May 18, 2022

Speech and Language Delays – What Causes Them and How Can Speech Language Therapy Help?

Does your child need speech language therapy? 

Key takeaways:

  • Speech and language delays can be a result of developmental delays/disorders, Autism spectrum disorder (ASD), and hearing loss/deafness.
  • Children with cognitive delays comprise 50% of those with speech-language delays.
  • Speech language therapy helps build language skills and comprehension.
  • Speech therapy can also address mechanical issues like pronunciation, articulation, fluency, and volume.
  • Sessions include fun treatment activities that improve speech intelligibility, build comprehension, word retrieval, expressive language, and conversational skills.

You’re not alone if you’ve ever wondered if your child’s speech and/or language is developing on track. Speech and language delays are surprisingly common, with an estimated one in five children experiencing a speech or language delay. While some delays can be typical (some kids don’t start consistently saying words until they’re around two years old), you should be aware of the signs and symptoms of an actual delay.

Let’s discuss the most common causes of speech/language delays, signs that there may be an issue, and how speech language therapy can help.

Speech milestones: Birth to three years old

All children learn to communicate at different rates, but there are developmental speech and language milestones you can expect. Here are some typical milestones for children from birth to three years of age.

Birth to three months:

  • Seems to recognize your voice
  • Quiets or smiles when you talk
  • Coos and gurgles

Three to six months:

  • Responds to changes in your tone of voice
  • Pays attention to music
  • Makes speech-like babbling sounds (pa, ma, ba)
  • Maintains eye contact

Six to nine months:

  • Smiles and laughs during games
  • Looks when you point
  • Turns when you call their name
  • Understands family member names
  • Says simple duplicated babbles (dada, mama, bababa)
  • Recognizes tones and emotions like anger, sadness, or happiness

9 to 12 months:

  • Waves “hi” and “bye”
  • Understands simple words
  • Looks at you when you talk
  • Looks at familiar objects and people when mentioned
  • Starts using some single words meaningfully

One to two years:

  • Follows simple directions
  • Points to a few body parts upon request
  • Responds to simple questions
  • Points to pictures in a book when named
  • Using a lot of new words
  • Starts naming pictures in books
  • Puts two words together like “more apple” and “mommy book”

Two to three years:

  • Understands opposites like go-stop, big-little, up-down
  • Follows two-part directions
  • Understands new words quickly
  • Uses over 50 different words
  • Uses two and three-word phrases
  • Lets you know their toileting needs
  • Talks about things not in the room

Signs of speech-language delays

If your child has reached age three without achieving these milestones, it doesn’t automatically mean there is something wrong but it may be time to speak to their pediatrician and seek out a speech-language pathologist for an evaluation as these could be signs of an underlying issue. Signs of speech-language delays include:

  • Not responding when you call their name (7 months – 1 year)
  • Makes only a few sounds, not using gestures like waving or pointing (7-12 months)
  • Does not understand what others say (7 months – 2 years)
  • Says only a few words (12-18 months)
  • Does not put words together to make sentences (1.5 – 3 years)
  • Says fewer than 50 words (2 years)
  • Has difficulty playing and talking with other kids (2-3 years)
  • Has a lot of trouble saying sounds or words, stretches sounds out (like ‘ffffffarm’) or pauses a lot while talking (2.5 – 3 years)

Now, let’s look at common causes of speech-language delays.

Autism spectrum disorder (ASD)

ASD is a neurodevelopmental disorder characterized by deficits/difficulties in social communication, social interaction, and the presence of restricted, repetitive behaviors. While ASD can be diagnosed as early as 18 months, many children don’t get diagnosed until they’re older or have started pre-school.

Speech and language delays are one of the many challenges facing children with ASD. They often have trouble relating to and communicating with others, making it harder for them to develop language and functional communication skills.

Deafness or hearing loss

About 2-3 out of 1,000 children are born with hearing loss in one or both ears. Genetics or infections during pregnancy may lead to congenital hearing loss or deafness.

Babies and young children may also suffer hearing loss due to injury, infection, or illness, such as jaundice, temporary loss of oxygen, measles, mumps, meningitis, or a perforated eardrum.

Hearing loss can make it difficult for children both to understand and to use spoken language correctly. Two common types of hearing loss are conductive and sensorineural.

Conductive hearing loss: Sounds don’t pass through the outer and middle ear, making it hard to hear soft sounds. This type of hearing loss can have benign causes, including:

  • Fluid in the middle ear from colds or allergies
  • Ear infections
  • Earwax
  • Object stuck in the ear

There may also be a structural issue with how the middle and outer ear is formed.

Sensorineural hearing loss: This hearing loss occurs from inner ear damage. It can involve damage to nerve pathways and can lead to permanent hearing loss.

If you think your child may have a hearing problem, it’s crucial to have them tested by a qualified audiologist.

Some signs of hearing loss include:

  • Inability to hear faint sounds
  • Doesn’t respond to sounds or naming being called
  • Not following simple directions
  • Language/speech delays
  • Unclear speech

Intellectual disability

Children with an intellectual disability, Down syndrome, cerebral palsy, ADHD, or fetal alcohol spectrum disorder make up many cases of language delays. They may have delayed receptive language comprehension as well as expressive delays such as using gestures. The degree of delay usually depends on the severity of diagnosis.

Developmental language delay

Developmental language delay is one of the most common causes of speech and language delay.  Separate from cognitive skills and intelligence, these children present with a delay in their receptive language, expressive language, or a combination of receptive and expressive language skills.  While some children do “grow out of it,” early intervention is imperative to decrease persisting levels of delay and potential future disorders related to academic skills including reading, writing, communication, and beyond.

A note on selective mutism

Selective mutism is a childhood anxiety disorder that causes a person to be unable to speak in certain social situations. For example, some children may only speak at home with familiar family members but remain silent at school, in other social situations, or with strangers. It’s more common in girls than boys. Selective mutism is not a reflection of language skills and early intervention and treatment is key to remediation.

A note on bilingualism

Research shows us that bilingual children’s language development is not negatively impacted by exposure to more than one language.  At some times, these kids may know one language better than the other, mix grammar rules, or go through a “silent period” lasting several months when they start using a new language which is typical and does go away.  If you notice difficulty in use of both (or all) languages, it may be time to connect with a speech-language pathologist.

How speech language therapy at Lumiere Children’s Therapy can help

Speech language therapy can help build communication skills and the ability to understand spoken words. Therapy additionally addresses the mechanics of spoken language, including pronunciation, articulation, fluency, and volume.

Some children may need support in one specific area such as building receptive and expressive language skills while others need support targeting their speech intelligibility, fluency, or voicing, and some other even related to feeding/swallowing. Others may benefit from support across all domains of speech, language, communication, and swallowing.

Our credentialed, ASHA-certified speech language pathologists address difficulties with receptive and expressive language, articulation, phonology, motor planning, and much more in a warm, supportive, playful environment.

Lumiere Children’s Therapy is a full-service, multidisciplinary pediatric therapy practice located in Chicago that serves the developmental needs of children from birth to 18 years of age. Learn more about how our team of clinicians works to improve the lives of children and their families.

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