Being a parent means a dozen new questions with each new phase of your child’s growth. It’s exciting and daunting! When it comes to their speech development, the questions seem to multiply. You find yourself asking:

• Does he know enough words?
• Does she sound like other children her age?
• Am I reading to him enough?
• How is her hearing?
• When will he start speaking?
• When will I be able to hear real words?

Often these questions stem from a concern about whether or not your child has a speech delay. But what is toddler speech delay? And as a parent, how do you recognize it and what can you do about it? More questions!Let’s try to answer some.

What is a toddler speech delay?

Often when we refer to toddler speech we’re actually referring to both speech and language, as children are developing language skills as soon as they are born, and well before they can actually articulate words. They learn to talk and communicate over a series of milestones that occur in a certain order and around the same time for most children. That’s not to say that all children learn the same thing at exactly the same age, but typically they learn common things within certain age ranges. Refer to C.S. Mott Children’s Hospital’s table of milestones that indicate normal speech development for a list of these milestones.“Delay” is simply when your child is reaching these milestones but much later than expected.According to the American Academy of Pediatrics, one out of 5 children will learn to talk or use words later than other children their age. The American Academy of Family Physicians reports that 10% of preschool children suffer from speech and language delays.

What are the causes?

Many children are simply what is called “late bloomers” and will catch up with other children by the age of 3 without any medical interventions.Sometimes, however, a speech delay is caused by a more serious condition. It’s important to be aware of these, which include:

• Oral impairment, or physical issues with the tongue or mouth
• Oral-motor problems, or a problem with the part of the brain responsible for the muscles in the mouth
• Hearing problems
• Slow development
• Developmental delay related to genetic differences or disorders (syndromes)
• Illness, injury or environmental factors
• Autism spectrum disorder

Does bilingualism cause speech delay?

There is often a concern that bilingualism will cause of speech delay. According to the research of Annick De Houwer, Professor of Linguistics at Erfurt University, “There is no scientific evidence that hearing two or more languages leads to delays or disorders in language acquisition. Many, many children throughout the world grow up with two or more languages from infancy without showing any signs of language delays or disorder.”Yes, the brain must work harder to learn two languages, so it is not uncommon for bilingual children to have an initial silent period and a temporary delay in using one or both languages, but this often resolves itself and the child will be speaking both languages closely along the same timelines as children speaking one language. Parents of bilingual children should look to the talking milestones as suggestions and focus on the signs of progress, instead. Learn more about raising bilingual children from the American Speech-Language-Hearing Association (ASHA).

What are the signs of speech delay?

Though every child develops at their own pace, if they are not talking as much as other children their age, they may indeed have a speech delay. Along with the talking milestones, there are corresponding signs for speech delay at various ages that you can look for in your child’s speech development. Here are just a few:12 months:

• Isn't using gestures, such as pointing or waving bye-bye

13-15 months:

• Doesn’t say simple words like “mama” or “dada,” or says them unclearly

18 months:

• Prefers gestures over speaking
• Has trouble imitating sounds
• Doesn’t understand simple words like “no”

24 months:

• Can imitate speech but doesn't speak words or phrases spontaneously

3 years:

• Can’t talk in short sentences

4-5 years:

• Can’t tell a simple story

For more comprehensive and detailed charts of both milestones and signs of delay, see this resource on ASHA.

What can you do to help your toddler?

Keep talking, reading, singing...

You’re talking to your baby, narrating the day with “self-talk”, reading books, singing songs, and playing with them. Keep it up! Children learn speech and language through exposure and repetition. This is even more important if they are a late bloomer. For more ideas check out, Ten Simple Strategies to Help Your Baby Develop Speech.

Avoid screen time

Research presented at the 2017 Pediatric Academic Societies Meeting suggested that children who have screen time on handheld devices may have a higher risk for speech delays. Unfortunately, as Dr. Catherine Birken, the study’s principal investigator and a staff pediatrician at The Hospital for Sick Children noted: “While new pediatric guidelines suggest limiting screen time for babies and toddlers, we believe that the use of smartphones and tablets with young children has become quite common.” The problem with these devices is that they do not provide the interactive, give-and-take, qualities of real-life, human communication which is essential to proper speech development.

Be sensitive to frustrations

Living with a speech delay is frustrating, for parent and child. Your child wants to communicate with you. If they’re not able to do so successfully they may act out, get angry, and even resort to unexpected behavior to get their point across. Be patient. Continue to talk to them and communicate with them. Offer lots of encouragement and praise when they try to speak. Let them know you’re in it together.

Get medical attention and support

You know your child best. If you think there’s a reason for concern with your child’s speech development, do not hesitate to consult with your child’s physician.As already mentioned, not all speech delays will require treatment. Many children have trouble with some sounds, words, and sentences while learning. Your child’s physician will do an overall assessment and help identify if there is an underlying medical problem or if any treatment  might help. They might refer your child to one or both of the following specialists:

• A Speech-language Pathologists to help with language, speech, sound, voice and stuttering problems
• An Audiologists to check on and help with hearing problems

Rest assured that if there is a medical condition causing your child’s speech delay, there are treatments and educational programs to support them. Should your child be diagnosed with a speech or language disorder, ask your physician about Early Steps, Florida’s early intervention program, and check with your child’s school about special education services. Become familiar with the Individuals with Disabilities and Education Act (IDEA).Speech delays are not uncommon and do not necessarily require medical attention. There are lots you can do to offer your late bloomer support in their speech development, and even speech delays that do require medical treatment can often be resolved well enough for the child to go on to have satisfying, productive communication. So keep asking questions! And if you feel the need to discuss this or any other concerns sign up for 24/7 pediatric services online with Blueberry Pediatrics.