Speech Delay

When it comes to your child’s speech and language development, many parents find themselves asking, “What’s normal?”

Children progress at different rates. Determining whether your child is simply a "late talker" or needs professional help isn’t always easy. We put together this informational guide to help you better understand speech delays. Keep reading to learn the common signs and symptoms of a speech delay, how a speech delay is diagnosed and treated, and more.

1What is considered delayed speech?

2Does your child have a speech delay?

3What is the difference between a speech delay and a language delay?

4How is a speech delay diagnosed?

5What causes a speech delay?

6Everyday tips to support your child's speech development

7Helpful speech therapy exercises to use at home for speech delay

8How does Expressable evaluate and treat speech delay?

9Speech delay questions to ask your healthcare provider or speech therapist

What is considered delayed speech?

Speech and language skills begin with a baby's coos. As the months pass, babies eventually begin to babble. This soon progresses to one of the most joyous moments for a parent: their child’s first understandable words.

Toddlers commonly begin talking at around 12 months, but you may hear their first words a bit before that, or a bit after. A typical 2-year-old can say about 50 words and speak in two-word sentences. By age 3, their vocabulary increases to as many as 1,000 words.

A speech delay is when a toddler doesn’t meet these typical speech milestones. Speech delays are a common developmental problem that affects as many as 10% of preschool children.

Because all children progress on their own timeline, it can be hard to tell whether your child is just a late talker (and will soon be chatting a million miles a minute), or whether there’s a problem that needs professional treatment.

This is why assessment and diagnosis by a certified speech-language pathologist, also known as a speech therapist, is so important. Speech delays can be treated, and research has shown that earlier interventions lead to better outcomes.

Does your child have a speech delay?

As mentioned, it’s hard to know if your child is simply taking a bit longer to reach a speech or language milestone, or if there's a deeper problem that needs attention. Here are some common signs and symptoms of speech delays, broken out by age group.

By 12 months

• Your child isn't using gestures, such as pointing or waving goodbye

• Has trouble imitating sounds

By 18 months

• Your child prefers making gestures over vocalizations (sounds) to communicate

• Has trouble understanding simple verbal requests

By 24 months

• Your child can only imitate speech or actions

• Doesn’t produce words or phrases on their own

• Says only some sounds or words repeatedly, and can't use words to communicate more than their immediate needs

• Can't follow simple directions

• Has an unusual tone of voice (such as raspy or nasal sounding)

By 36 months

• Your child doesn’t use at least 200 words

• Doesn’t ask for things by name

• Is hard to understand even if you live with them

Is your child on track? Take our free online screener to find out if your child might benefit from a speech evaluation. The screener is tailored by age and takes just a few minutes to fill out.

What is the difference between a speech delay and a language delay?

Speech delays and language delays are often confused. They can be difficult for untrained professionals to tell apart. However, there are important differences between the two.

Speech is the physical act of producing sounds and saying words. A child with a speech delay is often hard to understand. While they may use words and phrases to express their ideas, they often have trouble forming the correct sounds. The inability to understand your child can be frustrating and disheartening for parents.

Conversely, a toddler with a language delay may make the correct sounds and pronounce some words. However, they can’t form phrases or sentences that make sense.

Some children have either a speech delay or a language delay, and some have both. Distinguishing between the two is important, as it will inform treatment decisions. If you think your child may have a speech or language delay, it’s important to seek help from a speech-language pathologist. They’re the most qualified professional to provide an evaluation and diagnosis.

How are speech delays diagnosed?

If you think your child might have a speech problem, it's important to see a speech therapist. During the initial evaluation, the therapist will ask about your child’s speech and language, as well as other developmental milestones and behaviors.

To diagnose a speech delay, your speech therapist will evaluate:

• What your child understands (called receptive language)

• What your child can say (called expressive language)

• Your child’s sound development and how clearly they speak

• Your child's oral-motor status (how the mouth, tongue, and lips work together for speech, as well as eating and swallowing)

The speech therapist will also review your child's medical history and talk with you about your concerns. Based on the results, speech therapy may be recommended for your child.

If you're concerned about your child's speech, you can schedule a free consultation call with an Expressable specialist. We're here to answer your questions and help you decide on the right next steps. If your child does need speech therapy, the earlier they begin, the sooner they'll make progress!

What causes a speech delay?

Your child’s development timetable may simply be a little different, and they’ll eventually catch up. But speech or language delays can also signal something about your child’s overall physical and intellectual development. Here are some common causes of speech delays.

• Oral impairment: Many kids with speech delays have oral-motor problems, which is a problem in the areas of the brain responsible for speech. This makes it hard to coordinate the lips, tongue, and jaw to make speech sounds. These children also might have other oral-motor problems, such as feeding problems.

