Helping Your Child With Speech Delay

As the parent of a young child, you’re always on the lookout for milestones related to crawling, walking and speech. While it’s important to keep an eye on all of these, speech and language delays are some of the most common developmental delays. If you think your child might have a speech delay, it’s important to seek treatment so they can gain these foundational communication skills. At ENT for Children, our team can determine if your child is experiencing a speech or language delay and provide the best treatment for their needs. 

Speech Development

Speech delay, as the name suggests, occurs when your child takes longer than usual to start talking. Parents, caregivers, and doctors will monitor your child’s speech milestones as they develop. When a child misses these milestones, it is important to be aware of the signs or symptoms of hearing-related speech delay. The symptoms differ depending on the child’s age.

By 12 Months

Babbling and cooing mark the earliest stages of speech development. During this phase, children start using their voice to respond to their environment. Babies should be able to recognize the names of common objects like “ball.” Children with hearing loss at this age may show the following signs:

• Doesn’t use gestures like shaking the head, pointing or waving
• Doesn’t babble to talk
• Doesn’t attempt to pronounce consonants like “b” or “p”
• Doesn’t respond to words such as “no.”

15-19 Months

As children grow, their vocabulary should expand. Your child should be able to mimic sounds and words. Symptoms that suggest hearing loss at this age include:

• Doesn’t point to what they want
• Doesn’t point to at least one part of the body when asked
• Doesn’t have a rapidly growing vocabulary. Children this age should be able to learn at least one word per week.

18 to 24 Months

Most toddlers should be able to say 50 or more words by the time they turn two. Although the number may vary in some cases, children at this age should still be able to combine two words together, like “baby crying.” A two-year-old should also be capable of identifying common objects. Children who suffer from hearing loss at this age may exhibit the following signs:

• Doesn’t imitate words modeled by you or family members
• Doesn’t respond to simple directions
• Doesn’t imitate actions
• Can’t join two words together
• Cannot point and identify images in picture books
• Doesn’t know how simple household items like a toothbrush or a spoon work

3 to 4 Years

Your child should be able to combine two to three words into sentences frequently at this age. Often, children experience a burst in their vocabulary at this age. A three-year-old should also be able to comprehend certain commands. For example, he/she should know what commands like “Put this on the table” or “lie on the bed” mean. Symptoms that are indicative of hearing loss at this age are as follows:

• Cannot understand short instructions
• Cannot speak short phrases
• Unclear speech
• Does not want to interact with other children
• Does not want to detach from the parent
• Stutters frequently

At 4 Years

• Does not understand the concept of “different” and “same”
• Cannot use pronouns like “you” and “me” properly
• Hasn’t mastered most single consonants.

Language Development

Speech involves the verbal expression of language or articulation (how words are formed), while language refers to a broader form of communication. Children with hearing loss may struggle with practicing one or both. For example, a child with hearing loss might be able to articulate single words but may not be able to combine two or more words into a sentence.

On the other hand, some children with hearing loss may be able to use words to share ideas, but their speech could be slurred or difficult to understand. Similarly, a child with hearing loss might speak clearly but still have trouble following directions.

Hearing loss is most often associated with delays in speech and language development in children. ENT for Children might recommend screening tests for a child showing signs of speech delay that could be caused by hearing impairment. These are useful speech and language development milestones for your child to achieve.

At 18 months

• Uses 10 to 20 different words
• Starts to combine 2 words, such a “all gone,” “daddy bye-bye”
• Uses words to make wants known, such as “more,” “up”
• Points to own toes, eyes, and nose
• Brings a familiar object from another room when asked
• Knows and says the names of 5 things
• Mixes real words with jargon, on occasion

At 2 years

• Has a vocabulary of around 200 words for speaking
• Understands simple questions and commands. Identifies body parts
• Uses mainly the names of things, actions, people, and situations in their language
• Sentence length consists of 2 to 3 words
• Asks “what’s this?” “what’s that?” and “where’s my …?”
• Refers to self by name.
• Listens to stories and points to pictures when asked.
• Asks for a drink, toilet or food

At 2½ years

• Uses about 450 words
• Gives first name
• Uses past tense and plurals and combines nouns and verbs
• Refers to self as “me” rather than by name
• Uses “no” or “not” in speech and may say “no” when he or she means “yes”
• Answers “where” questions
• Uses short sentences to announce what he or she has done or will like (for example, “me do it,” or “me want to jump”)

How Are Speech Delays Treated? 

Our speech therapist will work with your child to develop a customized treatment plan that will improve their language skills. Specific activities will depend on your child’s age and individual needs, but the goal is to enable them to better understand spoken words and encourage them to respond verbally.  

As your child’s primary caregiver, you’re an important part of their support team, and our provider will share ways to encourage them to speak with you. No matter the cause and extent of your child’s speech delay, we’re here to work with your family. 

How Can my child Support My Child? 

Many parents ask how they can best support their child’s speech and language development. The best answer to this question may be “READING.” Reading for a child’s enjoyment should include 2-3 books every night. One of these books should ideally be the same exact book each night. Repeating the same book nightly over several years helps the child know the book by memory by around 3 to 3½ years old. This can make it seem like your child knows how to read, but in reality, they are reciting the words from memory at the correct page.

This repetition is a valuable tool for your child’s speech and language development. Some examples of common books used for this repetitive activity include: “The Little Engine That Could,” “Green Eggs and Ham,” “Ten Apples Up On Top,” “The Little Gorilla” and more.