Typical Signs Warning of Speech Delay in Children
1. What is speech delay in children?
Speech is a verbal communication tool expressed through sound. The three main components of speech are: pronunciation, voice quality, and fluency. Speech disorders occur when a child can produce sounds, but others cannot understand what they are saying, such as: stuttering or slurring.
Language is a means of expressing and receiving information, through speech or gestures (body language, sign language). Language is a measure of intelligence, so language development disorders are often more serious than speech disorders.
Speech and language disorders refer to abnormal language development, which is the most common form of developmental delay in children, occurring more frequently than other types of delays (e.g., visual, motor, cognitive, social, and emotional skills delays).
Language delay or speech delay in children is when a child's language develops in the normal sequence but at a slower pace compared to other children.
2. Warning signs of speech delay in children
2.1. Speech delay in children aged 3 - 4 months
The child does not respond to loud noises.
The child does not make cooing sounds.
Or the child starts cooing but does not imitate other sounds (by 4 months old).
Some signs can help identify early speech delays in children
2.2. Speech delay in children aged 7 months
The most reliable warning sign is: the child does not respond to sounds.
2.3. Speech delay in children aged 12 months
The child does not attempt to communicate with others (while other babies have started using sounds, gestures, or words), even when the child needs help or wants something.
The child does not know any words, such as: “mama” or “dada”.
Does not babble, does not produce consonants (e.g., p or b).
The child does not know how to perform simple actions like: waving goodbye, shaking their head to say no, pointing at objects they want.
The child does not respond when their name is called.
Does not understand and does not react to simple words like: “no”, “hello baby”, and “bye bye”.
The child shows no interest in the world around them.
2.4. Speech delay in children aged 16 months
The child at 16 months still does not understand and does not respond to words like: “no”, “get up”.
Cannot say any words.
Does not know how to point to objects or pictures in front of them when asked, for example, when parents ask: “Where is the ball?”.
The child does not know how to point to things they like, as if to express “Mom/Dad, look here!” and combines it with the action of looking up at their parents.
2.5. Speech delay in children aged 18 months
The child cannot point to some body parts (e.g., head, eyes, nose) when asked by adults.
The child cannot say 6 words at all.
The child cannot or does not want to try to communicate in any way, even when they need help.
Does not know how to point to what they want.
Still cannot say simple words like: “mama”, “carry me”.
The child does not understand simple commands, for example, “Don’t touch that”.
Does not respond verbally or with gestures when asked by parents or relatives “What is this?”, “Where are the baby’s shoes?”.
2.6. Speech delay in children aged 19 - 23 months
The child’s vocabulary increases slowly (not achieving one new word each week).
Children with speech delays do not learn any new words each week
2.7. Speech delay in children aged 24 months
The child has not spoken a total of 15 words.
Cannot produce speech independently and only repeats what parents or others have said.
Cannot engage in simple conversations with sentences of 2 words, for example: “Mom carry me”, “Drink more” (or can say it but stutters).
Does not want or cannot use words to communicate, except in emergencies.
Does not understand longer instructions or questions, for example: “Take your shoes”, “Do you want to drink?”, “Where is Dad?”.
Does not know how to pretend to play with dolls or play by themselves, for example: feeding the doll, talking to the doll, grooming themselves.
Does not know how to imitate the actions or words of others.
When looking at books, the child cannot point to a picture that parents name.
The child cannot connect two words together.
Does not know the purpose of common household items, for example: toothbrush, bowls.
Note: at this age, about 1 in 5 children may show signs of speech delay, and many of these children will catch up with their peers as they grow.
2.8. Speech delay in children aged 25 – 35 months
The child cannot say simple sentences of about 2-4 words.
Cannot name some body parts.
Does not remember things that are repeated many times, for example: a short poem.
Cannot ask simple questions independently.
No one in the family can understand what the child means.
2.9. Speech delay in children who are 3 years old
The 3-year-old child does not use any pronouns (I, mom, dad).
Cannot combine words into a short sentence, for example: “Mom help me”, “Want to drink more”.
Does not understand short instructions or questions, for example: “Take your shoes and put them on the shelf”, “What do you want to eat for lunch?”.
The child’s speech is very unclear, making it difficult for both family members and outsiders to understand.
Frequently stutters, very difficult to produce sounds or words, and the child’s face grimaces when speaking.
The child does not ask questions.
Shows little interest or even no interest in storybooks.
Does not show interest or interact with other children.
Especially, the child has great difficulty separating from parents.
2.10. Speech delay in children aged 4 years
The child cannot pronounce most consonants correctly.
Does not understand the concepts of “same” and “different”.
The child does not use the pronouns “I” and “mom” correctly.
3. What are the signs of simple speech delay in children?
According to statistical studies, about 1 in 5 children experience speech or word use delays compared to their peers. Some children even show behavioral disorders due to frustration from their inability to express what they want to say.
Simple speech delay may sometimes be temporary, and this can improve with family support. Parents need to encourage their children to practice speaking through gestures or sounds, and spend more time playing, reading, and talking with them every day.
In some cases, speech delay may require assistance from medical professionals. Sometimes, speech delay can be a warning sign of more serious issues. Common issues associated with speech delay may include: hearing loss, developmental delays in other areas, or even childhood autism. Language development delays in young children can also be a sign of learning disabilities, which can only be diagnosed when the child reaches school age.
If a child shows the above signs of speech delay, the first thing parents need to do is check the child's hearing ability. Even if the child seems to hear well, do not be complacent, as most children are very good at guessing based on adults' images and gestures. Hearing impairments need to be detected and treated promptly. Parents should not wait and hope that the child will overcome the impairment on their own. It is essential to take the child for a specialist examination if there are concerns about their language development. Speech delay or any language abnormalities, if detected early and treated promptly, can significantly improve the child's communication abilities.
Choosing prenatal and delivery care at Vinmec International General Hospital ensures that from the womb, the baby is screened for congenital defects; examined immediately after birth, and screened for hearing loss or congenital deafness - causes of speech delays.
5 “red flag” signs related to speech delays associated with autism in children that parents should be aware of:
Does not babble by 12 months old
Does not know how to signal (pointing, waving, shaking hands...) by 12 months old
Cannot say single words by 16 months old
Cannot form 2-word sentences by 24 months old (not including repeating words)
Loss of language skills or communication skills at any age
If parents notice any unusual signs in their child, they should take the child to reputable facilities for examination and treatment.