• Developmental speech and language disorder: Some speech and language disorders involve brain function and may be a sign of a learning disability. Your child may have trouble producing speech sounds, using spoken language to communicate, or understanding what other people are communicating. Speech and language problems are often the earliest sign of a learning disability.

• Hearing loss: A toddler who can’t hear well, or hears distorted speech, is likely to have difficulty forming words. Hearing loss is often overlooked, but fortunately it’s also easily identifiable. One sign of hearing loss is that your child doesn’t acknowledge a person or object when you name them, but does if you use gestures. However, signs of hearing loss may be very subtle. Sometimes a speech or language delay may be the only noticeable sign.

• Autism spectrum disorder: Speech, language, and communication problems can be early signs of autism.

• Lack of stimulation: We learn to speak from the people around us. Therefore, it’s hard for children to naturally pick up speech or words if they’re not actively engaged with language. Lack of verbal stimulation can keep a child from reaching developmental milestones.

• Neurological problems: Certain neurological problems, like cerebral palsy, muscular dystrophy, and traumatic brain injury, can affect the muscles needed for speaking.

Everyday tips to support your child's speech development

• Start talking to your child at birth. It may sound (or feel) silly, but even newborns benefit from hearing speech.

• Respond to your baby’s coos and babbling with positive signals.

• Play simple games with your baby. Think peek-a-boo and patty-cake.

• Talk to your child a lot. Even a simple act like narrating what you’re doing can be helpful.

• Read books aloud. If your kiddo loses interest, then just talk about the pictures.

• Sing to your child and provide them with music. Learning new songs helps your child learn new words and also builds memory skills, listening skills, and expression of ideas with words.

• Expand on what your child says. For example, if your child says, “Dora,” you can say, “Here is Dora!”

• Describe for your child what they are doing, feeling, and hearing in the course of the day. For example, “You are hungry.”

• Give your child your full attention when they’re talking to you. When you ask them a question, give them enough time to respond before filling in the silence.

• Ask your child lots of questions.

• Don’t point out or correct grammar mistakes. Instead, just model good grammar by saying phrases correctly.

Helpful speech therapy exercises to use at home for speech delay

Many studies show caregivers play an essential role in helping their child reach their speech and language goals. Think about it: You spend the most time with your child. Considering that children learn to communicate during everyday activities and conversations, no one is better positioned than you to help improve their speech delay.

Your speech therapist should empower you to take an active role in your child’s progress. In speech therapy, you'll learn strategies and cues that you can easily practice with your child at home.

Expressable has developed a collection of videos with helpful at-home exercises to get you started. You'll find the whole series here.

Our clients also have access to our Expressable client portal, featuring demo videos, tips, and practice activities tailored to each child's needs. The more you practice speech therapy techniques at home, between sessions, the faster your child will make progress!

How does Expressable evaluate and treat speech delay?

Expressable matches families with a licensed speech therapist trained to evaluate and treat speech delays and disorders. All therapy is delivered online via face-to-face video conferencing, at a time that works best with your schedule.

As described above, your Expressable speech therapist will perform a detailed evaluation to determine your child’s current communication strengths and differences. From there, they will build a treatment plan with goals tailored for your child. Your child’s age and development will influence how your speech therapist interacts with them during video sessions:

Ages 0-3: Parents and caregivers attend sessions with their child. You'll work directly with your child's speech therapist to learn cues and at-home strategies. This way you can confidently practice with your child at home and improve your child's communication. Learn more about the importance of parental involvement in children’s speech therapy here.

Ages 3-6: Caregivers attend video sessions alongside their child so they both learn valuable skills from their speech therapist. Practicing these skills outside the sessions will continue to promote at-home skill building.

Ages 7 and up: Most children attend video sessions on their own, but caregivers are welcome to attend as well. Your speech therapist will keep you in the loop with updates and tips during each session.

Speech therapy is a partnership between the client, family, and speech therapist. All Expressable clients have access to our client portal, which is packed with educational Learning Paths covering the strategies taught in therapy sessions. You can access examples, tips, demo videos, and more to help support your child at home. Plus, through the portal, you'll receive weekly home practice activities tailored to your child’s needs. Remember, the more you practice speech and language during everyday routines, the faster your child will make progress!

Find out more about Expressable speech therapy during a free consultation call with one of our specialists. We're here to listen to your concerns and help determine the right next steps for your child.

Speech delay questions to ask your healthcare provider or speech therapist

• Why is my child not talking yet?

• Is it normal for my child to not be speaking yet at his age?

• My child seems to have trouble understanding what I’m saying, but they respond to gestures. Is it possible they have hearing loss?

• Could my child have a developmental or learning disability?

• What can I do to help my child speak or understand better?

• What types of exercises, activities, or games can I do with my child to help with their speech development?

• How will a speech delay affect my child’s school performance?