential to daily life are usually the first words that a child masters.

Aside from those keywords, your child’s speech will mostly be limited to babbling sounds at 12 months. Over the following six months, though, you should start to see your child begin to develop more advanced communication such as:

  • trying to copy your words
  • imitating the back and forth of real conversation
  • inflecting his speech ask a question (saying "Jui?" when asking for juice) or making a demand (shouting "Jui!" when shouting for juice.)
  • spontaneously using words rather than just responding to sounds you make
  • using a combination of gestures and vocalized sounds to communicate what he wants to say

While paying attention to the words or sounds your child is making is important, it’s also to consider whether or not your toddler can follow simple directions that involve one step (Pick up the block.).

18 to 24 months:

There continues to be a wide range of normal in verbal skills during this developmental period. In addition to variations in development, your child’s personality and circumstances can play a role in how many words you hear and how often.

On average, though, by the time your child reaches age 2, you can expect to see him reach the following milestones:

  • increasingly adding words to his vocabulary
  • forming two-word phrases – although they won’t be grammatically correct (“no go,” “book read”)
  • using words to identify pictures in a book or surroundings
  • naming body parts, animals and sometimes animal sounds (“moo” for cow)

Again, you should also consider how well your child is able to comprehend what you say. Does he respond to you when you ask questions? Can he follow simple two-step commands by age 2?

2 to 3 years:

Between age 2 and 3 is usually when parents see an explosion in children's speech and verbal skills. It's often said that a child's vocabulary grows to 200 or more words, but the important thing is to see a consistent increase in the number of words your child starts to use week by week.

Some of the milestones to look for this year include:

  • saying more words and picking up new words that he hears regularly
  • combining three or more words into sentences (which may still be grammatically awkward)
  • beginning to identify colors, shapes, and concepts such as more or less and big versus little
  • singing nursery rhymes and songs or repeating stories from books you've read often together
  • beginning to express feelings with words ("I hungry," "Sam sad")

At this age, it's still common that people outside your immediate family or caregiver system may not be able to understand your child as well as you can. In the coming year, your child’s speech should become clearer and clearer. 

If you are concerned about your child's speech, talk to your pediatrician about causes of speech delays and ways you can support language development at home.

Source:

Bowers, J. Michael, et. al. Foxp2 Mediates Sex Differences in Ultrasonic Vocalization by Rat Pups and Directs Order of Maternal Retrieval, The Journal of Neuroscience, 20 February 2013 (accessed 11 March 2013)

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