UNDERSTANDING SPEECH-LANGUAGE DELAY IN BABIES, TODDLERS, AND PRESCHOOLERS

Understanding Speech-Language Delays: A Guide for Parents

Every child develops at their own pace, but some may take longer than expected to reach important speech and language milestones. When this happens, it’s called a speech-language delay. This means a child may have difficulty with speaking, understanding language, or both.

Speech-language delays may occur independently or as a symptom of broader developmental conditions, such as autism spectrum disorder or hearing impairment. Speech delay vs. autism—while both may involve delayed speech, autism is also characterized by differences in social interaction, nonverbal communication, and repetitive behaviors. Our article on understanding speech-language skills in children offers more clarity on what to watch for and how professionals assess progress.

Speech vs. Language: Understanding the Difference

Think of speech and language like playing an instrument:

🎵 Speech is the sound—like the notes played on an instrument. The way we pronounce sounds and words is similar to pressing the right keys or strings on an instrument.

🎼 Language is the music—the structure, meaning, and organization of the notes. It allows us to communicate ideas, understand others, and express thoughts effectively.

🎶 Social Communication is knowing when to play the right music in the right context. Just like a musician adjusts their performance based on the audience and setting, children must learn when and how to use language appropriately in different situations. This includes skills such as taking turns in conversation, understanding tone of voice, and recognizing social cues.

📌 If a child has difficulty verbalizing words because they don’t know the exact “notes” that represent the words, it’s an expressive language issue. They don’t yet have a full mental representation of the words they want to say, just like a musician struggling to remember which notes belong to a song.

📌 If a child knows the “notes” (words) but produces the sounds incorrectly, it’s a speech issue. This is similar to a musician who understands the music but struggles to play the correct notes on an instrument.

📌 If a child is having a hard time understanding the “notes” compared to peers, it’s a receptive language issue. Just like a musician who struggles to read sheet music and follow along with the song, a child with receptive language difficulties may have trouble understanding what others are saying, following directions, or processing new information.

📌 Children with receptive language issuesoften also have attention and focus difficulties. It can be hard to tell whether a child is struggling to understand language or if they are simply distracted or inattentive. While Speech-Language Pathologists (SLPs) are trained to assess language comprehension, they collaborate closely with psychologists to help determine whether attention-related challenges, such as those related to ADD/ADHD, may be contributing to the child’s difficulties. This team approach ensures the most accurate understanding and appropriate support for each child.

📌 A Speech-Language Pathologist can also help determine whether a child is simply developing more slowly within the normal learning curve or if they fall into the red flag clinical range and need services to help move the needle. Some children may be late bloomers and catch up on their own, while others may require targeted intervention to build critical language and communication skills. Language delays can also be prognosticators for learning disabilities in children.

Speech Sound Development

Speech sound development follows four main stages, with different sounds emerging at different ages as part of a child’s phonetic development—the gradual process by which children learn to produce speech sounds correctly.

✔ Early developing sounds such as /p/, /m/, and /w/ are typically among the first children learn to produce.
✔ Later developing sounds like /r/, /l/, and “th” often take longer to master and may not fully emerge until a child is older.

By age four, most children are expected to produce the majority of speech sounds correctly. When a child continues to use patterns of sound errors—called phonological processes—beyond the expected age, this can impact speech clarity and may signal a speech sound disorder. These processes should gradually disappear, or be eliminated, as children develop clearer, more adult-like speech.

To better understand typical development, a speech clarity chart and phonological processes chart can provide useful benchmarks. If you suspect a delay or difficulty, it’s helpful to review the speech clarity chart alongside a child’s age and consult a specialist about the most appropriate treatment approaches for speech sound disorders.

How a Speech-Language Pathologist (SLP) Evaluates Your Child

When evaluating a child’s speech and language development, a speech-language pathologist considers two important factors:

• Chronological Age – The child’s actual age in months or years (e.g., 12 months, 3 years, etc.).
• Linguistic Age – This refers to how the child’s vocabulary, grammar, and social communication compare to other children their age.

