What is a speech delay | Speech vs language delay | Speech delay Statistics | Milestones | Signs of speech delay | Causes | How many words should a 18 month old say | Late talkers | How can parents help | Should you worry | Speech therapy
Is your 18 month old not talking making you worried?
It may simply mean that your child is developing at their own pace and hitting milestones at their own time—which is perfectly normal.
But it may also signal something serious. In this case, detecting and treating your child early allows you to prevent emotional, social, and cognitive deficits associated and improve their development.
Ahead, this article takes a closer look at speech delays and what it might mean if your 18-month-old is not talking.
If you’re worried your child may have a speech delay, there are some signs you can look for, and perhaps more importantly, there are things you can do to help them get over the hump.
What Is A Speech Delay?
A child has a speech delay when they do not develop their speech and language skills at an expected rate. When a child’s speech development is significantly below the norm for children of the same age, the child is considered to have a speech delay. The language skills they acquire typically follow the normal progression, but at a slower rate.
Difference between speech and language delay
Although these terms are often used interchangeably, speech delay and language delay are not the same.
Speech is the motor act of articulating the verbal expression of language. It is the verbal production of language. Speech delay is a condition in which a child has difficulty producing speech.
Language is the use of symbols to communicate interpersonally. It includes receptive language (understanding of language) and expressive language (conveying information). Language delay occurs when a child has difficulty understanding or expressing language. Language is not only spoken or heard. It can also include a visual form used in, for example, sign language1.
Very active toddler not talking could be due to either or both of these conditions.
Speech delay statistics
Here are some statistics for speech and language delay
- Speech delays are a fairly common developmental problem. It affects anywhere from 3% to 10% of preschool children2.
- It is one to four times more common in boys than in girls3.
- Children with all three of the following risk factors are 7.7 times more at risk of language delays than those who have none of them – low maternal education, male gender, and family history of developmental communication disorder4.
- Behavioral issues may also accompany language disorders. 40-75% exhibit challenging behaviors5,6. These children may become easily frustrated when they can’t express what they need or want.
Baby speech developmental milestones
As children start learning to talk, they progress from cooing to babbling, echolalia, jargon, words, and word combinations. Typical speech development patterns are as follows7:
|Age||Language Development milestones|
|6 months||Coos reacting to a voice|
|11 months||Imitate sounds and say things like “Mama/Dada” without knowing the meaning|
|12 months||Say “Mama/Dada” and know their meanings. Imitate words with two or three syllables|
|15 months||Have a limited vocabulary of around 4 to 7 words|
|18 months||Have a vocabulary of around 10 words|
|21 months||Have a vocabulary of around 20 words|
|24 months||More than 50 words in vocabulary. Can make two-word phrases and most of the speech can be understood by strangers|
|2.5 years||Know more than 400 words. Can form phrases with 2 to 3 words. Most of the speech can be understood by strangers|
|3 years||Know how to use plurals and past tense, object counting words and can form sentences with up to 5 words.|
|4 years||Form long sentences with 3 to 6 words. Ask questions and tell stories. Speech can be easily understood.|
|5 years||Long sentences can contain up to 8 words. Can name colors, count money, etc.|
Signs Of A Speech Delay in 18-month-olds
If your 18-month-old is not talking, the following signs could indicate a speech delay8.
- Your child does not babble, point, or gesture
- They do not use at least three words, such as “mama” or “dada”
- They cannot point to a few parts of the body when asked (like hands, head, feet)
- They don’t understand simple commands (like “Roll the ball”)
- They don’t respond to simple questions with words or gestures (like “Where’s your shoe?”)
- They don’t enjoy simple stories, songs, or rhymes
- They cannot use one or two-word questions (such as “Where mama?” or “Bye-bye”)
- They have trouble putting two words together (like “More milk”)
- They cannot imitate different speech sounds
What Causes speech delay in toddlers
Speech delays are caused by different factors in different children. There is no single underlying issue for everyone. However, there are some common conditions that could delay language skill development. Here’s a closer look at some of the more common causes.
Many late-talking toddlers are often the result of developmental delays. It occurs when the central neurologic process required for producing speech is delayed. It is more common in boys and in families with late bloomers.
The majority of these children do not ultimately have language disorders9. These children usually have normal speech development by the time they enter school.
The ability to hear plays a significant role in our ability to speak. A child’s ability to speak, use language effectively, and understand others will be severely impacted if their hearing is impaired.
Hearing issues can be the result of congenital defects, but they can also be temporary due to, for example, an ear infection.
Auditory processing disorder can also cause some children to struggle with understanding speech in noisy environments10.
According to one research, approximately 50% of children’s speech/language delays are caused by this condition2.
