One of the first things you likely learned as a parent? No two kids are alike. All children have their own temperaments, sleeping habits and food preferences. And they'll hit those developmental milestones like walking, talking or self-feeding on their own timelines too.

That's why it's rarely cause for concern if a toddler strings together her first sentence or scribbles a few months later than most of her peers. But in some cases, taking significantly longer to reach key markers in areas like behavior, movement or speech (or not reaching them at all) could be a sign of a developmental delay.

Pediatricians check to make sure that toddlers are ticking off their developmental boxes during well-child visits. But if your sweetie has signs of a potential delay, there's a good chance that they'll show up on your radar first. 

And it's important to bring it up with the doctor sooner rather than later if you sense that something might be off. Diagnosing delays early may help toddlers get the care and support they need to reach their developmental milestones and avoid falling further off track.

Signs of a developmental delay

Developmental delay symptoms aren't one-size-fits-all. A toddler who's struggling with certain speech milestones, for instance, won't necessarily have all the same symptoms as one with a fine motor skill or gross motor skill delay.

In other cases, a toddler might have delays in multiple areas and show a wide range of symptoms. 

That said, there are some broader signs that parents should watch for that could indicate a developmental issue.[1] These can include:

Speech delays in toddlers

While no child goes straight from uttering her first word to being ready for a speaking role on Broadway, speech delays may be a sign of an oral-motor or motor-speech disorder.[2]

A child with an oral-motor disorder has trouble controlling her lips, tongue and jaw muscles, which makes mouth skills — from talking to eating or even sipping from a straw — tough to master.

While these are physical issues, there are also speech-motor disorders, and they often have a neurological component. In both cases, a child's speech can be harder to understand. 

One of the most common speech delays in toddlers is articulation disorder, which happens when a child frequently lisps, leaves out consonants, or substitutes one sound for another.

Another is childhood apraxia of speech (CAS) or dyspraxia of speech, where a child has trouble moving and coordinating the different parts of her mouth in order to form words.

The causes of speech delays aren't fully understood. In some cases, experts suspect that the culprit could be a neurological glitch affecting the brain’s ability to send the right signals to the mouth muscles.

Others may be caused by a too-weak mouth, jaw or tongue muscle that can make speech more difficult. Genetics, hearing problems in children and birth defects such as cleft palate can also contribute.

Signs of speech delays in toddlers

A child with an oral-motor disorder or speech delay may:

  • Have a droopy or “long” face (which may cause her mouth to hang open)

  • Refuse to eat food that needs to be chewed, or chew very slowly

  • Gag frequently when eating (and not just when asked to swallow less appealing foods like peas)

  • Have food falling from her mouth

  • Weigh less and be shorter than other tots the same age

  • Be hard to understand

  • Drool past the age of 18 months

  • Lisp excessively

  • Take extra time to form words while speaking

  • Use mostly vowel sounds after 18 months (“aah-aah” instead of “mama”)

  • Leave out some consonants in words around age 3 ( “at” instead of “cat”)

  • Add extra sounds to words (“animinal” instead of “animal”) — though this is quite common in young children with normal developmental function too

  • Substitute certain sounds when speaking (“wittle” instead of “little”); this, too, is common in young toddlers, so if a tot who does this improves as she nears age 2, she’s likely fine

  • Have trouble stringing together syllables in the right order (“minacin” instead of “cinnamon”)

Diagnosing toddler speech delays

The earlier you get a diagnosis, the more effective treatment may be, so don’t hesitate to bring up any concerns you may have with your child’s doctor.

The pediatrician will also be on the lookout for lags in your toddler's language development during screenings, and may even recommend a hearing test to rule out some simple explanation, like fluid in the ears.

Just remember: Apraxic symptoms and articulation disorders tend to become more apparent around age 2 and beyond. At that point, your pediatrician may refer you to a speech-language pathologist (possibly through a state early-intervention program) to get a diagnosis.

Treating toddler speech delays

Sometimes childhood speech delays will clear up on their own. If your child's pediatrician doesn't think treatment is necessary, you may be able to help your little one hone her speech skills simply by taking lots of time each day to interact and communicate with her. Just reading, playing and chatting together can sometimes make a big difference. 

Children with apraxia and other oral-motor issues can also benefit greatly from speech-language therapy, which will probably not only help your little one but also be fun for your tiny talker.

A speech therapist may lead your child in some fun, favorite toddler activities — like blowing bubbles, whistling, licking candy and playing word games — to bolster her mouth muscles.

Outcome of toddler speech delays

Many tots can completely overcome their speech delays and feeding problems through therapy. Even toddlers with extreme apraxia can learn to express themselves in other ways, such as sign language or by pointing to pictures in a language notebook to get a message across.

Regardless of how they do it, most kids will find a way to let you know what’s going on in their little heads, so don’t worry: You won’t miss a single smart, sweet, funny thing.

