A typical 2-year-old can say about 50 words and speak in two- and three-word sentences. By age 3, their vocabulary increases to about 1,000 words, and they’re speaking in three- and four-word sentences.
If your toddler hasn’t met those milestones, they may have a speech delay. Developmental milestones help gauge your child’s progress, but they’re just general guidelines. Children develop at their own rate.
If your child has a speech delay, it doesn’t always mean something is wrong. You may simply have a late bloomer who’ll be talking your ear off in no time. A speech delay can also be due to hearing loss or underlying neurological or developmental disorders.
Many types of speech delay can be effectively treated. Continue reading to learn the signs of a speech delay in toddlers, early interventions, and how you can help.
How speech and language delays are different
Although the two are often difficult to tell apart — and frequently referred to together — there are some differences between a speech and language delay.
Speech is the physical act of producing sounds and saying words. A toddler with a speech delay may try but have trouble forming the correct sounds to make words. A speech delay doesn’t involve comprehension or nonverbal communication.
A language delay involves understanding and communicating, both verbally and nonverbally. A toddler with a language delay may make the correct sounds and pronounce some words, but they can’t form phrases or sentences that make sense. They may have difficulty understanding others.
Children can have a speech delay or a language delay, but the two conditions sometimes overlap.
If you don’t know which one your child may have, don’t worry. It’s not necessary to make a distinction to have an evaluation and start treatment.
Speech and language skills begin with the cooing of an infant. As the months pass, seemingly meaningless babbling progresses into the first understandable word.
A speech delay is when a toddler hasn’t met typical speech milestones. Children progress on their own timeline. Being a little late with conversation doesn’t necessarily mean there’s a serious problem.
What’s typical for a 3-year-old?
A typical 3-year-old can:
- use about 1,000 words
- call themselves by name, call others by name
- use nouns, adjectives, and verbs in three- and four-word sentences
- form plurals
- ask questions
- tell a story, repeat a nursery rhyme, sing a song
People who spend the most time with a toddler tend to understand them best. About 50 to 90 percent of 3-year-olds can speak well enough for strangers to understand most of the time.
If a baby isn’t cooing or making other sounds at 2 months, it could be the earliest sign of a speech delay. By 18 months, most babies can use simple words like “mama” or “dada.” Signs of a speech delay in older toddlers are:
- Age 2: doesn’t use at least 25 words
- Age 2 1/2: doesn’t use unique two-word phrases or noun-verb combinations
- Age 3: doesn’t use at least 200 words, doesn’t ask for things by name, hard to understand even if you live with them
- Any age: unable to say previously learned words
A speech delay may mean that their timetable is a little different and they’ll catch up. But speech or language delays can also tell something about overall physical and intellectual development. Here are some examples.
Problems with the mouth
A speech delay can indicate an issue with the mouth, tongue, or palate. In a condition called ankyloglossia (tongue-tie), the tongue is connected to the floor of the mouth. This can make it difficult to create certain sounds, particularly:
Tongue-tie can also make it hard for infants to breastfeed.
Speech and language disorders
A 3-year-old who can comprehend and nonverbally communicate but can’t say many words may have a speech delay. One who can say a few words but can’t put them into understandable phrases may have a language delay.
Some speech and language disorders involve brain function and may be indicative of a learning disability. One cause of speech, language, and other developmental delays is premature birth.
Childhood apraxia of speech is a physical disorder that makes it hard to form sounds in the right sequence to form words. It doesn’t affect nonverbal communication or language comprehension.
Hearing loss
A toddler who can’t hear well, or hears distorted speech, is likely to have difficulty forming words.
One sign of hearing loss is that your child doesn’t acknowledge a person or object when you name them but does if you use gestures.
However, signs of hearing loss may be very subtle. Sometimes a speech or language delay may be the only noticeable sign.
Lack of stimulation
We learn to speak to get in on the conversation. It’s hard to pick up on speech if no one engages with you.
Environment plays a crucial role in speech and language development. Abuse, neglect, or lack of verbal stimulation can keep a child from reaching developmental milestones.
Autism spectrum disorder
Speech and language problems are very often seen with autism spectrum disorder. Other signs may include:
- repeating phrases (echolalia) instead of creating phrases
- repetitive behaviors
- impaired verbal and nonverbal communication
- impaired social interaction
- speech and language regression
Neurological problems
Certain neurological disorders can affect muscles necessary for speech. These include:
In the case of cerebral palsy, hearing loss or other developmental disabilities can also affect speech.
Intellectual disabilities
Speech can be delayed due to an intellectual disability. If your child isn’t speaking, it may be a cognitive issue rather than an inability to form words.
Because toddlers progress differently, it can be a challenge to distinguish between a delay and a speech or language disorder.
Between
Your pediatrician will ask questions about your toddler’s speech and language capabilities as well as other developmental milestones and behaviors.
They’ll examine your child’s mouth, palate, and tongue. They may also want to have your toddler’s hearing checked. Even if your child seems responsive to sound, there could be hearing loss that makes words sound muddled.
Depending on initial findings, your pediatrician may refer you to other specialists for more thorough evaluation. These may include:
- audiologist
- speech-language pathologist
- neurologist
- early intervention services
Speech-language therapy
The first line of treatment is speech-language therapy. If speech is the only developmental delay, this may be the only treatment needed.
It offers an excellent outlook. With early intervention, your child may have normal speech by the time they enter school.
Speech-language therapy can also be effective as part of the overall treatment plan when there’s another diagnosis. The speech-language therapist will work directly with your child, as well as instruct you on how to help.
Early intervention services
Research suggests that speech and language delays at 2 1/2 to 5 years of age can lead to difficulty with reading in elementary school.
Speech delay can also lead to problems with behavior and socialization. With a doctor’s diagnosis, your 3-year-old may qualify for early intervention services before they start school.
Treating the underlying condition
When speech delay is connected to an underlying condition, or occurs with a coexisting disorder, it’s important to also address those issues. This may include:
Here are some ways you can encourage your toddler’s speech:
- Talk directly to your toddler, even if just to narrate what you’re doing.
- Use gestures and point to objects as you say the corresponding words. You can do this with body parts, people, toys, colors, or things you see on a walk around the block.
- Read to your toddler. Talk about the pictures as you go.
- Sing simple songs that are easy to repeat.
- Give your full attention when talking to them. Be patient when your toddler tries to talk to you.
- When someone asks them a question, don’t answer for them.
- Even if you anticipate their needs, give them a chance to say it themselves.
- Repeat the words correctly rather than directly criticizing errors.
- Let your toddler interact with children who have good language skills.
- Ask questions and give choices, allowing plenty of time for response.
It may very well be that there’s nothing wrong and your child will get there in their own time. But sometimes a speech delay could signal other problems, such as hearing loss or other developmental delays.
When that’s the case, early intervention is best. If your child isn’t meeting speech milestones, make an appointment with your pediatrician.
In the meantime, keep talking, reading, and singing to encourage your toddler’s speech.
A speech delay for a toddler means they haven’t reached the milestone for speech for a particular age.
Sometimes a speech delay is due to an underlying condition that needs treatment. In these cases, speech or language therapy can be used in conjunction with other therapies.
Many toddlers speak earlier or later than average, so it’s not always a cause for concern. If you have questions about your child’s speech or language abilities, see their pediatrician. Depending on their findings, they can refer you to the appropriate resources.
Early intervention for speech delay may get your 3-year-old caught up in time to start school.
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