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Speech Delays

As many as 10% of children experience a speech delay, according to the American Academy of Family Physicians. Children develop on their own timeframe -- but if you notice your child is not speaking as much as most kids his age, he could have a speech delay.

Top 8 Causes of Speech Delays, from the American Academy of Family Physicians

Most Common Causes:

  1. Hearing loss
  2. Slow development
  3. Mental retardation

Other causes:

  1. Psychosocial deprivation (the child doesn't spend enough time speaking with adults)
  2. Being a twin
  3. Autism
  4. Elective mutism (the child just does not want to speak)
  5. Cerebral palsy

Contact your doctor if you believe your child is not talking at the level of his age group, or if you have concerns about his development, advises the Mayo Clinic. The doctor may refer your child to a hearing specialist or a speech and language specialist.


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What Moms Can Do about Speech Delays

Pediatrician Dr. Cara Natterson provides moms with advice about speech delays occurring in babies and toddlers:

Birth-12 months: Babies don't speak in words. But they have a lot to say. In fact, new parents often remark about how surprisingly noisy their babies can be. Babies should coo from early on; cries take on different intensities and pitches depending upon what a baby needs. It is worrisome when a child is silent -- this can be a sign of hearing loss. It takes several months (up to 4 or even 5) for a baby to be able to tell where a sound is coming from.

If a 5- to 6-month-old cannot localize a sound, this too may be a sign of hearing loss. There are many parents who claim their children have large vocabularies -- even speak in sentences -- before their first birthday. But this is very subjective. Most babies have non-specific words (like "mama" and "dada," which don't necessarily refer to their mom or dad) by one year; some certainly have a few clear and consistent words that a stranger can discern, but if your child doesn't, there is no need to panic.

12-24 months: This is the time for real vocabulary explosion. At one year, most children can understand what their parents are trying to say but they cannot speak in response; by two years, they have up to 50 or 60 words in their vocabulary (some even more) and they can usually put two words together. Children who don't have a large volume of words by 2 years can become increasingly frustrated: they know what they want but they cannot say it. Some children are diagnosed with a speech delay at this point. But as it turns out, many don't have a true speech delay; rather, they lack the necessity to speak. I have taken care of many children whose parents, caretakers, and siblings wait on them hand and foot, anticipating every grunt and gesture.

These kids don't need to acquire words because they can get everything they need without them. I have also taken care of many highly-independent children who get what they need themselves -- for instance, they will walk to the fridge, open it, and help themselves to food at a year and a half. Some of these children also have smaller vocabularies because they can do for themselves and they don't need to use their words. Regardless, if you are concerned that your child has delayed speech, this is an appropriate age window in which to bring it up with your pediatrician.

2-3 years: The vocabulary multiplies rapidly over this time and children become highly verbal. The typical 3-year-old questions everything ("But why? Why mommy?"). Speech delays in this age range tend to be more obvious to parents and when they are not, schoolteachers or daycare providers will often point them out.

4-5 years: The focus in this age group moves away from speech delay (because it has almost always been identified well before age 4) and toward articulation instead. Parents worry about lisps and mispronunciations. We all know that young children vocalize differently than we do, but you should ask your doctor and your child's teacher about specific articulation issues if you are concerned.

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Additional Resources for Speech Delays