📌 Some children may be on the lower end of the typical range but still progressing within normal limits. Others may be in the red flag range, where their delays are significant enough to impact daily communication and learning. 

Our licensed speech-language pathologists conduct thorough evaluations based on both chronological and linguistic age. Whether you’re concerned about expressive language, speech clarity, or social-pragmatic development, an SLP can help you determine if your child is developing within the expected range or may benefit from support.

If you need remote access to services, we offer online speech, language, and feeding therapy across the U.S., making high-quality intervention available regardless of location.

When ASD is part of the picture, we provide targeted speech-language therapy for autism led by skilled professionals, including a dedicated team of autism-focused speech pathologists. Our team also includes NYC SLPs who specialize in a wide range of developmental conditions and communication profiles, including ASD, ADHD, apraxia, and more.

If you’re wondering whether your child’s speech challenges reflect a deeper processing style, gestalt language processing is another important concept, particularly for children who repeat entire phrases or exhibit echolalia.

How Many Words Should My Child Be Saying?

Understanding what is typical for expressive language development can help determine if a child may have a delay. Here are average word counts by age:

📌 At 15 months → ~14 words
📌 At 18 months → ~68 words
📌 At 23 months → ~200 words
📌 At 24 months → ~200-300 words
📌 At 30 months → ~570 words

📌 A Speech-Language Pathologist can assess whether a child’s progress falls within the normal learning curve or if they are in the red flag clinical range and need intervention to help them catch up.

Why Early Support Matters

For some children, a wait-and-see approach may be appropriate if they are slightly behind but making steady progress. However, for children in the red flag range, early intervention can significantly improve communication skills and prevent long-term difficulties.

A Speech-Language Pathologist can:
✔ Identify whether a child is developing at their own pace or needs targeted intervention.
✔ Provide personalized strategies to improve speech, language, and comprehension.
✔ Support families in creating a language-rich environment to encourage communication growth.

📌 Early support can make a big difference in building strong communication skills! If you’re concerned about your child’s speech or language development, a Speech-Language Pathologist can help assess their needs and determine the best next steps.

Example of a 3-Year-Old with Mixed Expressive Language Delay and Delayed Play Skills

Emma is a 3-year-old who attends a small preschool class. Her teachers have noticed that while other children her age are talking in short sentences and engaging in pretend play, Emma primarily communicates using single words or gestures. When she wants a toy, she will point or grab it instead of saying, “Can I have that?” or “My turn!” She also struggles to put words together to express her thoughts.

When given a doll, she holds it but doesn’t attempt to feed it, dress it, or pretend to put it to sleep like her peers. When playing with other children, she often watches from the side but doesn’t initiate interactions. If another child takes her toy, she may whine or cry instead of using words to communicate her frustration.

At home, Emma’s parents have noticed that she has trouble following simple directions, such as “Go get your shoes” or “Put the book on the table.” Sometimes, she seems to understand, but other times, she looks confused and needs help. She also struggles with answering simple questions like, “What do you want for snack?” and instead repeats part of the question (“Snack?”) instead of responding with a choice.

Example of a School Age Student with Mixed Expressive and Receptive Language Issues

Liam is a 6-year-old in first grade. His teacher notices that he often looks confused when given multi-step directions, such as “Get your notebook, turn to page five, and write your name at the top.” Instead of following all three steps, Liam might only complete one, like opening his notebook but not turning to the right page.

During class discussions, Liam struggles to find the right words to express himself. When asked to describe what he did over the weekend, he pauses for a long time and says, “I… um… went… it was fun.” His sentences are short, and he has trouble organizing his ideas.

Liam’s parents also notice that when they read a bedtime story and ask him simple questions, he often answers off-topic or needs the question repeated multiple times.

An evaluation by an SLP reveals that Liam has mixed expressive and receptive language difficulties—he struggles both with understanding what others say and with forming his own thoughts into clear sentences.

Therapy focuses on:
✔ Receptive Language Support: Teaching Liam strategies to follow directions and break down spoken information.
✔ Expressive Language Development: Expanding his vocabulary, helping him form longer sentences, and practicing storytelling skills.

