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Speech Delay vs Language Delay

A child speaking on toy telephone


Speech and language delay are often determined based on the set developmental milestones for every age group based on the average age at which the 95% of the children attain those milestones. Having knowledge regarding these milestones can be quite helpful for parents, as it provides a better idea as to when they should consult a speech therapist if they suspect any speech or language delay in their child.


What is the difference between speech and language? 


Speech is the verbal expression of language and includes articulation (the way we form sounds and words). It is the actual process of making sounds using various organs like lungs, vocal cords, mouth, tongue, teeth, etc.


Language is giving and getting information. It's understanding and being understood through communication- verbal, nonverbal, and written.


What are speech and language delay?


Even though speech and language are often used interchangeably in routine conversation when referring to any delay in this domain, they are quite different.


Speech delay- also known as alalia, refers to a delay in the development or use of the mechanisms that produce speech. A child with speech may use words to express himself, but it may be difficult to understand them.


Language delay- refers to delay in the development or use of the knowledge of language. The child may pronounce the words correctly, but it would be difficult for them to form sentences.


Signs and symptoms of speech and language delay


Even though it can be quite worrisome for the parents if their child is unable to communicate as effectively as his/ her peers, parents often delay consulting a specialist hoping that their child will eventually catch up. Speech milestones can be quite helpful when a parent suspects their child to have speech delay.


Few speech and language milestones as per various age groups have been mentioned below.


A baby who doesn't respond to sound or vocalize should be immediately assessed.


At 12 months-

  • Should be using gestures like pointing or waving bye-bye.

  • Should be able to communicate their needs.


At 15 to 18 months-

  • The child prefers gestures over vocalizations.

  • Should be able to identify body parts.

  • Should be able to imitate sounds.

  • Should be able to understand simple verbal requests like, no, bye, hello, etc


By 2 years-

  • Should form 2 or 3 words long sentences.

  • Should use words and oral communication to express themselves, rather than just relying on gestures.

  • Should be able to identify immediate family members.

  • Should be able to follow simple directions


You should also refer to a specialist if your child's speech is difficult to understand.

  • Parents and caregivers should be able to understand 50% speech of a 2 year old child and 75% speech of a 3 year old.

  • For a 4 year old most of the speech should be understandable by a stranger too.



Cause of speech and language delay


Hearing Loss- It is well understood that, in order to learn something we need to observe someone doing the task. Hence if the child can't hear you, how will he develop speech? Speech delay is quite common in long term ear infections.


Developmental anomalies- Congenital malformations like cleft lip, cleft palate, short frenulum, and weak palatopharyngeal muscles.


Mental retardation- Mental retardation accounts for about 50% of cases of speech delay in children.


Developmental language delay/ maturation delay- It is due to delayed neurological development required for speech.


Psychosocial deprivation- The immediate environment around the child is very important for the development of speech. The child who is facing abuse or neglect often lags behind in the development of speech.


Autism- It is a neurological developmental disorder in which the child has difficulty in development in certain domains, i.e, social interaction, behavior, and learning.



Treatment of speech and language delay


If you suspect speech delay in your child you should consult a Speech-Language Pathologist (SLP). They are experts in communication. Your pediatrician can also give you a referral to see a speech therapist.


Speech therapy is quite effective for speech delay. The speech-language pathologist helps your child in learning how to use gestures to help them communicate better. They help the child formulate words, phrases, and sentences helping him to speak and read more clearly. In speech therapy sessions parents learn the activities and strategies to use at home to support their child’s speech and language development. Speech-language pathologists not only target attention, sitting, comprehension, and expression goals but also play, social communication, memory, and reasoning skills.




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