Late Talking: Speech or Language Delays in Toddlers

As with everything in child development, kids learn to talk at different rates. While most tots tend to be able to say a few first words around the one-year mark, not all do — there’s a wide range of normal when it comes to a toddler's language and communication skills.

As a parent, it’s equally normal to wonder if you should be concerned about your child's language development. Before you start asking around and comparing your little one to others his age, here’s what you should know about so-called "late talkers," or speech or language delays, as well as signs of a possible speech or language problem.

What is a late talker?

A toddler between 18 and 30 months old who isn’t speaking much or at all but is otherwise developing normally may be considered a late talker. It’s estimated that up to 17.5 percent of kids up to age 3 who take longer may have a speech or language delay.

Late talkers might be pacing behind on toddler speech milestones but are still able to understand much of what they hear (which is known as receptive language), use gestures to communicate (such as waving or pointing) or continue to learn new words, just more slowly.

A late talker might have one or both of the following:

• Speech delay: Speech refers to the words we say and how we say them. Children with speech delays might have trouble articulating words and be difficult to understand.
• Language delay: Language refers to the way we communicate with others. Children with language delays might be able to say some words, but only have a few words or be unable to put more than two words together.

A variety of factors might contribute to a toddler's late-blooming speech:

• Birth stats. Babies who were born underweight or before 37 weeks are at an increased risk of becoming late talkers as toddlers.
• Twinning. Twins are more likely to be late talkers than singletons. 
• Family history. Late talkers tend to run in the family.
  
• Other interests. Sometimes toddlers who develop early in other areas (like climbing and jumping) tend to master language more slowly because they’re so busy concentrating on those other skills. 
• Lack of necessity. Children whose parents (or older siblings) are quick to anticipate their needs might take longer to speak up — because there is less of a need to.
• History of hearing loss or ear infections. Past infections or difficulty hearing can slow speech development.

How to help a late talker develop speech

The good news: Up to 70 percent of late talkers tend to catch up in language development without intervention by the time they start school. In the meantime, try these steps to help bring out your child’s inner chatterbox:

• Talk, talk, talk. Not sure how to talk to your tot? Narrate what you’re doing, tell them about your day, label items around the house, read books — the more your toddler is exposed to language, the more words he’ll eventually pick up.
• Expand your child’s vocabulary. Add to words your tot does say — if he says "ball," comment back by saying "red ball" or "throw ball" to build on his speech.
• Ask the right kinds of questions. Start with questions that will elicit a "yes" or "no" from your toddler, like "Do you want a snack?" and work your way up to questions that include a choice, like "Do you want an avocado or banana?"
• Try sign language. Research shows sign language may help your little one with language development.
• Sign up for day care or classes. Toddlers who play in language-rich environments and socialize with other kids their age are more likely to pick up language skills. 
• Encourage imitation skills. Incite your tot to copy motor skills such as clapping, jumping and blowing kisses, then work your way up to imitating sounds and then words.

Talking to your doctor about speech or language delays

There's a range of normal when it comes to a child's development, and a speech or language delay refers to a toddler whose speech is coming along a bit more slowly. But there's a difference between late talking and a true speech or language disorder. The "wait and see" approach may not be the best course of action.

Remember: You know your child best. If you have any concerns about your child's development, consult your doctor, especially if you notice the following:

• By 18 months: Your child doesn’t communicate nonverbally by pointing at objects, doesn't gain new words or doesn't have at least six words
• By 2 years: Your child doesn't use two-word phrases or is unable to follow simple instructions
• By 3 years: Your child has unclear speech, doesn't speak in sentences or doesn't understand simple instructions

Other signs to watch out for besides late talking include:

• Loss of sounds or words your child previously said
• Difficulty understanding language or following directions
• Trouble imitating sounds or mouth movements
• Lack of gestures like pointing or reaching for items of interest
• Decreased eye contact and social skills
• Chewing, drinking, swallowing and overall feeding difficulties

Your child's pediatrician may refer you to an audiologist for a hearing test or speech-language pathologist (SLP) for an evaluation. These specialists assess how well your toddler understands language and communicates with both verbal speech as well as gestures.

From there, an SLP might recommend speech therapy or make recommendations as to what else you can do at home to encourage your toddler's language development. If needed, an SLP can also refer you to an early intervention program. With early intervention, the sooner you get your child the care he needs, the better the outcome.