With early intervention, Liam can strengthen both his understanding and use of language, making it easier for him to participate in class and communicate his ideas confidently.

Signs and Symptoms by Age

Babies (0-12 months)

• Lack of cooing or babbling by 6 months.
• No response to sounds, voices, or their name by 9 months.
• Limited use of gestures such as pointing, waving, or clapping by 12 months.

Why This Matters: Early vocalizations are foundational for later speech. Addressing delays in this stage can prevent compounding issues.

Signs Your Toddler (1-3 years) May Need Speech or Language Support

Every child develops at their own pace, but some toddlers may show signs that they need extra support in their speech and language development. If your child is between 1 and 3 years old, here are some red flags to watch for:

🔴 Limited vocabulary – By 24 months, your child should be using at least 50 words. If they are saying fewer words, it may be a sign of a language delay.

🔴 Difficulty following simple directions – By age 2, your child should be able to understand and respond to simple requests like “Give me the ball” or “Come here”.

🔴 Lack of interest in social interactions or play – If your child doesn’t seem interested in playing with others, making eye contact, or engaging in pretend play, they may need extra support with communication and social skills.

🔴 Not using gestures – By 12 months, toddlers typically wave, point, or reach for things they want. If your child isn’t using these gestures, it may be a sign they need help with communication.

🔴 No two-word phrases by 24 months – Your child should be starting to combine words like “more milk”, “want toy”, or “go outside” by age 2. If they are only saying single words, it may indicate a delay.

🔴 Difficulty making eye contact or responding to their name – If your child rarely looks at you when talking or doesn’t respond when you call their name, this could be a sign of a communication delay.

🔴 Speech that’s hard to understand – While it’s normal for toddlers to mispronounce some words, by age 2-3, you and familiar adults should be able to understand most of what they say. If their speech is very unclear, it might be a sign of a speech delay.

📌 If your toddler is showing any of these signs, a Speech-Language Pathologist (SLP) can assess whether their development is within the normal range or if they may benefit from early intervention. Identifying and addressing delays early can make a big difference in their communication skills!

Why This Matters: Toddlers rapidly expand their vocabulary and begin forming sentences. Delays here may indicate a need for professional evaluation.

A speech language pathologist can support children with speech-language delays by helping them build essential language skills, such as vocabulary, by improving communication in babies, toddlers, and preschoolers.

Signs Your Preschooler (3-5 years) May Need Speech or Language Support

As your child grows, their speech and language skills should also be developing. By ages 3 to 5, children should be using longer sentences, telling simple stories, and engaging in conversations. If your child is struggling with any of the following, they may need extra support:

🔴 Limited vocabulary – By age 4, your child should be using around 1,000 words. If they seem to struggle with learning new words or using a variety of words, they may need some help expanding their vocabulary.

🔴 Trouble forming sentences or using grammar correctly – By this age, children should be speaking in sentences like “I want to play outside” instead of “Me want go outside”. If they are still speaking in very short phrases or mixing up word order, they may need language support.

🔴 Difficulty telling simple stories or describing events – By age 4-5, children should be able to talk about their day, describe what happened in a story, or explain something that just happened. If they have trouble putting their thoughts into words, it could be a sign of a language delay.

🔴 Struggles with following multi-step directions – If you say, “Put your shoes on, grab your backpack, and come to the door,” and your child only does one or two steps, they may be having trouble understanding or remembering spoken language.

🔴 Repeating sounds or omitting parts of words – Some children may continue using phonological processes, which are patterns of sound errors, beyond the age they should have outgrown them. For example, saying “wabbit” instead of “rabbit” or “nana” instead of “banana”. If your child is frequently leaving out sounds or repeating sounds beyond the expected age, they may need help with speech clarity.

🔴 Challenges understanding questions or responding appropriately – By ages 3-5, children should be able to answer simple questions like “What’s your name?”, “Where do you live?”, or “What do you want to eat?” If they struggle to understand or answer, it may be a sign they need extra support in their language development.

