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Parents can’t wait to hear their child’s first words. But sometimes, children don’t meet their developmental milestones, indicating they may have a speech delay.
If you’re worried about your child’s speech, seeking an evaluation and getting the appropriate help as early as possible is crucial. Our THINK Neurology for Kids team — Shaun S. Varghese, MD, Cristina R. Marchesano, MD, Lorena Herbert, MD, Barbara Kiersz-Mueller, DO, Lauren Weaver, MD, Alicia Walls, MD, Sundeep Mandava, MD, Patricia DeForest DO, Robby Korah, FNP-C, Jennifer E. Martin, CPNP-PC, Tammy DeLaGarza, FNP-C, and Heather King, CPNP-PC — is here to help.
We specialize in pediatric neurology, which is the underlying cause of many speech problems. Here, you'll learn about the types and causes of speech delays.
Speech delay explained
A speech delay means your child's ability to form sounds and words, and talk is developing slower than most children their age.
Speech is often linked with language (speech-language delay), but they're two different skills, and one can occur without the other.
Language involves your child's ability to convey information, using speech to communicate in a way others can understand.
Signs of a speech delay
Though every child develops at their own pace, they follow the same progression and general timeline. You can identify a possible problem by monitoring your child's developmental milestones. They may have a speech delay if they don't meet an expected milestone.
These are examples of the developmental milestones for speech. Your child should:
Birth to 3 months
Make cooing sounds, have different cries for varying needs, and start to recognize your voice.
4-6 months
Babble when playing and make speech-like sounds (but not words).
By 1 year
Say one or two words (usually mama or dada), but the sounds may not be clear to everyone. Babble strings of sounds like upup (to get picked up) or baba (for a bottle) and use sounds to get your attention.
By 15 months
Say one or two words beyond mama and dada, look at an object when you name it, and point to ask for something or get help.
By 18 months
Say three or more words (other than mama and dada) and follow one-step directions.
By 2 years
Put at least two words together, use more gestures (beyond waving and head nodding), and point to pictures in a book when you ask questions like, “Where is the dog?”
By 2 1/2 years
Can speak about 50 words and put two or more words together (“doggie runs” or “go bye-bye”)
By 3 years
Have a conversation with at least two back-and-forth exchanges and talk well enough for most people to understand. Ask “who,” “what,” “why,” and “where” questions.
By 4 years
Say sentences with four or more words, talk about something they did that day, repeat words from a story or song, and answer simple questions.
By 5 years
Use or recognize rhyming words, carry a conversation with three or more exchanges, and tell a simple story. For example, they may say, “The dog ran away, and Daddy found him.
Causes
Sometimes, a speech delay is just that: a delay. With support from parents and speech-language professionals, your child will catch up and move forward without ongoing speech problems.
However, a speech delay may signal an underlying problem, such as:
Speech-language disorders
Speech-language disorders often occur when there’s a problem in the brain area controlling the tongue, lip, and jaw muscles needed for speech.
There are several speech-related disorders, including:
- Apraxia of speech (the brain doesn’t communicate with muscles)
- Dysarthria (weak speech muscles)
- Orofacial myofunctional disorders (unusual muscle movement)
- Speech sound disorders (difficulty making the appropriate sounds)
- Aphasia (difficulty explaining thoughts or understanding others)
- Stuttering (may be due to a neurological condition)
Voice disorders can also cause speech delays. These conditions develop when there is a problem with the vocal folds (cords).
Developmental disabilities and neurological conditions
A speech delay may be a symptom of a developmental disability or neurological condition, such as:
- Autism spectrum disorder (ASD)
- Attention-deficit/hyperactivity disorder (ADHD)
- Intellectual disability
- Rett syndrome
- Hearing disorders
- Cerebral palsy
- Traumatic brain injury (TBI)
- Right hemisphere disorder (TBI or tumor affects the right side of the brain)
- Central auditory processing disorder (the brain doesn’t recognize or interpret sounds)
How pediatric neurologists can help
With only a few exceptions, the speech delay causes listed above arise from neurological conditions. Our expertise in pediatric neurology is required to get to the source of the problem and create the best treatment plan.
Call THINK Neurology for Kids if you have questions about your child's speech or need to schedule an appointment. We have offices in The Woodlands, Katy, Sugar Land, Austin, San Antonio, and Gulf Coast, Texas