“He’s a boy—boys always talk late”… “She’s fine—her older sister is always talking for her.” Your two year old son is still not talking.

He says a few words, but in comparison to his peers, you think he’s well behind. You remember that, at his age, his sister could put sentences together. Hoping he will catch up, you postpone seeking professional advice. Some kids are early walkers; some are early talkers you tell yourself. Nothing to worry about…

This is a common scenario among parents of children who are slow to talk. Unless parents observe other areas of “slowness” in the early development of their child, they may hesitate when it comes to seeking advice on delayed speech. Frequently they may excuse or justify the child’s not talking by reassuring themselves that “he’ll outgrow it,” or “he’s just more interested in physical things.”

Children as young as 12–18 months, whose parents have concerns about communication skills should probably be seen by a speech-language pathologist. When delays are present it is not a good idea to take the “wait and see” approach. Though late talking children tend to catch up with their peers, research has shown that they often have difficulty with reading and spelling and overall learning skills. Early intervention is the key to developing age level appropriate communication skills.

Speech-language pathologists can observe and assess your child’s communication skills and compare his/her skills to children who are “typically developing” for that age. As a result of this process parents will know if a problem exists or not.

There is a difference between speech and language. Speech is simply pronunciation of words. It refers to how well a child can say words and sounds. Language means expressing and receiving information in a way that is meaningful. It is understanding and being understood through communication. A child with a language problem may be able to say words well but unable to put more than two words together. Conversely, another child’s speech may be difficult to understand but he uses words and phrases to express ideas. Though problems with speech and language differ, they tend to overlap. Some children also have listening problems that can interfere with the development of speech and language skills.

There are many reasons for delays in speech, language and listening development. Chronic ear infections, the number one childhood illness, cause problems with hearing. If a child has trouble hearing, he will have trouble understanding, imitating, and using speech. Chronic ear infections are a primary cause of listening and learning problems. Other causes of communication problems are premature birth, developmental delays, oral-motor problems, chronic and prolonged pacifier use, and head trauma. When parents have a better understanding of why their child isn’t talking, they can learn ways to encourage speech development.

Like so many other things—speech development is a mixture of nature and nurture. Parents should begin communicating during infancy; this includes reading, playing imitative games, singing and talking. Nursery rhymes, because of their rhythmic appeal, are fun for both parents and children. It may be difficult for parents to tell whether their child is immature in his ability to communicate or if he has a problem that requires the services of a speech-language pathologist.

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You should be concerned if your child:

Birth to 12 Months:

• Avoids eye contact
• Rarely babbles; is unusually quiet
• Shows little interest in imitating gestures such as “bye-bye”
• Does not have interest or intention to communicate
• Is not attentive to sounds in the environment

12–18 Months:

• Avoids eye contact
• Doesn’t say simple words like “mama,” “dada,” “juice,” “more,” etc.
• Is unable to point to common body parts when asked
• Is unable to follow simple commands such as “stand up,” “give me,” “sit down”

18–24 Months

• Has an expressive vocabulary of less than 50 words
• Is not beginning to form 2-word phrases like “baby cry,” “daddy go”
• Has difficulty pointing to picture’s names
• Does not spontaneously attempt to imitate or produce words
• Is disinterested in talking

24–36 Months

• Avoids eye contact
• Has difficulty singing songs or imitating parts of simple nursery rhymes
• Has difficulty naming most common household objects
• Doesn’t put two and three words together in phrases
• Has difficulty sitting and attending to a book or movie for more than a few minutes
• Is very difficult to understand