Please note: This information was current at the time of publication but now may be out of date.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. 2023;108(2):online

Related article: Speech and Language Delay in Children

What is speech and language delay?

Speech and language 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 their own pace, but some children are behind in speech development compared with other children the same age because of speech and language delay. Your doctor may think that your child has speech delay if they aren't able to:

  • Use at least three words by 15 months of age

  • Follow one-step directions by 18 months of age

  • Use two-word phrases by two years of age

  • Follow two-step directions by two-and-a-half years of age

  • Speak well enough for others to understand them most of the time by three years of age

What causes speech and language delay?

The most common causes include developmental delays, hearing loss, or intellectual disability.

Other causes include:

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

  • 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?

Children who are raised speaking two languages might mix up the two languages when first learning to talk, but they tend to meet the same milestones as children who speak only one language.

How will my doctor know if my child has speech and language 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.

How is it treated?

Your doctor might refer your child to a speech therapist to help them learn to understand and speak better. A speech therapist can also teach you new ways to encourage your child. Your doctor might also refer your child to another specialist, such as an audiologist, if another condition is causing speech delay or if there is concern for hearing loss.

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