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Am Fam Physician. 2011;83(10):1195

See related article on speech and language delay.

What is speech delay?

Speech delay can cause your child to have problems saying words and phrases, understanding what is being said, or putting feelings, thoughts, and ideas into words.

Every child develops at his or her own pace, but if your child doesn't talk as much as other children 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:

  • Use at least three words by 15 months of age

  • Follow one-step directions by 18 months of age

  • Point to pictures or body parts when they are named by two years of age

  • Use original two-word phrases by two and a half years of age

  • Follow two-step directions by three years of age

What causes it?

Common causes of speech delay include slow development, hearing loss, or intellectual disability. Other causes include:

  • Cerebral palsy (seh-REH-bral PAWL-zee; a movement disorder caused by brain damage)

  • Apraxia (uh-PRAK-see-uh) of speech (trouble making sounds in the right order)

  • Dysarthria (diss-AR-three-uh; problems with the muscles used for speech)

  • Selective mutism (not talking in certain settings)

  • Autism (a developmental disorder)

Will it affect my child if we speak two languages at home?

Your child might mix up the two languages when first learning to talk, but this is normal. By five years of age, your child will probably be able to speak both languages well.

How will my doctor know if my child has speech delay?

Your doctor will evaluate your child's speech and mental and physical development. He or she may also test your child for hearing problems.

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. Your doctor might refer your child to a speech therapist to help him or her learn to understand and speak better. A speech therapist can also teach you new ways to encourage your child.

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