Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 1999;59(11):3135

See related article on the child with speech delay.

How do I know if my child has speech delay?

If your child doesn't talk as much as most children of the same age, the problem may be speech delay. Your doctor may think your child has speech delay if he or she isn't able to do these things:

  • Babble by 12 to 15 months of age

  • Understand simple words (like “no,” or “stop”) by 18 months of age

  • Talk in short sentences by three years of age

  • Tell a simple story at four to five years of age

What causes speech delay?

These are the most common causes of speech delay:

  • Hearing loss

  • Slow development

  • Mental retardation

Other causes include:

  • Bilingualism (two languages are spoken in the child's home)

  • Psychosocial deprivation (the child doesn't spend enough time talking with adults)

  • Being a twin

  • Autism (a kind of brain problem)

  • Elective mutism (the child just doesn't want to talk)

  • Cerebral palsy (a movement disorder caused by brain damage)

What can my doctor do to find out if speech delay is the problem?

Your doctor can listen to your child's speech and check your child's mental development. Your child should also have a hearing test, just in case your child is having trouble hearing.

What can be done if my child has speech delay?

Your child may not need any treatment. Some children just take more time to start talking. The way your doctor might treat your child depends on the cause of the speech delay. Your doctor will tell you the cause of your child's problem and explain any treatments that might fix the problem or make it better. A speech and language pathologist might be helpful in making treatment plans. This person can also show you how to help your child talk more and speak better.

Other health care workers who may be able to help you and your child include: an audiologist (a hearing doctor), a psychologist (a specialist in behavior problems), an occupational therapist (who might teach your child how to listen or how to lip read) and a social worker (who can help with family problems). Your family doctor will refer you to these health care workers if your child needs their help.

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