A Comprehensive Guide to Child Speech Delays: What You Should Know

Childhood development is a tricky subject, with every child developing at different paces in different ways. There are, however, some commonalities across development and key milestones that have been proposed to track the development of speech in children.  

What Are Speech Delays?

Children typically learn language independently, but there are benchmarks for speech development. A speech delay is when a child does not meet these benchmarks, like saying their first words somewhere between 12 and 18 months or constructing simple sentences at age 3. Delays can be split into three main categories: articulation (how well they speak), expressive language (being able to express thoughts), or receptive language (understanding spoken words). 

Causes range from hearing impairments, developmental disorders like autism, or purely environmental causes like limited language exposure. Some children recover on their own, but persistent delays usually require varying forms of intervention. 

Looking out for problems from an early age can make all the difference, since speech delay can impact social, emotional, and academic development. If you notice your child having difficulty communicating, a visit from a pediatrician or speech-language pathologist can help you determine the next step to take with confidence. 

Normal Developmental Milestones

We have looked at what a delay looks like, but to understand deviations from the norm, one must accept at least normative milestones for comparison. So, here are the key speech milestones based on research:

6 months 

Babbling with consonant-vowel sounds like “ba, ba.”

12 months

Saying first words, like "mama" or "dada." 

18 months

Uses 10-20 words and starts combining words (e.g., "more juice"). 

2 years

Speaks in two-word phrases and has a vocabulary of 200-300 words. 

3 years

Forms simple sentences (e.g., "I want ball") and is understood by family. 

4 years

Uses longer sentences (4-5 words) and is mostly clear to strangers.

 5 years 

Speaks in complex sentences and tells simple stories.

Causes of Speech Delays

Exact causes of speech delays vary, but there are a few common culprits to look out for: 

1. Hearing Problems

A toddler or child who struggles to hear, or can’t hear clearly, will likely struggle to understand and therefore respond to others. Children who suffer from hearing problems will often become frustrated as they begin to see and understand that other children are able to communicate their needs while they are not. 

Common signs of hearing loss include frustration communicating even when there is background noise, unclear speech, difficulty following conversation, and failing to acknowledge people approaching them.

2. Developmental and Language Disorders

Several developmental disorders can affect speech and cause delays. Autism spectrum disorder (ASD) often affects speech development. Children with ASD will typically struggle to match speech to context and produce fluent speech at the same milestones. ASD is seldom diagnosed in children under 2.

The current diagnostic manual for mental disorders (DSM-5) includes ‘global developmental delay’, which describes children under 5 who show developmental delays in more than two areas, including speech. While it is only a placeholder diagnosis, paying attention to key areas where problems are apparent can help to get kids back on track. 

The DSM-5 also includes language disorder, speech sound disorder, and social communication disorder. Most of these disorders have overlapping symptoms and can be complex to diagnose; very few children under 4 or 5 are or will be diagnosed, hence why it is so important to see an appropriate specialist. 

3. Oral-Motor Issues

Oral-Motor Issues arise from problems controlling the muscles of the jaw, lips, and tongue, making talking and eating difficult. In children, these issues can cause speech delays. Childhood apraxia of speech, a neurological disorder, disrupts motor planning, leading to inconsistent or unclear speech despite knowing words. 

Dysarthria, caused by muscle weakness from conditions like cerebral palsy, results in slurred or breathy speech. Both impair clear communication, with apraxia more common in developmental delays and dysarthria tied to physical limitations. Early speech therapy is essential to improve skills and support developmental progress.

4. Environmental Factors

There are a whole host of environmental factors that can cause or exacerbate speech development and cause delays. Reduced interaction with other children can make it harder for children to learn social cues and pick up novel language. A lack of language stimulation can make it equally hard for children to learn how to speak. A stressful home environment can make it equally difficult for children to focus on speech.

Diagnosing Speech Delays

Generally, concerned parents will seek help from their family doctor or mention any concerns during checkups. Family doctors, especially pediatricians, are well trained in the development of speech. However, some speech delays are better addressed by speech language pathologists. Luckily, there are plenty of specialists with the requisite qualifications and key skills, like those attained via online SLP programs, who can effectively diagnose and treat children. 

Progress in Treatment 

Speech delays are complex and often hard to distinguish from normal developmental challenges. However, the earlier treatment starts, the more effective it is likely to be. Research shows that 7.7% of U.S. children ages 3-17 have a voice, speech, language, or swallowing disorder, but only 55.2% receive intervention services. Boys (59.4%) and White children (60.1%) are more likely to receive help than girls (47.8%) or Black (45.8%) and Hispanic (47.3%) children, highlighting disparities in care and different racial attitudes towards childhood development.

Treatment for speech delays varies depending on the specific issue, but speech-language pathologists are well-equipped and highly capable of treating anything from apraxia to stuttering, ASD, and much more. 

Overcoming Delays 

The bottom line is that most speech delays are manageable, sometimes they are symptomatic of a larger underlying problem, and other times they are simply part of a child's development. Delays in speaking can be managed with care and understanding. 

**Please note this article should not serve as medical advice; if you suspect your child or a child you care for may have a speech delay, contact one of the many health helplines, your family doctor, or a speech-language specialist.