Speech and Language Delays in Toddlers
Many parents become concerned when their child isn’t beginning to speak as well or as clearly as their same aged peers. Certainly there is some normal variability in the age at which children acquire speech and language, but when should a parent become concerned and seek further evaluation?
Typically, first words appear around one year of age. To be considered a “word”, it does not necessarily have to be pronounced correctly, just used consistently (e.g. a child may say “du”or “ju” for juice). Simplification of adult forms of words is a normal developmental process at this age. Some children acquire their first words prior to their first birthday, other children a few months after. Children born prematurely require an age adjustment where first words would be expected to appear approximately thirteen months from the planned due date not the actual birth date.
By a child’s second birthday, he/she should have a minimum of 50 words in their speaking vocabulary. At two years, your child should be beginning to combine words into short phrases and sentences e.g. “more juice”, “mommy go”. Between two and three years of age, speech and language skills should show a dramatic increase. By three years of age, a child should have several hundred words in their vocabulary and be speaking in more lengthy sentences and be able to carry on a short conversation with an adult. Your child should be speaking clearly enough so that most people outside of your immediate family can understand what your child is saying when the context is known.
Language is dynamic and a two-three year old child should be using it to communicate a variety of different functions such as to request, tell about an object, share information and refuse/protest. Communication involves turn taking between the speaker and the listener on a shared topic.
A child should be assessed if the child:
- Has a limited speaking vocabulary by their second birthday
- Is not combining words by their second birthday.
- Uses few consonants and is difficult to understand during their second year
- Does not seem interested in communicating or playing with others.
- Does not use pointing and words to regularly draw a parent’s attention to objects in their environment.
- Shows limited growth in vocabulary or a regression in speech skills.