Speech delay what is it

Intracranial hemorrhage. Feeding difficulties, excessive drooling. Encephalitis, meningitis. Recurrent otitis media. Head trauma. Ototoxic drugs. Psychosocial stress, family conflicts. Abnormal social play, lack of empathy, inability to relate to others. Speech delay. Chromosomal abnormalities. Pendred syndrome, Waardenburg syndrome, Usher syndrome. Prader-Willi syndrome, Williams syndrome, Bardet-Biedl syndrome. Upward slanting eyes, Brushfield spots, epicanthic folds, brachycephaly, simian creases.

A thorough developmental history, with special attention to language milestones, is extremely important in making the diagnosis.

The physician should be concerned if the child is not babbling by the age of 12 to 15 months, not comprehending simple commands by the age of 18 months, not talking by two years of age, not making sentences by three years of age, or is having difficulty telling a simple story by four to five years of age. Generalized delay in all aspects of developmental milestones suggests mental retardation as the cause of a child's speech delay. The medical history should include any maternal illnesses during the pregnancy, perinatal trauma, infections or asphyxia, gestational age at birth, birth weight, past health, use of ototoxic drugs, psychosocial history, language s spoken to the child, and family history of significant illness or speech delay.

A precise measurement of the child's height, weight and head circumference is necessary. A review of the appropriate parameter on the growth chart also can help in early identification of some types of speech delay. Any dysmorphic features or abnormal physical findings should be noted. A complete neurologic examination should be performed and should include vision and hearing evaluations.

The Early Language Milestone Scale Figure 1 is a simple tool that can be used to assess language development in children who are younger than three years of age. It relies primarily on the parents' report, with occasional testing of the child. The test can be done in the physician's office and takes only a few minutes to administer.

If the child is bilingual, it is important to compare the child's language performance with that of other bilingual children of similar cultural and linguistic backgrounds. Reprinted with permission from Coplan J. ELM scale: the early language milestone scale. Austin, Tex. A comprehensive developmental assessment is essential, because a delay in speech development is the most common early manifestation of global intellectual impairment.

The Denver Developmental Screening Test is the most popular test in clinical use for infants and young children. Children whose results indicate an abnormal condition require more definitive testing with one of the standardized and validated tests of intelligence. All children with speech delay should be referred for audiometry, regardless of how well the child seems to hear in an office setting and regardless of whether other disabilities seem to account for the speech delay.

Tympanometry is a useful diagnostic tool. When coupled with results from pure-tone audiometry, measurement of eardrum compliance by means of a tympanometer helps to identify a potential conductive component e.

An auditory brain-stem response provides a definitive and quantitative physiologic means of ruling out peripheral hearing loss. Additional tests should be ordered only when they are indicated by the history or physical examination.

A karyotype for chromosomal abnormalities and a DNA test should be considered in children who have the phenotypic appearance of fragile X syndrome. An electroencephalogram should be considered in children with seizures or with significant receptive language disabilities. The latter may occasionally be related to subclinical seizure activities in the temporal lobe. The management of a child with speech delay should be individualized.

The health care team might include the physician, a speech-language pathologist, an audiologist, a psychologist, an occupational therapist and a social worker. The physician should provide the team with information about the cause of the speech delay and be responsible for any medical treatment that is available to correct or minimize the handicap.

A speech-language pathologist plays an essential role in the formulation of treatment plans and target goals. The primary goal of language remediation is to teach the child strategies for comprehending spoken language and producing appropriate linguistic or communicative behavior.

The speech-language pathologist can help parents learn ways of encouraging and enhancing the child's communicative skills. In children with hearing loss, such measures as hearing aids, auditory training, lip-reading instruction and myringotomy may be indicated; occasionally, reconstruction of the external auditory canal, ossicular reconstruction and cochlear implantation may be necessary. The use of a high-risk registry as well as universal hearing screening may help to identify hearing loss at an early age.

Psychotherapy is indicated for the child with elective mutism. It is also recommended when the speech delay is accompanied by undue anxiety or depression.

In autistic children, gains in speech acquisition have been reported with behavior therapy that includes operant conditioning. Parents and caregivers who work with children with speech delay should be made aware of the need to adjust their speech to the level of the particular child.

Teachers should consider the use of small group instruction for children with speech delay. Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. He is also a pediatric consultant at the Alberta Children's Hospital, and medical director of the Asian Medical Centre, which is affiliated with the University of Calgary Medical Clinic, all in Calgary.

