Speech And Language Development Delay In Children
Babbling and speech recognition are a few of the milestones we look forward to in toddlers. Is your child reaching these milestones as expected? Here is what you need to know about development delay.
By Team ParentCircle
Sashi still remembers the exact moment her child uttered his first word “mamma” when he was just nine months old. How delighted she was! Today she is standing outside the doctor’s office, with a file that says her three-year-old son possibly has a language delay. She is shocked, confused and terrified. But, she hasn’t lost hope. After all, her doctor has assured her that therapy will help.
Yes, you read it right. If your child’s ability to speak and understand language is slower than his peers, knowing what to expect and when to seek help is most important. Most delays can be corrected or reversed with therapy and care. The earlier you start, the better it is for your child.
Understanding language and speech
First, let’s understand the difference between ‘language’ and ‘speech’. ‘Language’ is about the use of words to express and understanding what is spoken. ‘Speech’ is more about the sounds, the articulation of words, the pace and the rhythm.
A child can have issues with either language or speech development, or both. Difficulty in reading and writing is often related to issues with language development. If you find your child’s speech or language lagging, as compared to his peers, the first step is to understand if it is a ‘delay’ or a ‘disorder’.
Language and speech delay
A child with a language and speech delay will develop necessary skills in the right sequence. However, he will be slower than his peers.
A child with a language delay might pronounce words well, but he may not be able to string a meaningful sentence together.
A child with a speech delay might know the use of words and phrases, and she may even express ideas. However, there may be a lack of clarity of words or sounds thus making it difficult for the listeners to understand her.
It can be due to an impairment in the tongue or palate (the roof of the mouth). It could also be due to a short frenulum (the fold beneath the tongue), which can limit tongue movement for speech production.
Language and speech disorder
A disorder is when the child’s development follows an unusual pattern or sequence. It will not be like that of his peers.
A child will be unable to understand what is spoken to her (receptive language disorder) or will be unable to express her thoughts in words (expressive language disorder).
In this case, a child will have difficulty in producing speech sounds correctly or fluently, or he may have voice problems. He may be stuttering, omitting or replacing some letters, or may have other difficulties in pronunciation.
How to spot
Early identification and medical intervention is the key to correct a delay or treat a disorder. Seek immediate medical help if your child:
- Consistently lags behind her peers in reaching milestones
- Doesn’t respond to sounds or says single words by one year of age
- Is having difficulty understanding commands, requests or expressing needs
- Doesn’t speak clearly by three years of age
- Is unable to form sentences or doesn’t tell stories
- Doesn’t understand the difference between ‘same’ and ‘different’ or ‘you’ and ‘me’ even at four years of age
- Has interrupted fluency in speech
- Repeats words when spoken to but is unable to use them in the right context
- Doesn’t use the singular, plural or tenses properly by five years of age
Sometimes, language delay is also accompanied by some unusual behaviour. Watch out, if your child:
- Doesn’t cuddle or smile back like other babies
- Is often in her own world
- Prefers to play alone
- Can say the letters of the alphabet, numbers or words but is not expressing his needs using words
- Doesn't seem to be afraid of anything
The above list of health watches is not exhaustive. As a parent, when you have a cue, trust your gut and act at once. Always, seek a second opinion for reassurance and guidance.
If you notice any abnormalities in your child’s speech and language development, speak to a speech-language pathologist at the earliest. Problems in hearing can also impact a child’s speech and language as a child learns to talk by listening.
Sometimes these delays can be an indication of other serious underlying conditions such as developmental delays in other areas, learning disabilities, autism spectrum disorder (ASD), neurological disorder, cerebral palsy or hearing impairment.
Most speech or language issues can be treated or cured with intensive therapy, the right treatment and/or surgical intervention. If your child is not treated early, he will have difficulty catching up even when treatment is provided later in his life.
What to expect during your doctor’s visit
Knowing what to expect can help you prepare for the appointment with a speech-language pathologist.
- To identify the issue, the doctor will assess your child by speaking to him and asking you some questions about your child’s behaviour and communication.
- If your doctor feels your child doesn’t need treatment and the issue will resolve on its own, he will reassure you. He will give some simple tips for you to work with your child at home to help her improve.
- Your doctor may also require your child to undergo a hearing test to assess his hearing ability. If your child can hear well but still has language and speech problems he may order further tests to identify the underlying cause.
- If there are other associated conditions such as a hearing problem, cleft lip, ASD or other developmental issues, the doctor will refer you to the specialist concerned for treatment, surgical intervention or additional therapy. In such cases, your doctor will advice you to take help from a multidisciplinary team that can include an occupational therapist, audiologist, physiotherapist and a psychologist.
What to expect in speech-language therapy
If your child has a delay, she may be advised to undergo speech or language therapy. Your speech-language pathologist will start with trying to improve your child’s vocabulary. He will:
- Help your child understand the meaning of words
- Encourage your child to practise verbal interactions
- Slowly introduce your child to common words
- Repeat words and use them in different sentences in an exaggerated manner to emphasise the words
Remember, the therapy is a long process and your cooperation is essential in making it successful. Speech-language therapy may usually extend anywhere between 30 minutes to one hour for a minimum period of six months. The fee begins at about Rs 200-300 per sitting. There are also several government-run centres that you can approach.
Speak to your child’s therapists about how you can help your child at home. You can:
- Involve your child in peer group interactions
- Avoid the use of gadgets as a distraction during your child’s mealtimes or when she is crying
- Interact with your child by speaking, reading and storytelling
- Respond to his sounds and gestures
Tip: Find an inclusive school and enrol her in a class, based on her ability and not based on her age. If not, peer pressure can create stress and lead to regression in your child’s development.
Government-run therapy centres in India
- All India Institute for Speech and Hearing, Mysuru
- Ali Yavar Jung Institute in Mumbai, Kolkata, Secunderabad
- National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru
- National Institute of Speech and Hearing, Trivandrum
- National Institute of Empowerment of People with Multiple Disabilities (NIEPMD), Chennai
- All India Institute of Physical Medicine and Rehabilitation, Mumbai
At the end of the day, adequate stimulation at home and the timely support of a speech-language pathologist can help your child improve his communication. Most importantly, remember to act early. Always keep track of your child’s overall development and speak to your doctor about it.
Expert inputs from Krishna Raj, an audiologist and speech-language pathologist.