At Pediatric Associates of Jacksonville, Dr. O, along with her physicians, nurses and medical staff are expert caregivers–from helping your child to feel better, to educating your child about staying healthy, to rewarding your child for positive behavior.
Here you will find articles with relevant topics that focus on your child’s physical and emotional health. Our goal is to provide care and knowledge that lasts a lifetime, and teach you and your child to love growing healthy!
Delayed Speech and Language Development
As a child grows from infancy to toddlerhood, one of the most fascinating (and often entertaining) developments is when he or she begins to talk. It is usually during this time that we get our first glimpse into his or her unique personality. The first 3 years of life is a critical period for the development of speech and language. During this time, the brain is uniquely in tune to all the sights and sounds from a child’s environment, and is rapidly developing all the necessary connections for language and speech. In this article, we will explore the normal development of speech and language, signs of speech delay, some common causes of speech delay and the importance of early intervention and therapy.
Definitions:
Language: Socially shared rules which include what words mean (receptive language) and how to put words together to communicate with others (expressive language)
Speech: Verbal means of communicating that consists of articulation (how sounds are made) and fluency (rhythm of speech)
1. American Speech Language/Hearing Association
Normal Speech Development
Infants begin processing language and word associations at an amazingly young age. New research suggests infants recognize their own name at 4 months of age and although they may only use 1 or 2 words, they likely recognize hundreds of words by 12 months of age. Receptive language (what speech a child understands) is much superior than expressive language (what a child can articulate) in these first few years of life. It is important to remember that certain sounds are beyond the oral/motor capability of toddlers until they reach a certain age. In fact, certain sounds such as “th, sh, ch, k “ usually cannot be pronounced accurately until age 6 or 7. The following table is a short list of normal speech and language development by age and includes some common “red flags” pediatricians are on the lookout for that may indicate a child needs further professional evaluation.
| Age | What your child should be able to do | Red Flags |
|---|---|---|
| 1-3 months | Responds to sounds, coos, chuckles |
Does not startle to loud noises |
| 4-6 months | Laughs Babbles more than 2 sounds Imitates sounds like "ooh" and "ahh" Responds to his or her name |
|
| 9 months | Says "Mama", "Baba", or "Dada" | |
| 12 months | Says 1 or 2 words Follows simple directions–waves bye-bye |
Does not use single words like "Mama" or "Dada" |
| 15 months | Says 4 or 5 words Will point to people and objects |
|
| 18 months | Knows names of things and people | Does not use at least 15 words |
| 24 months | Uses 2 or 3 words together Says "mine" About half of speech is understandable |
Does not follow simple instructions |
| 36 months | Speaks in at least 3 word sentences Follows 2 requests About 75% of speech is understandable |
Does not use language to communicate more than his/her immediate needs |
| 4 years | 90% of speech should be understandable Able to name objects/animals in pictures |
Speech is still difficult to understand |
| 5 years | Speech should be totally understandable although he or she may have articulation problems Understands common opposites–big/little, hard/soft |
* For more extensive information, The American Speech-Language-Hearing Association offers a detailed chart of language development online at www.asha.org.
Some Common Causes of Speech Delay
Some common causes of speech delay/language delay include hearing problems, global developmental delay, speech processing problems, and oral/motor problems.
All children with speech and language problems should have a hearing evaluation. Children with a history of recurrent ear infections are at risk for hearing problems that can lead to language delay. Children with global developmental delays, which include autism-spectrum disorders to children with a history of prematurity, usually have language/speech delays as well as other delays such as motor delays and/or social delays requiring speech as well as other therapies. Speech/Language processing problems are disorders where the brain has not matured enough to produce speech. Usually these children have normal receptive language and only show delays in expressive language and speech. “Late talkers” usually fall under this category, but some children may have a significant expressive language delay that requires intervention to promote normal speech/language development and prevent other language-based learning disabilities in the future. Oral/motor problems primarily affect articulation and can be corrected with appropriate speech therapy by a licensed practitioner.
Early Intervention and Speech Therapy
Language development is one of the many aspects of childhood development that is closely monitored at each well child check. If there are any delays noted during the exam, children are referred to the appropriate specialist in the field who will conduct an extensive hearing and developmental exam based on the child’s age. If there are any concerns about how your child’s speech is developing, it should be brought to their physician’s attention as soon as possible. Early intervention is key to helping children with speech delay continue to develop language and communicate effectively in the future.
Michelle Marie Williams, M.D., F.A.A.P.