Speech delay. Everything parents need to know.

How often does it occur? What might be responsible? How does it manifest?

One issue that often worries parents is when their child will speak. Concerns begin when the child is approaching the age of three and yet oral speech is non-existent or quite reduced compared to children of the same age.

As the literature shows, 4% of children have delayed oral language development. It is worth mentioning that speech and language disorders occur more often in boys than in girls with a ratio of 3:1.

But what is responsible for this? What are the risk factors?

Factors that may be responsible for delayed speech onset may include:

• Perinatal factors. Complications during childbirth affect speech development. Premature delivery and low birth weight are also risk factors.
• Genetic factors have been found to play the most important role. Hereditary predisposition, about 39% of children with speech delay have a first-degree relative with either the same disorder or a history of language impairment.
• Environmental factors. Poor living conditions, reduced language stimuli, inadequate language patterns in the family, bilingualism, psycho-emotional deprivation and child abuse are associated with cognitive and language delay.
• Otitis media is often accompanied by temporary hearing loss and can lead to chronic hearing loss with effects on speech initiation.
• Quite common is Developmental Anomaly. As it is known, every child has its own rate of development, so in some children the neurological maturation is quite slow, which results in a delayed onset of speech.

To determine whether a child has a speech delay, we need to know the developmental milestones.

Based on the typical stages of development, a child who has reached the age of 2.5 years and whose oral language is developing smoothly should:

• Have an expressive vocabulary of 50-250 words (nouns, names, verbs).
• Saying his/her name, naming familiar objects (not necessarily with clear articulation).
• Use personal pronouns correctly (I, you, me, etc.).
• Use simple complete sentences (Mum, let's go home).
• Beginning to understand grammatical phenomena (e.g. using simple plural forms)

But when do we talk about speech delay? What are the characteristics that should worry parents?

We talk about speech delay when the child is 2.5 years old and:

• He usually communicates with signs (shows what he wants).
• His expressive vocabulary is less than 10 words (he says only 'mom', 'dad', 'sleep',...).
• They find it difficult to mention their name.
• It does not use personal pronouns and the plural.
• He does not always follow commands we give him (e.g. give me the spoon).
• Does not do word combinations (e.g. Mum I want swings)

In most cases, speech delay is directly linked to the onset of learning difficulties. Therefore, for the child's effective communication and subsequent successful school performance, speech delay should not be overlooked by parents.
The sooner the child is diagnosed and placed in a therapeutic programme, the sooner the child's oral language problems and therefore learning will be addressed.