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Does My Child Have a Speech and/or Language Delay?

Warning Signs for Speech and Language Delays
If you suspect your child has a language or speech delay, getting them an appointment with a speech-language pathologist could be one of the important things you do for your child.  The warning signs for delays in speech and language development may be subtle, but can be observed in children in many aspects: their academic pursuits, their development, their behaviour, or their social-emotional conduct.  According to a 2006 study, five to eight percent of preschool children are affected by a speech and language delay (Wankoff 176).

If you are concerned about your child having a speech and language delay, the following list should help you evaluate your concerns.  Compare your child’s behaviour to the warning signs listed below for their age group and the younger age groups.  If you are unsure about your observations or how they compare to these warning signs, we recommend that you book an appointment with a speech-language pathologist to assess your child’s speech and language development.

Why Intervention is Important

One of the most important struggles that children with speech and language delays experience is the ability to form a sense of self.  One of the purposes of communicating and interacting with people is to form an identity and understand one’s agency in the world.  A child who struggles to communicate day-to-day loses this opportunity and will likely experience issues in self-esteem and issues in building meaningful relationships with others.

General Warning Signs to Keep in Mind as Your Child Grows

  • General lack of language use
  • Difficulties in word retrieval
  • Difficulties regulating behaviour
  • Noncompliant behaviour
  • Inattentiveness
  • Poor frustration tolerance

Warning Signs: Birth to 8 Months

  • Prominent feeding difficulties
  • Diagnosed motor or sensory impairments
  • Little or no interest in exploratory play of objects or environment (through vision, touch, or hearing)
  • Little or no reciprocity with eye gaze or body gestures
  • Limited vocalizations

Warning Signs: 8 to 12 Months

  • Little or no understanding of joint attention
  • Little or no communication through facial expressions or gestures
  • Little or no responsivity to others
  • Little or no display of emotion
  • Babbling of only one consonant and vowel combination (consistently saying one babble sound like “wawa” or “baba”)

Warning Signs: 12 to 18 Months

  • Deficient in comprehension of simple words or concepts
  • Difficulty with or understanding turn-taking activities
  • Fewer than 2 communicative acts (speech, gestures, facial expressions) per minute
  • Lack of vocal or gestural reciprocity
  • Lack of awareness of object function
  • Lack of object search or object play
  • Expresses a small range of meanings
  • Small range of communicative functions expressed (greetings, requests, protests, questions, statements, story-telling)

Warning Signs: 18 to 24 Months

  • Lack of pretend play
  • Slow-growing vocabulary
  • Little or no utterances of two or more words
  • Lack of reciprocation in speaking
  • Rarely initiates communication (typically imitates or echoes the language)

Warning Signs: 2 to 3 Years

  • Preference for playing alone
  • Little or no pleasure in peer interactions
  • Lack of elaborate play schemas or symbolic/pretend play
  • Low level of grammatical complexity used (few sentences with more than one verb)
  • Rarely initiates communication (typically imitates or echoes the language)
  • Fewer than 5 communicative acts (speech, gestures, facial expressions) per minute
  • Family members and strangers have difficulty understanding child when child communicates
  • Persistent interruptions in their own speech (hesitations, repetitions, prolongations, interjections)
  • Typically noncompliant (follows own agenda, does not follow instructions)

Warning Signs: 3 to 4 Years

  • Strangers cannot understand child when child communicates
  • Little or no competence for conversation (does not initiate, maintain, or change topic)
  • Little turn-taking in conversation
  • Little or no vocabulary growth
  • Minimal use of grammatical markers for tense, person, and number
  • Does not discuss non-present events and has not begun to tell narratives
  • Behaviour noncompliance, inattentiveness, anxiety, or oppositionality

Warning Signs: Kindergarten Children

  • People have difficulty understanding when child communicates
  • Difficulty expressing language
  • Deficient listening comprehension
  • Resistance to learning sound games or letter-sound correspondence

Warning Signs: First and Second Graders

  • Difficulty learning to read
  • Challenges in listening comprehension for conversation, television, movies, or jokes

Warning Signs: Third and Fourth Graders

  • Poor expressive language (difficulty answering questions or formulating verbal messages or managing conversations)
  • Deficits in listening and/or reading comprehension
  • Challenges in decoding unfamiliar words

Wankoff, L. S. (2011). Warning Signs in the Development of Speech, Language, and Communication: When to Refer to a Speech-Language Pathologist. Journal of Child and Adolescent Psychiatric Nursing, 24(3), 175-184. Retrieved February 4, 2016.

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