Fine motor delays and gross motor delays in toddlers

Children with fine motor delays have difficulty using their small muscles, so tasks like grasping crayons with their fingers are tricky. When it comes to gross motor delays, the trouble instead is with large muscles and mastering skills like walking, kicking, hopping and climbing stairs.

Underlying neurological conditions, such as cerebral palsy or muscular dystrophy and dyspraxia, a motor skill disorder that makes it difficult to plan and complete tasks, affect how well the brain sends signals to muscles and are usually to blame for motor skill issues.

Structural issues (like having one leg that's shorter than the other) or vision problems may also be the cause of some fine motor delays.

Signs of fine and gross motor skill delays in toddlers

Some important warning signs to watch for include:

  • Being late to reach physical milestones, like rolling over and sitting up 

  • No signs of walking by 18 months

  • Stiff limbs or low muscle tone (she can’t hold much weight)

  • Frequently walking on tip toes 

  • Having trouble holding and using objects — managing a cup, for example, or scribbling with a crayon 

  • Being clumsy and falling frequently 

  • Drooling beyond 18 months of age

  • Having trouble chewing and swallowing

  • Losing toddler motor skills, such as waving bye-bye or jumping, that she’s already mastered (unless she’s sick, stressed or learning a new skill — backsliding is normal in those cases)

Diagnosing fine and gross motor skill delays in toddlers

Although your pediatrician will be monitoring your munchkin’s milestones at well-child doctor appointments, diagnosing a physical delay will really start with you.

Keep an eye out for the signs listed above, and if you notice any deficiencies or other indicators of toddler developmental delays bring them to the pediatrician’s attention as soon as you become aware of them. 

Your doctor may suggest further screenings, probably by a developmental specialist and/or neurologist, or perhaps through a state early-intervention program. These screenings will focus on your child’s muscle tone, muscle strength, reflexes and coordination.

After that, a developmental specialist will look at the results of the screenings and come up with an official diagnosis, which could be anything from hypotonia (i.e. low muscle tone), dyspraxia or simply a motor delay.

Treating fine and gross motor skill delays in toddlers

Here’s some good news: The typical Rx for children with motor delays includes occupational, physical and speech-language therapies, which typically feel more like play than work to a tot.

For instance, to strengthen a child’s hand muscles, an occupational therapist may give her manipulative toys to handle. Improving balance and coordination may involve spending time on playground equipment.

Outcome of fine and gross motor skill delays in toddlers

Children with severe motor delays due to conditions such as cerebral palsy may need life-long care. But kids with mild motor delays can learn to move normally, catch up with their peers and look forward to leading independent lives as grown-ups.

Causes of developmental delays in toddlers

Developmental delays can stem from a number of factors, but in some cases, doctors aren't able to pinpoint a specific culprit. Possible causes of developmental delays include:

  • Being born prematurely

  • Neurological or genetic conditions such as cerebral palsy or muscular dystrophy

  • Genetic conditions like Down syndrome or chromosomal disorders

  • Serious brain injuries or infections like encephalitis 

  • Vision or hearing problems

  • Alcohol or drug use during pregnancy

  • Trauma, abuse or neglect

  • Exposure to environmental toxins, like lead

  • Problems during labor or delivery

Treatments for developmental delays in toddlers

Therapy can often bring toddlers with developmental delays up to speed with their peers, especially when started early. Even if a delay can't be cured, the right care plan can help kids achieve more important milestones — and do more of the things they love.

The type of therapy a toddler might receive will depend on the specific delay. Your child's pediatrician might recommend:

  • Physical therapy. Physical therapy helps kids with physical delays get stronger so they can move more easily. Your toddler might practice crawling or walking on a playground or at an indoor gym, practice kicking or splashing in the water, or play games that hone her balance and coordination skills.  

  • Occupational therapy. Occupational therapy guides kids through exercises that make it easier for them to perform everyday activities. For toddlers, that might mean working on fine motor skills so your child can learn to do things like scribble or draw, feed herself, and get dressed. 

  • Speech-language therapy. Speech-language therapy helps toddlers improve their pronunciation of sounds and syllables, often through play activities. Toddlers with weak mouth or jaw muscles might also practice tongue, lip or jaw exercises (like blowing bubbles) or work on eating foods with different textures or temperatures, which can help them become more aware of what's going on in their mouths.

When to call the doctor

It's never too soon to bring up concerns about delays with your child's pediatrician. The best advice? Trust your gut. If your tot's developmental timeline seems very different than that of her peers, or if she has habits or behaviors that seem off, let the doctor know. Together you can talk about your toddler's symptoms and decide if she should be evaluated for a delay.

Developmental delays can be challenging to deal with, and it's easy to worry whether your toddler will be able to catch up to other kids her age. But with early intervention and a dedicated care team, you can get your cutie on the road towards reaching her goals — and thriving.