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Speech & Language Delays

Dear Debi,
My 4-year-old daughter might have a speech or language delay. How can I tell?
Patty Taylor
Debi's Tips
Debi Gutierrez
Debi Gutierrez
  • Observe your child
  • Speech is pronouncing words
  • Language is vocabulary & sentence structure
  • Discuss concerns about speech or language delays with your doctor or local school district
Expert Advice
Amy Johnson
Amy Johnson
Speech-language pathologist
A speech delay has to do with how a child is pronouncing his words. When we refer to speech, we’re referring to the way a child uses his lips, his tongue, his cheeks, his jaw to form sounds. Speech is the actual output of sound – the articulation.

A language delay has to do with vocabulary and how a child puts words in a sentence. We want to see that children are developing a certain amount of vocabulary and that they’re putting phrases together and building sentences. Receptive language means how well they are understanding – or receiving – words they hear. Expressive language refers to how well they’re developing their vocabulary and starting to build phrases and sentences.

A child can have a delay in any combination of these language and speech areas. You could have a child that has a very good understanding of receptive language, but has an expressive delay. Or you could have a child with good receptive language, good expressive language, but has a speech delay.

Speech and language development go hand-in-hand together. Here are some “rules of thumb”:
  • Before 6 months – makes eye contact; gestures before babbling; turns head or cries when he/she is tired of an activity; smiles and laughs
  • 6-12 months – babbling; puts multiple-speech sounds together; recognizes people; responds to their name
  • 12-18 months – follows simple directions; turns pages of a book; responds to a question by pointing; groups objects in play (such as: all of the toy cars go here and all of the play food goes there)
  • 18-24 months – puts two words together (such as: “more milk”); names and shows parts of body; makes the sounds of various animals
  • 24-36 months – vocabulary of 50-300 words or more; three-word phrases; able to ask, “Why?”; understands and uses some prepositions
  • 3 years – speech should be mostly intelligible
  • 3-5 years – most language and sounds are developed by this point
It should be noted that some sounds and sound processes may not have developed yet. It is not uncommon, for instance, that a 3-year-old child will have difficulty producing some later-developing sounds, such as the “R” and the “L” sounds. Hence, children may say “wabbit” instead of “rabbit” or have difficulty blending words in consonant clusters (such as saying “geen” for “green” or “tees” for “trees”).

While there is a range of typical speech and language development, you should begin to be concerned when your child is more than 6 months later than the “rules of thumb” outlined above.

If you have a child with a speech or language delay, instead of trying to shift the child’s attention to something you want them to look at, start to join into what they’re already doing. While you’re engaging with that child, pick one or two words to focus on. For example, if you’re playing with blocks and the child likes putting the blocks into something, you might just want to concentrate on the word “in.” So, every time you put a block in you say, “in,” “in,” “in,” “in.” Then, before you put the next block in, wait. See what they might do to cue you. Waiting is an amazing strategy. We’re usually all so quick to fill in for them. Signing is another great strategy because maybe the child isn’t going to be ready to produce a sound yet, but they might be more ready to use their hands to sign.

If you suspect your child has a speech or language delay, contact your local regional center if your child is under the age of three. If your child is over age three, contact your local public school. Ask for an evaluation for your child. By law, the school must provide this evaluation within 60 days. They are not required to give services (therapy), however, until the age of three. Some school districts – but not many – may have an “Early Start” program that can provide intervention. Also, speak to your child’s pediatrician as a sounding board to rule out any medical and/or audiological problems.
Child Care provider Comments
Bridgette Smith
Bridgette Smith
Mother of two, expecting her third child
My 5-year-old, Maxwell, had a speech delay and he was diagnosed with ankyloglossia – which means he was tongue-tied. Once he got his tongue surgically fixed, he progressed amazingly. Prior to the surgery, his vocabulary at the age of 3 consisted of about 20 words. After his surgery and with the assistance of a speech therapist, his vocabulary jumped to about 200 words in just 3 months. He’s finished with his speech therapist and now that he’s in school, he’s up to speed.
Cathy Agnew
Cathy Agnew
Cares for her grandchildren, mother of two
The biggest challenge is trying to understand what my grandson wants. Usually, he will take your hand and lead you to the kitchen or give you a sign if he wants to go out. But if there’s something he wants and you can’t figure out what it is, he will get very frustrated. It’s frustrating for me because you know there’s something he wants but you just can’t figure it out.
Karolina Ramirez
Karolina Ramirez
Child care provider for 6 years
I recommend that Patty repeat words and make sure she is telling her daughter the appropriate names for objects. Even if your child can’t say words back to you, the child will learn what everything is called. She will become aware that everything has a name and what those names are just by hearing other people say them. There are also great age-appropriate books that engage the child in repetition, such as “Old McDonald,” “Itsy Bitsy Spider,” “Brown Bear Brown Bear.”

Language Bingo Featured Activity:
Language Bingo
Speech and Language Delays Featured Video:
Speech and Language Delays
Topic: Special Needs
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