Leung graduated from the University of Hong Kong and completed a residency in pediatrics at the University of Calgary. Kao graduated from the University of Alberta, Edmonton. He completed a residency in pediatrics at the Alberta Children's Hospital. Address correspondence to Alexander K. Childhood apraxia of speech is a physical disorder that makes it hard to form sounds in the right sequence to form words.

However, signs of hearing loss may be very subtle. Sometimes a speech or language delay may be the only noticeable sign. We learn to speak to get in on the conversation. Environment plays a crucial role in speech and language development. Abuse, neglect, or lack of verbal stimulation can keep a child from reaching developmental milestones. Speech and language problems are very often seen with autism spectrum disorder. Other signs may include:. In the case of cerebral palsy, hearing loss or other developmental disabilities can also affect speech.

Speech can be delayed due to an intellectual disability. Because toddlers progress differently, it can be a challenge to distinguish between a delay and a speech or language disorder. Between 10 and 20 percent of 2-year-olds are late to develop language, with males three times more likely to fall into this group. Even if your child seems responsive to sound, there could be hearing loss that makes words sound muddled.

Depending on initial findings, your pediatrician may refer you to other specialists for more thorough evaluation. These may include:. The first line of treatment is speech-language therapy.

If speech is the only developmental delay, this may be the only treatment needed. It offers an excellent outlook. With early intervention, your child may have normal speech by the time they enter school. The speech-language therapist will work directly with your child, as well as instruct you on how to help. Speech delay can also lead to problems with behavior and socialization.

Medical Records. About Us Who We Are. Patient Stories. Get Involved. Health Alerts: Coronavirus. Health Library. Flu Information. Nutrition Videos. Injury Prevention. Community Health Needs Assessment. Nothing to worry about… This scenario is common among parents of kids who are slow to speak.

From 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. The Difference Between Speech and Language Speech and language are often confused, but there is a distinction between the two: Speech is the verbal expression of language and includes articulation, which is the way sounds and words are formed.

Causes of Delayed Speech or Language Many things can cause delays in speech and language development. What Speech-Language Pathologists Do If you or your doctor suspect that your child has a problem, early evaluation by a speech-language pathologist is crucial. The speech-language pathologist will also assess: what your child understands called receptive language what your child can say called expressive language if your child is attempting to communicate in other ways, such as pointing, head shaking, gesturing, etc.

What Parents Can Do Like so many other things, speech development is a mixture of nature and nurture. Here are a few general tips to use 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. Try starting with a classic book such as Pat the Bunny , in which your child imitates the patting motion or books with textures that kids can touch.

Wave goodbye. Say "da-da" to dad and "ma-ma" to mom. Say at least 1 word. Point to items they want that are out of reach or make sounds while pointing. Between 1 and 2 years most toddlers will Follow simple commands, first when the adult speaks and gestures, and then later with words alone. Get objects from another room when asked. Point to interesting objects or events to get you to look at them too. Bring things to you to show you.

Point to objects so you will name them. Name a few common objects and pictures when asked. By 2 years of age most toddlers will Point to many body parts and common objects. Point to some pictures in books. Follow 1-step commands without a gesture like "Put your cup on the table. When milestones are delayed If your child's development seems delayed or shows any of the behaviors in the following list, tell your child's doctor.

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 or her name Acts as if he or she is in his or her own world Prefers to play alone; seems to "tune others out" Doesn't seem interested in or play with toys but likes to play with objects in the house Has intense interest in objects young children are not usually interested in for example, would rather carry around a flashlight or ballpoint pen than a stuffed animal or favorite blanket Can say the ABCs, numbers, or words to TV jingles but can't use words to ask for things he or she wants Doesn't seem to be afraid of anything Doesn't seem to feel pain in a typical fashion Uses words or phrases that are unusual for the situation or repeats scripts from TV Delays in language Delays in language are the most common types of developmental delay.

What your child's doctor might do Sometimes more information is needed about your child before your child's doctor can address your concerns. The doctor may Ask you some questions or ask you to fill out a questionnaire. Interact with your child in various ways to learn more about his or her development. Refer your child for evaluation through an early intervention program.

What to expect after the doctor's visit If your child's doctor tells you not to worry that your child will "catch up in time" but you are still concerned, it's OK to get a second opinion. Programs that help children and families If your child has delays or suspected delays, your child's doctor will probably refer you to an early intervention program in your area.

Remember As a parent, follow your instincts. More information Ask the Pediatrician: My baby is turning a year old this month. Should she be talking by now? Act Early. The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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