SingaporeMotherhood | Baby & Toddler

August 2022

Speech & Language Delays in Toddlers – Can Speech Therapy Help?

Children, in their early years, develop rapidly in the blink of an eye. A toddler acquires the foundations for speech and language from birth to three years old. This is a critical period in a child’s development. But how do we know if their speech and language skills are on track? Find out some of the signs of potential speech and language delays in toddlers, and how speech therapy can help.

What Are Speech & Language Delays in Toddlers?

For babies and toddlers, speech and language development refers to the understanding of languages. These include following instructions or answering questions, and the usage of language in expressing themselves. Speech can also refer to the clarity of pronunciation.

These foundations build up and support the child in the later stages of development as they mature. For instance, as they develop critical thinking and problem solving skills, and the ability to develop relationships with others. Speech and language abilities are also a crucial first step in literacy development. In other words, they are important in learning how to read and write.

Just like with any new skill, a child’s speech and language skills at this age needs practice. Often, a toddler has unclear pronunciation and understands more than he or she can say. However, it can be a concern when a child is not matching up to peers of the same age.

Do bear in mind that every child develops differently, and there is a range of expected and appropriate development. When looking at the developmental stages of a child, recognise that some children may take some more time. Conversely, some children may be more advanced at the same age.

(See also: Does My Child Have A Speech Delay?)

General Speech & Language Milestones

Below are some general milestones of speech and language development from birth to three.

At three to 12 months of age, a child should be:

  • Babbling or jargoning; e.g. they make sounds like “bababa”, “mamama”. They may also use long strings of sounds, appearing to have a ‘conversation’ with you.
  • Expressing themselves by laughing, crying, and/or cooing.
  • Using a range of gestures; e.g. pointing to get your attention, or reaching up towards you for a hug.
  • Trying to copy some sounds you make; e.g. “oh oh!” and animal sounds
  • Understanding some of what you say with some hints; e.g. when you say “give me that” while offering an open palm, they should know to give it to you.

Early first words may also appear at 12 months. A child at this age will continue to use babbling, jargoning, gestures, and some words to communicate.

At 12 to 18 months of age, a child should be:

  • Using more single words; i.e. should be saying at least eight to 10 words spontaneously.
  • Able to follow simple instructions, such as “let’s clean up” or “wear your shoes”.
  • Able to understand “no” — though they may not always obey!
  • Using gestures alongside words; e.g. pointing at a bird and saying “bird”.

At 18 months to two years, a child should be:

  • Combining two-word phrases together; e.g. “daddy hug” or “give me”.
  • Starting to understand simple questions; e.g. “What is this?” or “Where is the door?”
  • Somewhat comprehensible in their speech. Strangers should be able to understand them about 25 to 50 per cent of the time.

From two to three years of age, a child should be:

  • Speaking in longer sentences, in about three to four words, about a variety of things; e.g. “This is a train”, “Give me red ball”, or “Dog under table”.
  • Using a variety of sounds in their speech.
  • Strangers should be able to understand them about 50 to 75 per cent of the time.

(See also: Childhood Development: Is My Child Meeting Milestones at the Right Time?)

Signs of Speech & Language Delays in Toddlers

Below are some signs on when to be concerned if your child may be behind in their speech and language development.

At 12 to 18 months of age, signs of potential speech and language delays include:

  • Little to no sound play or babbling.
  • Not showing much interest when people play with them.
  • No response to their own name.
  • Not using gestures, particularly to ask for help or for what they want.
Image: Jep Gambardella

At 18 months to two years, signs of potential speech and language delays include:

  • Not using words or saying only a few words; e.g. three to five words.
  • Not able to follow simple instructions.
  • Only copying words but not spontaneously using words.

From two to three years of age, signs of potential speech and language delays include:

  • Using single words or not using any words.
  • Not asking questions (nearer to three years).
  • Does not understand longer instructions; e.g. “Go get your shoes and put them on”.
  • Using few sounds in their speech.
  • A familiar person understands them less than 50 per cent of the time.
  • Not being able to follow instructions or respond to simple questions like “What’s this?”

Do note that these are not definitive signs of a speech and language delay. They should not be used as a conclusive diagnosis of speech and language delays in toddlers.

