Speech and language delays are among the most common developmental problems in young children. There is quite a bit of variability in how quickly children learn to speak, but most children are using many words (at least 50) by age 2 and simple sentences by age 3. Sometimes speech delays are ignored on the premise that a child will simply “grow out of it,” but this is usually a mistake. Speech and language difficulties are significant in and of themselves, and may be part of other developmental problems, such as autism or learning disabilities.

Some children have difficulties mainly with “expressive language,” the actual production of words as speech. Others have difficulties with “receptive language,” or language comprehension, in addition to speech delays. These children typically have trouble understanding instructions and may have trouble identifying body parts, common objects or pictures. Still others have difficulties with “pragmatic language,” or the skills needed for real-life communication in social situations, such as conversation skills. Children with autism spectrum disorder especially have trouble with pragmatic language skills.

The American Academy of Pediatrics recommends that primary care doctors evaluate all children for developmental problems, including speech and language delays, at 9, 18 and 30 months of age using specialized screening tests. There are also a number of “red flags” that should alert parents and doctors that a child may have a significant speech-language disorder, including lack of eye contact, lack of interest in communication, not responding when called by name, using no single words by 15 months, using fewer than 50 words by 2 years, not using complete sentences by 3 years, or showing frustration due to communication difficulties at any age.

Here are the key steps to help your child with speech and language delays:

  • Trust yourself. If you are concerned about your child’s speech and language development, you should trust your instincts and act on your concerns by seeking out help for your child.
  • Have your child’s hearing checked. Ask your child’s doctor for a referral for a formal hearing evaluation by an experienced audiologist. Although most children with speech and language delays have normal hearing, it is very important to rule out hearing loss as early as possible. Research shows that early treatment for severe hearing loss (using hearing aids, for example) results in much better language outcomes.
  • Have your child evaluated. If your child is less than 3 years old, contact your local early intervention program to have your child evaluated. If your child is over 3 years of age, your local school district should provide assessments and treatment.
  • Obtain services for your child. These services may be home-based, clinic-based or school-based depending on your child’s needs and the types of services offered in your community. Most often a speech specialist, or “speech-language pathologist,” will work with your child and will help you find ways to encourage your child’s speech and language skills. Other child development professionals may also become involved depending on your child’s needs.

Things To Do at Home

There are many ways you can encourage your child’s speech and language development:

  • Engage in child-oriented language and conversation. For example, use short, simple sentences and vivid, concrete vocabulary and discuss topics that interest your child, such as his or her favorite food or color.
  • Encourage your child to initiate requests and be as specific as possible in communicating wants and needs.
  • Schedule one-on-one time with your child away from distractions.
  • Create opportunities for your child to interact with other children—play encourages communication.
  • Read to your child every day.
  • Use special teaching materials, such as computer programs and flashcards, with the advice of your child’s speech-language pathologist.
  • Limit television viewing. Even the best educational programs are far less helpful than real communication with real people.
  • Play games that encourage the use of words or the identification of objects or pictures by naming or pointing.

Recognizing your child’s speech and language problems as early as possible, getting your child’s hearing checked, getting your child involved in early intervention services, and encouraging communication at home are the key elements in helping your child to overcome speech and language delays.

More information about speech-language delays, as well as other common developmental problems, may be found in Louis Pellegrino’s recently released book, The Common Sense Guide to Your Child’s Special Needs: When to Worry, When to Wait, What to Do, available from Brookes Publishing Co.

Louis Pellegrino, M.D. is a developmental pediatrician and director of the Child Development Program at the Upstate Golisano Children's Hospital, Upstate Medical University in Syracuse, NY and is the author of the recently released "The Common Sense Guide to Your Childâs Special Needs: When to Worry, When to Wait, What to Do," published by Brookes Publishing Co.