Speech Delay In Children

Speech and language development is one of the most important milestones of a child, but it’s also one of the commonest developmental delays seen in our practice. Unfortunately, many children with speech delay presented late to us as parents may not be aware of the delay. 

What is speech delay?

Speech and Language delays include problems understanding what is heard or read (receptive language delays) or problems putting words together to form meaning (expressive language delays). Children with speech delay may face challenges developing communication skills and expressing themselves clearly.

What causes speech delay?

Several causes of speech and language delay include hearing loss, cleft palate, vocal cord problem, learning disabilities, autism spectrum disorder or cerebral palsy, etc. However, regardless of the cause, early detection of speech delay and establishment of a diagnosis should be the priority in order to support your child's future language skills.

How to identify speech delay?

Here are some guidance on the normal development of speech and language according to the child's age:

• Birth to 5 Months
  A baby starts to produce sound with vowels ‘A,E,I,O,U’ around 3 months of age, which is also known as ‘coo-ing’.
• 6 to 12 Months
  Infants start to babble, by adding consonants ‘B, P, D, T, M, N’ to the vowels to form single syllable words such as Ba, Ma, Da, Ta. This is the reason why mother is referred as ‘Mama, mummy’ and father is often called ‘dada, papa, daddy’. This is because infants learn to use the consonant M, B, D, P before other consonants. Around 8-10 months, your baby should be able to say repetitive bi-syllable words such as ‘baba, mama, dada, tata’.
• 12 to 18 Months
  By 12 months, your toddler should be able to label a person or object with certain words meaningfully. For example, ‘Mama’ refers to mother, and ‘papa’ refers to father. Their vocabulary will start to expand to 5-10 words during this period. Simple syllable words will be easily memorised such as ‘Car, Cat, Ball’.
• 18 to 24 Months
  Approaching the age of two, your child attempts to form two-word phrases, although they won’t be grammatically correct (“eat no”, “want I”). They may also repeat words that they hear, which is known as echolalia. At this time, their vocabulary may expand up to 50 words. They may also start to learn about basic body parts.
• 2 to 3 Years
  This is an exciting period as your child’s vocabulary will increase by leaps and bounds. Their vocabulary grows to 200 or more words during this time. They will also begin to identify colors, shapes, and concepts. They will start to refer to themselves by name, ‘eg. Alisha nak susu’. After 2.5 years old, they may understand the concept of pronouns such as ‘I, me, you, he/she’. Their speech is becoming more accurate, but may still leave off ending sounds. Strangers may not be able to understand much of what is said. Besides that, they may begin to use question words like ‘what’. They will also likely sing along the nursery rhymes and songs, but with incomplete phrases.

Speech Delay Symptoms

Below are some important red flags for a speech and language concerns which requires urgent attention:

• No babbling by 9 months.
• No first words by 15 months.
• No consistent words by 18 months.
• No word combinations by 24 months.
• Slowed or stagnant speech development.
• Problems understanding your child's speech at 24 months of age;
• Strangers having problems understanding your child's speech by 36 months of age.
• Not showing an interest in communicating, or using spoken language.

For families navigating these challenges, it is crucial to seek support and treat speech delay early. Consulting a speech therapist can help ensure your child's development stays on track, as professionals plan effective interventions for supporting child's development.

This article was contributed by Dr Goh Chun Hwee, Consultant Paediatrician at Pantai Hospital Ampang. To know more about where and when to see Dr Goh Chun Hwee at his clinic, click here.