Parents’ Guide to Language Delays and Speech Disorders in Children

Nearly 1 in 12 U.S. children ages 3 to 17 has had a disorder related to voice, speech, language, or swallowing, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). While parents understand the importance of monitoring for potential signs of these issues, some may not be aware of exactly how early they should be on the lookout for delays in their child’s speech and language development.

Certain factors may predict future hurdles: Preschool-age children who were born preterm—before 37 weeks’ gestation—have an increased risk for developing language impairments, according to research from Diane Loeb, Ph.D., CCC-SLP, Baylor University professor and Martin Family Endowed Chair of the Department of Communication Sciences and Disorders, and colleagues. While many infants born preterm will not have any issues down the road, it is important for new parents to be aware of the potential risk factors, as well as signs to look for as their child gets older.

Early intervention is a method for addressing language delays and speech disorders in children ages 0 to 3 years old. When parents understand how to monitor their child’s development and how to seek help from a speech-language pathologist (SLP) during these early years, they can help their child develop language skills and minimize developmental delays.

One way to monitor a child’s development is to make note of speech and language milestones, explained Hillary Guest, M.S., CCC-SLP, a speech language pathologist based out of Austin, Texas. While missing a milestone is not a definitive sign that a child has a speech disorder or language delay, paying attention to the rate at which the child acquires language skills can be a helpful tool.

Guest highlighted the following milestones for children ages 0 to 3 years old.

As young children develop, they may struggle to learn speech and language skills and hit important milestones. Each child develops at a unique pace; some may exhibit signs of a potential speech impairment, language delay, or language disorder at a different phase than other child. The Centers for Disease Control and Prevention’s resource on language and speech disorders in children offers the following information on how these conditions differ:

Speech disorders affect the ability to form speech sounds needed to communicate. This can manifest in several ways, including problems with fluency, which is difficulty making words or sentences flow smoothly, such as with stuttering.

Language delay refers to when a child’s ability to understand and use language develops more slowly than their peers. This can occur as a result of a number of factors, such as hearing, speech, and cognitive impairments. Psychosocial issues can also play a role—for example, children who experience neglect as infants may deal with language delays.

Language disorders are conditions that affect an individual’s ability to express their thoughts or understand communication directed at them. Examples of language disorders include aphasia, which is difficulty in understanding or speaking parts of language as a result of brain injury or brain development. Auditory processing disorder is another language disorder that affects the ability to understand the meaning of sounds and words.

Speech and language disorders can affect a child’s expressive and receptive language skills.

Not all causes for speech disorders and language delays are known, but some factors have been found to be more common among children who do experience these conditions.

Preterm birth, for example, is one potential risk factor. According to a study on language development, infants were more likely to experience language delays and other issues such as impaired cognitive development. In another study from 2019, researchers found that, from 23 to 36 weeks, each gestational week was associated with an 8.8% decrease in the likelihood of the child having a speech, language, and communication concern reported at 27 months of age.

As for why preterm birth may increase the likelihood of an infant developing a speech disorder or language delay as they grow, researchers of a study on language disorders published in Neural Plasticity offered this explanation: “When born [preterm], infants are prematurely led into a more invasive environment, which can have profound effects on the auditory brain maturation and subsequent speech and language acquisition.”

Comorbidities related to behavioral and developmental health are also common among children with speech and language issues, according to the CDC’s resource on language and speech disorders in children. Language and speech disorders can be present with emotional or behavioral disorders such as attention deficit hyperactivity disorder (ADHD) or anxiety; children with developmental disabilities including autism spectrum disorder (ASD) may also struggle with speech and language development.

While working with an SLP can be helpful at any age, taking steps to address development concerns early in a child’s life can give them a head start in building speech and language skills.

In an article on predictors of language outcome for children born preterm (PDF, 243 KB), co-authored by Loeb, researchers write that “prevention is one aspect of a speech-language pathologist’s scope of practice in communication disorders that has been neglected.”

Loeb and the team explain that early delays can lead to issues later in development. For example, a child showing poor expressive and receptive language skills at age 2 is a predictor of poor expressive and receptive language skills at age 5.

Guest also emphasized the importance of early intervention, as children are generally more receptive to therapy during the early developmental stages.

“When you’re at that early intervention age, you have the benefit that these are young children whose brains are still growing, and they’re learning a ton,” Guest said. “You can take advantage of what we know about the brain and its development in those critical years.”

The American Speech-Language-Hearing Association (ASHA) defines early intervention as a program for children ages 0 to 3 that provides support for cognitive skills, communication, physical and sensory skills, social-emotional skills, and adaptive or self-help skills.

Parents who are concerned about their child’s development of speech and language skills can find their community’s early intervention office through multiple sources:

According to ASHA, while primary providers can help refer parents to an early intervention program, their referral is not required in order to schedule an early intervention speech evaluation.

Parents may be nervous before their child’s first visit with an SLP. Taking steps to prepare for an early intervention speech evaluation can help calm those anxieties. Guest advises parents do the following before their child’s session.

Contact an insurance provider.
Some insurance plans do not cover speech-language pathology care in cases where the child’s condition is due to developmental issues such as autism spectrum disorder. Having a plan in place to cover the cost of care ahead of the first visit is critical.

Collect past medical information.
If a child has any documentation of their speech or language issues, such as an exam with a primary care provider or notes from a child care provider, this information can be factored into the SLP’s initial evaluation.

Gain an understanding of the process.
When a child has an early intervention speech evaluation, the process typically involves an initial assessment from the SLP, followed by a formal report. Next, the SLP will develop a plan of care, which can include ongoing therapy sessions as well as exercises for parents to use at home with their child.

Legal Disclaimer: Please note that this article is for informational purposes only. Individuals should consult their health care provider before following any of the information provided.

Citation for this content: The online speech pathology program from Baylor University’s Robbins College of Health and Human Sciences