The typical 2-year old can say around 50 words. A toddler should be able to form simple two and three-word sentences.
By the time your child is around 3-years old, they should be able to understand and use a whopping 1000-words and speak in simple three and four-word sentences.
If you think your toddler is quieter than his peers or hasn't met these milestones, they may have speech delay.
You must remember that a speech delay isn’t always a sign of physiological and psychological challenges. However, experts have linked speech delay to several developmental and neurological disorders over the last few years.
A number of developmental disorders may result in speech delay in children.
Getting to the root of your child’s speech delay is imperative to ensure that they are not at risk of a developmental or neurological disorder.
What Can Be The Potential Causes Of Speech Delay In Children?
Primary
Primary speech delays are typically not signs of another underlying condition. Speech-language therapy is helpful in most cases of primary speech delay.
Speech and Language Delay
Speech and language delay can be identified in children as young as 2 years. The cause of speech delay in 2-year old kids can be primary.
The only sign of primary speech and language delay is delayed speech. A child with primary developmental speech delay has normal (average or above average) comprehension, hearing, intelligence, articulation skills, and emotional relationships.
In most cases of primary developmental speech delay, speech therapists can help. You can seek the advice of speech-language pathologists (SLPs).
SLPs can assess and determine the best therapy routes for kids with speech delay. Parental participation can help in the treatment of speech delay in 2-year old children.
Research shows that interventions which last longer than eight weeks are typically more effective. Children may recover normal speech through toddler speech delay exercises by school-age.
Expressive Language Disorder
An expressive language disorder may cause speech delay in kids. However, they also have average or above-average intelligence, comprehension skills, hearing, articulation, and emotional relationships.
Speech delay in 2-year old may be due to a primary expressive language disorder.
Sadly, an expressive language disorder isn't self-correcting. Therefore, active early intervention by a trained speech-language pathologist is necessary. It is also essential for parents to provide speech therapy at home under the guidance of a clinician.
Expressive language disorder responds well to speech-language therapy, especially if it lasts for longer than eight weeks.
Receptive Language Disorder
In addition to delayed speech, the child may also show agrammatism and indistinct articulation. Children with a receptive language disorder may not point to objects or people when parents mention them by name.
They may have normal responses to non-spoken stimuli. However, they exhibit a lack of comprehension of spoken words.
Speech-language therapy is typically not as effective in addressing receptive language disorder. Research shows that children with this particular disorder rarely develop normal speech and oral language capacity.
Secondary
Conditions or disorders, such as hearing loss, selective mutism, autism spectrum disorder (ASD), intellectual disability, and cerebral palsy (CP) can result in speech delay among kids.
Speech-language therapy may help children with such disorders.
However, the improvement is typically limited.
Children may require medical and surgical intervention for addressing the condition causing the speech delay.
Autism Spectrum Disorder (ASD)
Children on the autism spectrum can have a wide range of speech abnormalities in addition to speech delay. If you notice your child repeating phrases without making new phrases, or struggling to start conversations, you should immediately speak to a speech-language pathologist (SLP).
Some of the other signs of autism spectrum disorder in children may include reversal of pronouns and regression of speech and language. Children on the spectrum may also have impaired social interactions and communication skills. They may exhibit repetitive behaviors (circumscribed interests).
It is common for SLPs to hear from parents of children with ASD that, “my 5 year old doesn't talk at all”. ASD currently has no cure.
An SLP can refer your child to a special developmental educator. Children on the autism spectrum may benefit from an early intervention that emphasizes increasing communication and boosting language skills.
Cerebral Palsy (CP)
Cerebral palsy (CP) may cause speech delay in children. In such cases, speech delay is typically due to the lack of coordination of the tongue and jaw muscles. Hearing loss and coexisting anomalies in the cerebral cortex may also contribute to speech delay in children with CP.
Speech-language pathologists (SLPs) can help a child with cerebral palsy by introducing alternative and augmentative communication systems. Your child may learn how to use speech synthesizers and symbol charts to communicate.
With extensive speech-language therapy, it may be possible for a child with cerebral palsy to improve their language and communication skills. Still, it may not be possible to improve their speech.
Childhood Apraxia of Speech
Childhood apraxia of speech is a lesser common disorder that affects a child's ability to make sounds in the correct order. Parents may have difficulty understanding the speech of a child with apraxia of speech.
Children who communicate via gestures, but show signs of speech delay, may be at risk of apraxia of speech. They have the motivation to communicate and the ability to understand spoken language.
While there have been several studies on the treatment and therapy of childhood apraxia of speech, there is limited evidence that supports speech improvement with extended therapy.
Dysarthria
Speech delay in children can also be a sign of dysarthria. It is a physical problem which manifests as speech difficulties that range from mild and moderate to severe.
A child with mild dysarthria may exhibit slurred speech and talk in a low-pitched voice. Profound dysarthria may be characterized by the complete inability to produce any words.
For some children with mild dysarthria, speech-language therapy can be instrumentally helpful. However, for severe dysarthria in children below 3-years of age, speech-language therapy may not improve speech and language skills significantly.
Hearing Loss
If children lose their ability to hear before they learn to speak, it may cause speech delay. If your child is showing signs of speech delay along with the tendency to not look at objects when you mention them or point at them, take them to an SLP immediately.
Children with hearing loss should see an audiologist. Sometimes, it is possible to restore hearing via minimally invasive surgical procedures. At other times, children may be able to hear and speak with the aid of a cochlear implant. Your child’s SLP and audiologist should be able to guide you towards the appropriate intervention strategy.
Research shows that early, family-based intervention can help your child catch up to their peers and promote communication skills.
Intellectual Disability
Delayed speech can also be a sign of intellectual disability in a child. In the case of intellectual disability, there may be a delay in the use of gestures and a generalized delay in reaching all developmental milestones.
Children with intellectual disabilities may show an overall deficit in comprehension.
An SLP can refer the child and their parents to a developmental educator. The child may require interdisciplinary evaluations such as audiology and speech-language therapy.
Selective Mutism
Children with selective mutism show the failure to speak in specific social situations. For example, a child can understand instructions perfectly and talk at home. Nonetheless, they may not speak in school at all.
Children with selective mutism need the attention of a speech-language pathologist as well as a therapist. A psychologist or behavioral therapist can help the child overcome the barriers that keep them from speaking in certain situations.
Research shows that a combined intervention consisting of speech therapy, cognitive behavioral therapy, family participation, and school involvement can help children with selective mutism.
The Take-Home Message
Speech delay in a child may be due to one or more of the factors mentioned above.
Some children who are younger than 3-years recover without the assistance of a professional. However, there is no way to tell which children will require the intervention of an SLP and which children will catch up to their peers on their own.
Therefore, if you notice the slightest signs of speech delay in your toddler, you should consult a speech-language pathologist (SLP). An SLP can test and evaluate the causes and extent of speech delay in a child.
