Speech is the motor act of communicating by articulating verbal expression, whereas language is the knowledge of a symbol system used for interpersonal communication.
In general, a child is considered to have speech delay if the child’s speech development is significantly below the norm for children of the same age.
A child with speech delay has speech development that is typical of a normally developing child of a younger chronologic age; the speech-delayed child’s skills are acquired in a normal sequence, but at a slower-than-normal rate.
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To determine whether a child has speech delay, the physician must have a basic knowledge of speech milestones.
Normal speech progresses through the following stages:
- echolalia (repeating words immediately after hearing it from another person),
- jargon words (words that are nonsense),
- word combinations, and
- sentence formation.
These stages are all completely normal and is the process children go through on their way to communicating effectively.
Speech delay is a common childhood problem that affects 3 to 10 percent of children (aafp.com).
The disorder is three to four times more common in boys than in girls (aafp.com).
Speech Delay and Other Disorders
|Birth to 3 months||4 to 6 months||7 to 12 months||1 to 2 years||2 to 3 years|
|Reacts to loud sounds with a startled reflex||Looks or turns toward a new or familiar sound||By the age of 1 your child should have around 3 words or so||By the age of 2 your child should have about 50 words||Between 2-3 years your child should have about 200 or so words|
|Soft sounds will often soothe and quiet||Responds to “no” command and changes in your voice||Knows words for common things such as, “cup” and saying such as, “bye-bye”||Uses 2 to 3 word sentences to talk about and ask for things||Can understand and respond to requests like “bedtime” and “dinner-time”|
|Will turn head towards the sound being heard||Will try to imitate his or her own voice||Makes babbling and jibberish sounds, even when alone||As each week and month passes more words are added to the vocabulary||Can name common and familiar objects , actions and concepts|
|Is awakened by loud voices and sounds||Enjoys toys and objects that make sounds||Starts to respond to requests such as “come here”||Can understand simple yes/no questions like “Do you want to play”||Will try to use words to express emotion like “happy” or “sad”|
|Smiles in response to certain voices when spoken to||Becomes scared when a loud voice or noise is heard||Enjoys games like peek-a-boo and nursery rhymes like Itsy-bitsy||Can understand commands like “stop” and “no more”||Uses two or three words to talk about and ask for things|
|Seems to know your voice and will quiet down if crying||Will start making sounds such as, “ooh,” “aah,” and “b” sounds||Imitates simple words and sounds; may use a few single words meaningfully||Will follow 2-step commands like, “clean-up” or “come here”||By 3 years of age, your child should be understood by an unfamiliar adult about 75% of the time|
Although it’s not always the case, speech delay can be seen in association with other disorders.
Again, this doesn’t happen all of the time. I’ve had children on my caseload that were just speech delayed and, with appropriate and consistent therapy, were on target with their peers by age 5.
The other disorders that are commonly seen with speech delay
- Hearing loss (severity will range depending on when assistance for the hearing loss was received)
- Maturation delay – developmental language delay
- Psychosocial deprivation – not spending enough time/poor quality of time with adults, or physical deprivation (e.g., lack of food, poor housing)
- Cerebral Palsy
- Family history
Many times parents hear the same old: “Don’t worry, he/she is just a late bloomer, he/she will catch up on her own!” Check here to clarify the difference between late talker and speech delay.
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