Common causes of speech & language delays in children

The number one key factor that determines proper speech and language development in children is hearing. This is why it is recommended that a child have a hearing test soon after birth. If a child is not developing normally with regards to communication, a hearing test is always the first critical step in diagnosis.

Possible causes for the increase in language or speech delays in children

Over the past couple of months, I have noted a spike in the number of children between the age of two and three years old being brought in for an assessment because parents are concerned that they are not speaking. Why this is happening is unclear but in discussions with other professionals and drawing on my own experience there appear to be three major factors to consider, namely:

Lockdown contributing to speech delays in children

Lockdown was necessary to keep our society safe but it has also taken its toll on children. During the first couple years of life, children are using all their senses to learn and make sense of the world. This is known as sensory integration. Lockdown prevented children in this age group from socialising, running freely on the grass, rolling about in ball pools, climbing jungle gyms and interacting with their environments.

All of these sensory experiences would have sent messages to the brain, stimulating all sorts of everyday activities and communication. Children who were not able to get all the sensory input they required may have suffered as a result. Children did not have the opportunity to interact with other children and adults, where they would have developed skills to express language and to receive it.

Screen time contributing to speech delays in children

I do believe that excessive screen time has a big impact on speech delays in children because children stare at stimulus on a phone, with no need to interact with another person. The phone does not encourage the child to express his or her own opinions or feelings. These are two important elements for communication.

Parent knowledge contributing towards early intervention of speech delays in children

One has to acknowledge that access to information on various platforms has enabled parents to find norms and information about possible problems in their child’s development. This is a good thing. Armed with this information, parents may present earlier than in times gone by because they have a wealth of information at their fingertips. Awareness of conditions which affect a child’s ability to interact and communicate have also come under the spotlight in recent times. This awareness has made early intervention possible and this is vital to successful outcomes.

Interventions such as speech therapy and occupational therapy are producing amazing results in children with certain speech delays but there are certainly things which parents can do and be aware of before intervention becomes necessary.

How does language and speech develop in children?

As mentioned above, the first three years of a child’s life are vital for speech development. This is because the brain is developing and a child’s ability to learn and acquire speech and language is at its best.

Think of yourself as an adult: learning a new language is very difficult and takes many years of practice. A child naturally acquires these skills, as this window between birth and three years of age is a critical period for the brain to absorb language and make sense of it.

These skills develop best if the environment is full of sound and where the child has plenty of exposure to other people speaking. If this window period is missed then language is far more difficult to acquire. With this in mind, one can see how lockdown and excessive screen time in the formative years has impacted the age group two to three years.

What are the normal stages of language development in the first 3 years of a child’s life?

Each child will be slightly different when it comes to speech but as I stated in the beginning, there are norms and speech and language development milestones that parents can watch out for. Stanford University put out a useful table to use as a guideline. What I really like about this is that is shows how speech and language begins from the moment your baby is born.

Stanford University: speech and language milestones in children

Birth to 5 months
  • Coos
  • Vocalises pleasure and displeasure sounds differently (laughs, giggles, cries, or fusses)
  • Makes noise when talked to
6 to 11 months
  • Understands “no-no”
  • Babbles (says “ba-ba-ba”)
  • Says “ma-ma” or “da-da” without meaning
  • Tries to communicate by actions or gestures
  • Tries to repeat your sounds
  • Says first word
12 to 17 months
  • Answers simple questions nonverbally
  • Says 2 to 3 words to label a person or object (pronunciation may not be clear)
  • Tries to imitate simple words
  • Vocabulary of four to 6 words
18 to 23 months
  • Vocabulary of 50 words, pronunciation is often unclear
  • Asks for common foods by name
  • Makes animal sounds, such as “moo”
  • Starting to combine words, such as “more milk”
  • Begins to use pronouns, such as “mine”
  • Uses 2-word phrases
2 to 3 years
  • Knows some spatial concepts, such as “in” or “on”
  • Knows pronouns, such as “you,” “me” or “her”
  • Knows descriptive words, such as “big” or “happy”
  • Uses 3-word sentences
  • Speech is becoming more accurate, but may still leave off ending sounds. Strangers may not be able to understand much of what is said.
  • Answers simple questions
  • Begins to use more pronouns, such as “you” or “I”
  • Uses question inflection to ask for something, such as “my ball?”
  • Begins to use plurals, such as “shoes” or “socks” and regular past tense verbs, such as “jumped”

What are the common causes of speech and language delays and problems in children?

I mentioned early on in the blog what I believe may be contributing to the sudden rise in the number of children not speaking but there are certainly conditions which a child may suffer from that may affect speech.

These include:

  1. Hearing loss A child who cannot hear well – or at all – will not be able to replicate speech.
  2. Learning difficulties Some children have learning difficulties which may affect their ability to produce sound, affect his or her ability to use language to communicate or they may find it difficult to understand what other people are saying.
  3. Auditory processing In this instance there is no problem with the child’s ability to hear but the brain has difficulty decoding speech sounds. A child with an auditory processing problem may struggle to follow instructions or understand a story.
  4. The autism spectrum Children with autism or who are on the spectrum often struggle with speech. This is often one of the early signs of autism but interventions such as speech therapy and occupational therapy can make a tremendous difference.
  5. Selective mutism This is when a child refuses to speak in certain situations. It may be that a child will speak at home but refuses to speak at school. This may be due to shyness but I have also experienced mutism amongst my ex-premature babies. Perhaps the traumatic birth and exposure to ICU traumatised these tiny people and this translates into a refusal to speak in a stressful environment. Psychology can really help these little ones.
  6. Prematurity This can lead to all sorts of delays in development including speech and language.

Conclusion

The ability to communicate is such an important part of all our lives. Not only does it allow us to express our needs and wants but it also allows us to belong to a community. Often parents will tell me that Granny says all her children were “late-bloomers”. It may well be the case that in certain families, children speak a little later than the norm, but with modern technology and expertise one should not just go with a generalised statement like this.

It can be very difficult for a parent or caregiver to tell whether a child has a hearing problem or a language disorder, so getting trained help sooner rather than later may make a huge difference in your child’s ability to socialise, learn and engage with the world.

As parents and caregivers we need to ensure that interaction is real and meaningful and not constantly interrupted by calls and messages. Children are fast learners and if they live in a world where parents communicate on devices, then this is likely to become their reality as well.

The problem with this is that they may miss out on an integral phase of their development and this will certainly have far reaching implications. Talk, sing, tell stories and engage. You will be constantly amazed and amused by your little one’s perception of the world.

References

https://kidshealth.org/en/parents/not-talk.html

https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/language-development/art-20045163

https://www.asha.org/public/speech/disorders/Late-Blooming-or-Language-Problem/

https://www.asha.org/public/speech/development/speech-and-language/

https://raisingchildren.net.au/toddlers/connecting-communicating/communicating/communicating-well-with-children

https://www.cdc.gov/ncbddd/childdevelopment/language-disorders.html

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