👉 Check out this guide on question-asking and answering milestones:
🔗 Question-Answering & Asking Milestones

🔴 Difficulty with social interactions or making friends – Language is key to making friends and playing with others. If your child has trouble joining in conversations, taking turns in talking, or understanding social cues, they may benefit from speech and language support.

🔴 Lack of interest in pretend play or imaginative activities – At this age, children should be engaging in pretend play, like acting out stories with dolls, pretending to be a superhero, or playing “restaurant” with toy food. If they don’t show interest in these kinds of activities, it could be a sign they need help with language and play skills.

📌 If your child is struggling with any of these areas, a Speech-Language Pathologist (SLP) can help determine if they are developing within the normal range or if early intervention could help them improve their communication skills. The earlier support begins, the easier it is for children to catch up and thrive!

Common Causes of Speech-Language Delays

Speech-language delays can arise from various factors, including developmental, environmental, and physical challenges. 

1. Developmental and Neurological Factors

• Speech Delay and Autism: Language delay is often one of the earliest signs of autism.
• Speech Delay and ADHD: Attention difficulties can impact a child’s ability to focus on verbal communication.
• Speech Delay and Dyslexia: A connection exists between speech delays and later challenges with reading and comprehension.
• Speech and Motor Delay: Difficulty coordinating the muscles needed for speech can affect articulation.
• Tongue tie in infants: Although it’s unlikely to cause a speech delay, it can restrict tongue movement, impacting early feeding and speech development.

2. Environmental and Behavioral Factors

• Speech Delay and Screen Time: Excessive exposure to screens reduces opportunities for meaningful verbal interactions.
• Lack of Interaction: Children need conversations, storytelling, and play to develop language skills.

3. Physical and Sensory Challenges

• Hearing Loss: Even mild hearing impairments can disrupt a child’s ability to mimic sounds.
• Frequent Ear Infections: Chronic ear infections can temporarily impact hearing, affecting speech development.

Identifying these causes is crucial for creating effective intervention strategies tailored to each child’s needs. Identifying these causes is crucial for creating effective intervention strategies tailored to each child’s needs. Engaging in back-and-forth conversations, known as conversational turns, plays a crucial role in building children’s brains and fostering speech-language development.

How Speech-Language Impairment Affects Learning

Speech and language impairments can have profound and lasting effects on a child’s learning and overall development. Academically, these delays often lead to challenges in reading, writing, and understanding classroom instructions, particularly when early intervention is not provided. Children with speech-language delays frequently struggle with phonics, vocabulary, and the ability to construct sentences, which can make it difficult to keep up with peers.

Socially, children with speech delays may find it harder to connect with others, leading to isolation or difficulty forming friendships. The inability to express themselves or understand others can create barriers to social interaction, which are vital for a child’s emotional growth. Emotionally, frustration from being misunderstood can result in tantrums, low confidence, and behavioral problems. Recognizing these potential impacts early and addressing them proactively can prevent compounding difficulties.

Diagnosing Speech-Language Delays

Diagnosing speech-language delays involves a combination of screenings and evaluations by healthcare professionals. Speech language delay milestones and red flags help parents and professionals recognize when intervention may be necessary. Pediatricians typically monitor developmental milestones during regular check-ups, using tools like the Ages and Stages Questionnaire to flag potential delays.

A formal evaluation by a speech-language pathologist (SLP) assesses the child’s comprehension, vocabulary, and articulation skills. This process includes observing the child’s ability to follow instructions, form words, and interact verbally. Understanding speech and language terms and speech language skills in children can help parents navigate professional evaluations and therapies.

For clinical documentation, speech-language delay may be classified under an ICD-10 code, providing a standardized framework for diagnosis. Early and accurate diagnosis is essential to creating an effective intervention plan.

A study by Calyn E. Evans explores early indicators of Childhood Apraxia of Speech (CAS) and its impact on developmental milestones. Findings show that children with CAS often experience delays in babbling, first words, and two-word combinations, with a higher likelihood of a family history of speech disorders or comorbid conditions. However, no significant differences were found between children with persisting and resolving CAS. The research underscores the importance of early diagnosis and intervention to improve speech development outcomes.

