This topic is divided into two parts: Primary and Secondary.
- Primary
Speech delay can be identified in children as young as 2 years of age. The reason of speech delay in 2 year old can be primary.
In this topic, we only focus on the reasons of a normal child where has normal (average or above average) development of hearing, comprehension, intelligence, articulation skills and emotional relationships
Expressive Language Disorder.
An expressive language disorder may cause speech delay in kids. However, they also have average or above-average intelligence, comprehension skills, hearing, articulation, and emotional relationships.
Speech delay in children at the age of 2 may be due to a primary expressive language disorder.
Unfortunately, an expressive language disorder is not getting any better by itself throughout the time. Hence, early intervention and support by a trained speech-language pathologist is necessary. It is also essential for parents to provide speech therapy at home under the guidance of the therapists.
Fortunately, expressive language disorder works well to speech-language pathology if it lasts for longer than eight weeks.
Receptive Language Disorder.
This reason normally shows agrammatism and indistinct articulation in child with speech delayed. Children with a receptive language disorder may not point to objects or people when parents mention them by name.
They may have normal responses to non-spoken stimuli. However, they exhibit a lack of comprehension of spoken words.
Speech-language therapy is typically not as effective in addressing receptive language disorder. Research shows that children with this particular disorder rarely develop normal speech and oral language capacity.
- Secondary
Conditions or disorders, such as living environment, hearing loss, selective mutism, autism spectrum disorder (ASD), intellectual disability, and cerebral palsy (CP) can result in speech delay in children.
Speech-language therapy may help children with such disorders. However, the improvement is limited. Children may require medical and surgical intervention for addressing the condition causing speech delay.
Living Environment.
Environments such as school and home play huge impact on speech and language skills of children.
Children those live in the environment with lack of face to face verbal interaction could result in speech delay. Some of the research trust that children learn from what they see, if they see person to person communication, they absorb all the languages spoken immediately.
If virtual language is limited at home environment, this is one of the most impacts on the child’s speech and language development.
Autism Spectrum Disorder (ASD)
Children with the autism spectrum can have a wide range of speech abnormalities in addition to speech delay. If you notice your child repeating phrases without making new phrases, or struggling to start conversations, you should immediately speak to a speech-language pathologist
Some of the other signs of autism spectrum disorder in children may include reversal of pronouns and regression of speech and language. Children on the spectrum may also have impaired social interactions and communication skills. They may exhibit repetitive behaviors
It is common for SLPs to hear from parents of children with ASD that, “my 5 year old doesn’t talk at all”. ASD currently has no cure
An SLP can refer your child to a special developmental educator. Children on the autism spectrum may benefit from an early intervention and support that emphasize increasing communication and boosting language skills
Cerebral Palsy (CP)
Cerebral palsy (CP) may cause speech delay in children. In such cases, speech delay is typically due to the lack of coordination of the tongue and jaw muscles. Hearing loss and coexisting anomalies in the cerebral cortex may also contribute to speech delay in children with CP
Speech-language pathologists (SLPs) can help a child with cerebral palsy by introducing alternative and augmentative communication systems. Your child may learn how to use speech synthesizers and symbol charts to communicate.
With extensive speech-language therapy, it may be possible for a child with cerebral palsy to improve their language and communication skills. Still, it may not be possible to improve their speech.
Childhood Apraxia of Speech.
Childhood apraxia of speech is a lesser common disorder that affects a child’s ability to make sounds in the correct order. Parents may have difficulty understanding the speech of a child with apraxia of speech.
Children who communicate via gestures, but show signs of speech delay, may be at risk of apraxia of speech. They have the motivation to communicate and the ability to understand spoken language.
While there have been several studies on the treatment and therapy of childhood apraxia of speech, there is limited evidence that supports speech improvement with extended therapy.
Dysarthria
Speech delay in children can also be a sign of dysarthria. It is a physical problem which manifests as speech difficulties that range from mild and moderate to severe
A child with mild dysarthria may exhibit slurred speech and talk in a low-pitched voice. Profound dysarthria may be characterized by the complete inability to produce any words.
For some children with mild dysarthria, speech-language therapy can be instrumentally helpful. However, for severe dysarthria in children below 3-years of age, speech-language therapy may not improve speech and language skills significantly.
Hearing Loss
If children lose their ability to hear before they learn to speak, it may cause speech delay. If your child is showing signs of speech delay along with the tendency to not look at objects when you mention them or point at them, take them to an SLP immediately.
Children with hearing loss should see an audiologist. Sometimes, it is possible to restore hearing via minimally invasive surgical procedures. At other times, children may be able to hear and speak with the aid of a cochlear implant. Your child’s SLP and audiologist should be able to guide you towards the appropriate intervention strategy
Research shows that early, family-based intervention can help your child catch up to their peers and promote communication skills.
Intellectual Disability.
Delayed speech can also be a sign of intellectual disability in a child. In the case of intellectual disability, there may be a delay in the use of gestures and a generalized delay in reaching all developmental milestones.
Children with intellectual disabilities may show an overall deficit in comprehension.
An SLP can refer the child and their parents to a developmental educator. The child may require interdisciplinary evaluations such as audiology and speech-language therapy.
Selective Mutism.
Children with selective mutism show the failure to speak in specific social situations. For example, a child can understand instructions perfectly and talk at home. Nonetheless, they may not speak in school at all.
Children with selective mutism need the attention of a speech-language pathologist as well as a therapist. A psychologist or behavioral therapist can help the child overcome the barriers that keep them from speaking in certain situations.
Research shows that a combined intervention consisting of speech therapy, cognitive behavioral therapy, family participation, and school involvement can help children with selective mutism.
