As with other developmental milestones and abilities, the age at which children learn language and begin to speak can vary. Knowing a few things about speech and language development can help parents know whether or not they should be concerned.

Signs of a speech or language delay

A baby who does not react to sound or who does not vocalize should be evaluated by a doctor as soon as possible. But it is often difficult for parents to know if their child is just taking longer to reach an developmental milestone in speech or language development or if he or she has a problem.

  • at 12 months : does not use gestures, such as pointing or waving
  • to 18 months : he prefers to communicate with gestures rather than vocalizations
  • 18 months: has difficulty imitating sounds
  • has difficulty understanding simple verbal commands
  • at 2 years : only imitates the speech or actions of others but does not generate words or phrases spontaneously
  • 2-year-olds: only makes some sounds or words repeatedly and cannot use spoken language to communicate more than immediate needs
  • 2 years old: cannot follow simple instructions
  • 2 years old: has a strange tone of voice or strange pronunciation (such as hoarseness or nasalness)
  • Parents and regular caregivers of the child should understand about 50% of what a 2-year-old says and about 75% of what a 3-year-old says.

Causes of speech or language delays

A speech delay in a child can be due to:

  • oral problems, such as changes in the tongue or palate
  • a short frenulum (the crease under the tongue), which can limit tongue movements

These occur when there is a problem in the areas of the brain responsible for the production of speech. This makes it difficult for the child to coordinate lips, tongue, and jaw to make speech sounds. These children may have other oral-motor problems, such as feeding difficulties.