Treatment Options and Accommodations

Treatment for speech-language delays often involves speech therapy, where children work with professionals to build their communication skills. Understanding speech production and expressive language skills is crucial in ensuring appropriate interventions for different speech and language challenges. Knowing how speech therapy helps can empower families to make informed decisions—it supports language development by targeting specific areas of need, improving articulation, comprehension, and expressive abilities through personalized techniques.

At Brooklyn Letters, our speech-language pathologists (SLPs) don’t just work with your child—we also teach you how to support and encourage speech therapy at home to boost their language development. Through play-based learning—like storytelling, games, and sing-alongs—your child will naturally expand their vocabulary while having fun. Our therapists guide parents in effective strategies such as expanding on their child’s speech, narrating activities, and incorporating visual aids to encourage communication growth. We’ll show you how to integrate these techniques into daily routines, making language learning a natural and effortless part of your child’s day. Supportive strategies like visual aids, simplified instructions, and giving extra time for verbal responses help children feel confident and successful as they build their communication skills.

Early intervention and speech therapy ensures that children receive the appropriate support at the right time, helping to mitigate long-term challenges and set them up for success.

Myths and Facts About Speech-Language Delays

Myth 1: Late talkers will always catch up.

Fact: While some children catch up naturally, other late talkers need intervention to meet milestones.

Myth 2: Bilingualism causes speech delay.

Fact: Learning multiple languages does not cause delays. Bilingual children may take longer to separate languages but catch up with time.

Myth 3: Boys talk later than girls.

Fact: Boys may develop slightly later, but significant delays in either gender require evaluation.

Myth 4: Speech delay indicates low intelligence.

Fact: Many children with speech delays have average or above-average intelligence.

Myth 5: All late talkers have autism.

Fact: Late talkers vs. autism—late talkers have isolated speech delays, while autism involves social and behavioral differences. A specialist can assess if support is needed.

Parent Strategies to Encourage Speech Development

Parents play a pivotal role in fostering their child’s speech and language development. Simple, everyday interactions can make a significant difference in helping children overcome delays and improve their communication skills. By creating a language-rich environment and engaging in activities that encourage verbal expression, parents can support their child’s progress effectively. Here are some practical strategies to help your child develop their speech and language abilities.

1. Engage in Daily Conversations

• Narrate daily activities and encourage your child to respond.
• Ask open-ended questions to promote longer conversations.

2. Read Aloud Together

• Choose books with pictures and discuss the images.
• Encourage your child to name objects and answer questions about the story.

3. Limit Screen Time

• Replace passive screen use with interactive activities, such as storytelling or role-playing games. Replace passive screen use with interactive activities, such as storytelling or role-playing games.
• This study concludes that directed media exposure, supported by active parental involvement, can enhance children’s language skills despite initial challenges. Thus, the study emphasizes the importance of effective supervision and management of screen time to support optimal language development.

4. Play Games That Promote Speech

• Singing, rhyming, and word games help develop language skills.
• Role-playing games encourage creative use of language.

Helping your child develop speech and language skills doesn’t require complicated tools or methods—consistency, patience, and meaningful interactions are key. 

FAQs About Speech-Language Delays

1. What is speech and language impairment?

Speech and language impairment is a condition where a person has difficulty speaking, understanding, or using language effectively. This can affect communication with others.

2. Is speech delay always a sign of autism?

No. While speech delay can be a symptom of autism, it can also result from hearing loss, developmental differences, or environmental factors.

3. Can screen time really cause speech delays?

Yes. Excessive screen time reduces the opportunities for face-to-face interaction, which are critical for language development.

4. How do I know if my child needs speech therapy?

If your child consistently misses developmental milestones or struggles with communication, it may be time to consider when to see a speech therapist—consult a pediatrician or speech-language pathologist to evaluate their needs and guide next steps.