(See also: Baby Sign Language: Why Every Parent Should Learn It and How to Start)

Causes and Risk Factors of Speech & Language Delays in Toddlers

In most cases, there is no known particular cause of speech and language delays in toddlers. However, studies show that there is likely to be a genetic or a biological component affecting speech and language development. Factors that may put a child at risk of speech and language delays include:

  • Being male.
  • A known family history of language or learning difficulties.
  • Developmental disabilities or disorders like autism spectrum disorder, Down syndrome, or other congenital conditions. Quite often, these conditions imply likely language delays.
  • Recurrent ear infections.
  • Environmental factors, such as excessive screen time.

Sometimes, delays in speech and language can be signs of more serious developmental disorders. These include hearing impairment, developmental delay, intellectual disability, and autism spectrum disorder. Parents and caregivers know their children better than anyone else. Seek professional advice from a speech therapist or your paediatrician if you suspect your child has speech and language delays.

(See also: 5 Ways to Help Children with Autism Read Better)

How Are Speech & Language Delays in Toddlers Managed?

Deciding to seek help and advice on a child’s speech and language delay is the first step.

A speech therapist will assess a child’s understanding and use of language. For young children, the speech therapist might use tests or play with the child to determine how the child uses words or responds to instructions and questions. They may also collect information from parents and caregivers about how the child uses and understands language at home. They may also ask more about the child’s background — for example, any known family history of language delays.

If the speech therapist suspects a speech and language delay, they may offer one-to-one therapy sessions or sessions in a group with other children. This depends on you and your child’s preferences and needs, as well as where you seek speech therapy from.

Options include:

  • Public restructured hospitals
  • Community services, such as Early Intervention Centres or community hospitals
  • Private speech therapists
  • Home-based services such as Homage, which offers in-person and online speech therapy services

(See also: Resources for Families of Children with Special Needs in Singapore)

Encouraging Speech & Language Development at Home

To encourage a child’s speech and language development, the most effective thing you can do is to have many conversations with them.

Talk with Your Child

Talk to the child as though they could talk back to you, starting from infanthood. Assume your child is responding to you through sounds and babbling, and wait for them to respond after you speak. When your baby starts babbling, copy them and do the same to start a back-and-forth exchange of babbling. This keeps the enjoyable conversation between you and your child going!

As your child becomes a toddler, keep talking about the things happening around them. For instance, what you are doing, what they are doing, and the surroundings. Make sure to use a variety of words when talking with your child. Remember to keep what you say short and sweet, so your child is able to catch what you are saying.

Respond to Your Child

As your child grows and starts to use gestures and words, respond to their attempts at communication. For example, if your child shakes their head, act as though they saying “no”. If they point to a toy, respond as though you think they want the toy. Noticing and responding to your child’s actions encourages them to communicate more with you.

Following your child’s lead is also a way to encourage more back and forth communication. If your child starts a conversation using a gesture, a behaviour, or sounds, respond to it and stick to the topic your child chooses. You can stress and add more meaning to what your child says and does too. For example, if your child points to a bear toy and says, “ba”, respond by pointing at the bear toy and say, “Yes, that’s a bear! It goes grrrr….”

(See also: 8 Ways to Boost your Baby’s Speech and Language Skills)

Read with Your Child

Read and share books with your child. Talk about the pictures and link the picture to what happens in real life. For infants and toddlers, they enjoy books with clear and colourful illustrations, and lots of different switches, materials, or flaps to explore. Children usually enjoy reading books over and over again. Let your child choose the books they want to read. The public libraries have a variety of books suitable for infants and toddlers to offer.

Can a Child with Speech & Language Delays Catch Up?

Image: Cottonbro

Studies show that 70 to 80 per cent of toddlers do catch up with their peers by the time they enter school. However, 20 to 30 per cent do not grow out of the language delay and have ongoing difficulties with language and literacy skills.

A wait-and-see approach, hence, may not be advisable, considering the possible long-term effect. If your child shows some of the risk factors mentioned above, consider bringing them for further evaluation and checks.

This article first appeared on Homage, an award-winning personal care solution that provides on-demand holistic home and community-based caregiving and medical services to seniors and adults, allowing them to age and recover with grace, control, and dignity.

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Speech & Language Delays in Toddlers – Can Speech Therapy Help?