Intellectual disability (also known as general learning disability and formerly called mental retardation) is a significant impairment of a child’s cognitive skills and adaptive functions11. Speech delay is a common symptom of intellectual disabilities.
A number of neurological disorders are associated with difficulties with speech, including Autism, Attention Deficit Hyperactivity Disorder (ADHD), and cerebral palsy.
Autism – Autism is a neurologically based developmental disorder. Among the symptoms of autism is difficulty with language development.
Attention Deficit Hyperactivity Disorder – Language disorders are more common in children with ADHD. Inattention and impulsivity can hinder opportunities to learn and practice spoken language skills.
Cerebral palsy – difficulty with coordination or spasticity of tongue muscles, hearing loss, coexisting intellectual disability, or a defect in the cerebral cortex can affect various aspects of language use.
Receptive aphasia is characterized by difficulties comprehending spoken language, leading to speech delay. Despite their disability, receptive aphasic children respond normally to nonverbal auditory stimuli.
Expressive aphasia (Expressive language disorder)
Expressive language disorder, a less common disorder, can show symptoms of late language emergence. These children may have normal IQs, receptive language skills, emotional relationships, and articulation skills. Brain dysfunction appears to be the primary cause of the inability to translate ideas into speech.
Deprivation, both physical (e.g., poverty, malnutrition) and social (e.g., child neglect) has an adverse effect on a baby’s speech development. Early childhood is the sensitive period for language development. Children living in abusive conditions are less likely to use verbal communication with their parents. They tend to develop speech/language disorders and lack any verbal communication skills in extreme cases12.
Elective mutism occurs when children do not speak in specific environments, i.e., at school but not at home or only with familiar people. Speech/language issues often co-occur with selective mutism, which is conceptualized as an anxiety disorder13.
Children who live in bilingual households may experience temporary delays in learning both languages. However, bilingual toddlers have a normal understanding of both languages at their age, and they usually become proficient in both languages before their fifth birthday.
How Many Words Should A 18-Month Old Say?
Each child develops at their own pace, and every child is different. Therefore, there are no hard and fast rules regarding the number of words an 18-month-old should say.
Generally, 18-month-olds know at least 10 words in their vocabulary.
Interestingly, 18 months also marks a time of dramatic increase in the number of words acquired by some children14. It is not unusual for a child to have a “language explosion” and their vocabulary to grow from 10 words to 250 words overnight.
Do Late Talkers Catch Up?
Many late talkers do catch up on their own. By the time they are ready for school, approximately 70 to 80% of them will be on par with their peers15 while approximately 20 to 30% of them continue to struggle with reading, writing, and language16.
However, if a child’s speech delay is related to neurological differences, then intervention and treatment should be applied as soon as possible so that it will not develop into further language difficulties.
How Can Parents Help When Their 18-Month-Old Is Not Talking?
If your 18-month-old is not talking, there are some things you can do to help them with their speech delay.
Talking to your baby during everyday activities not only helps them learn the language but also plays a key role in their brain development. The more your child is exposed to the language, the more words they’re likely to pick up17.
Caretakers naturally speak differently to children than to other adults. This type of “baby talk” has been found to play a critical role in language development.
More importantly, don’t just talk to your baby, talk with them, as if you are having a conversation with them.
Studies find that engaging in “conversational duets” can significantly help improve a child’s speech development18.
Encourage peer pretend play
Role-play or pretend play has been found to help language development in preschool children19.
You can invite other families with young children over or enroll your child in a daycare that offers plenty of free time for kids to engage in simple pretend play.
Encouraged imitation of sounds
A study suggests that children learn to speak by imitating others’ speech. Encourage your child to repeat after you to learn new words. Be sure to praise your child often to reinforce their effort.
Should You Worry If Your 18 Month Old Not Talking?
When it comes to developmental milestones, kids often learn at their own pace, whether it’s walking, talking, or potty-training.
It is normal that a toddler makes sounds not words. Some 18 month old screams instead of talking. A 16 month old not saying words is also not unusual.
But it can be worrisome if your 18-month-old is not talking at all.
Be sure to bring up this issue with your child’s doctor during their regular well-child checkup and get a referral to a speech-language pathologist for evaluation. It may also help to mention whether your 18 month old is not talking but understands your words.
A comprehensive evaluation is essential when a child does not meet expected speech and language milestones. Abnormal language development is often a secondary manifestation of other physical and developmental problems. The earlier the intervention, the better.
Will Speech Therapy Help An 18-Month-Old Who’s Not Talking?
Studies show that speech therapy can help kids with speech delays improve significantly, especially when given early.
However, before receiving speech therapy, be sure to check with your child’s pediatrician and a language therapist.
Depending on the reason why your 18 month old is not talking, the best type of therapy may vary. Once the cause and best type of therapy are identified, look for a speech therapist who specializes in it.
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