5. How can I tell the difference between a speech delay and a language delay?

Think of speech and language like music:

🎵 Speech is the sound—like playing the right notes on an instrument. If a child has a speech delay, they may struggle with producing sounds correctly, making it difficult for others to understand them.

🎼 Language is the music—the meaning behind the notes. If a child has a language delay, they may struggle with understanding or using words to communicate their thoughts, even if their speech sounds are clear.

📌 Speech Delay – The child knows what they want to say but has trouble making the right sounds.
🔹 Example: A child who says “wabbit” instead of “rabbit” or “poon” instead of “spoon.”
🔹 Like a musician who understands the music but struggles to play the correct notes.

📌 Language Delay – The child has difficulty understanding and using words to express themselves.
🔹 Example: A child who doesn’t combine words yet, saying “juice” instead of “want juice.”
🔹 Like a musician who has an instrument but doesn’t know which notes to play to make a song.

📌 A child can have both a speech and language delay. For example, they might struggle to pronounce words (speech delay) and also have difficulty putting sentences together (language delay).

6. How a Speech-Language Pathologist (SLP) assesses this?

A Speech-Language Pathologist (SLP) will first analyze the child’s spontaneous expressive words—the words they use naturally during play or daily activities.

This includes:
✅ Words or word approximations – If a child says “baba” for bottle and both the child and parent understand what it means, it counts as a word.
✅ Gestures and vocalizations – If a child is using gestures (e.g., pointing, nodding) but not using words, the SLP will consider this in the assessment.
✅ Combinations of words – By age 2, most children should be putting two words together, like “more cookie” or “go park.”

👉 An SLP can determine whether a child has a speech delay, a language delay, or both—and create a plan to help them develop strong communication skills.

7. How long do speech delays last?

The duration of speech delays varies depending on the cause and the child’s response to intervention. Some children outgrow mild delays by age 3, while others with more significant delays or underlying conditions may require longer-term therapy and support. Early intervention improves outcomes and can shorten the duration of delays.

8. Can speech delay be cured?

Yes, speech delays can often be improved or resolved with proper intervention, especially if addressed early. Many children catch up with the help of speech therapy, parental support, and addressing any underlying causes (like hearing loss or developmental conditions). However, the outcome depends on the severity of the delay and its cause. Some children with delays due to neurological or genetic conditions may require ongoing support rather than a complete “cure.”

9. Does speech delay go away?

Speech delay can go away in many cases, especially with early intervention and appropriate support. Some children naturally catch up by age 3, particularly if the delay is mild and not caused by underlying conditions. However, if the delay is due to factors like developmental disorders, hearing issues, or neurological conditions, it may persist and require ongoing therapy and support. Early assessment and treatment by a speech-language pathologist can significantly improve outcomes.

10. Can speech delay run in families?

Yes, speech delay can run in families. Genetic factors may play a role in speech and language development, and children with a family history of speech or language delays are at a higher risk of experiencing similar challenges. This can be due to inherited traits that affect the brain’s language-processing abilities, oral-motor skills, or overall development.

Studies have also shown that speech and language disorders, such as childhood apraxia of speech or developmental language disorders, often occur more frequently in families with a history of such issues. However, environmental factors, parenting styles, and early intervention also significantly influence outcomes, even in cases with a genetic predisposition.

Additional Resources for Parents

• American Speech-Language-Hearing Association (ASHA)
• Centers for Disease Control and Prevention (CDC)

By recognizing speech-language delays early and seeking appropriate interventions, parents can help their children overcome challenges and thrive. Early support is the key to unlocking every child’s potential.

Worried about your child’s speech development? Brooklyn Letters offers in-home and online speech-language therapy for babies, toddlers, and preschoolers across NYC, Long Island, Westchester, Connecticut, and New Jersey. Our expert speech-language pathologists provide personalized support to help your child overcome speech and language delays. With convenient in-home and virtual sessions, we make therapy accessible and tailored to your family’s needs. Early intervention is key—boost your child’s communication skills today!

Schedule a free consultation to discuss your child’s needs. Call or text (347) 394-3485 or email [email protected] to get started.