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Delayed Speech or Language Development - part 2

The Difference between Speech and Language

Speech and language are often confused, but there is a distinction between the two:

• Speech is the verbal expression of language and includes articulation, which is the way words are formed.

• Language is much broader and refers to the entire system of expressing and receiving information in a way that's meaningful. It's understanding and being understood through communication — verbal, nonverbal, and written.

Although problems in speech and language differ, they frequently overlap. A child with a language problem may be able to pronounce words well but be unable to put more than two words together. Another child's speech may be difficult to understand, but he or she may use words and phrases to express ideas. And another child may speak well but have difficulty following directions.

Warning Signs of a Possible Problem

If you're concerned about your child's speech and language development, there are some things to watch for.

An infant who isn't responding to sound or who isn't vocalizing is of particular concern. Between 12 and 24 months, reasons for concern include a child who:

• isn't using gestures, such as pointing or waving bye-bye by 12 months

• prefers gestures over vocalizations to communicate by 18 months

• has trouble imitating sounds by 18 months

• has difficulty understanding simple verbal requests

Seek an evaluation if a child over 2 years old:

• can only imitate speech or actions and doesn't produce words or phrases spontaneously

• says only certain sounds or words repeatedly and can't use oral language to communicate more than his or her immediate needs

• can't follow simple directions

• has an unusual tone of voice (such as raspy or nasal sounding)

• is more difficult to understand than expected for his or her age. Parents and regular caregivers should understand about half of a child's speech at 2 years and about three quarters at 3 years. By 4 years old, a child should be mostly understood, even by people who don't know the child.

Causes of Delayed Speech or Language

Many things can cause delays in speech and language development. Speech delays in an otherwise normally developing child can sometimes be caused by oral impairments, like problems with the tongue or palate (the roof of the mouth). A short frenulum (the fold beneath the tongue) can limit tongue movement for speech production.

Many kids with speech delays have oral-motor problems, meaning there's inefficient communication in the areas of the brain responsible for speech production. The child encounters difficulty using the lips, tongue, and jaw to produce speech sounds. Speech may be the only problem or may be accompanied by other oral-motor problems such as feeding difficulties. A speech delay may also indicate a more 'global' (or general) developmental delay.

Hearing problems are also commonly related to delayed speech, which is why a child's hearing should be tested by an audiologist whenever there's a speech concern. A child who has trouble hearing may have trouble understanding, imitating, and using language.

Ear infections, especially chronic infections, can affect hearing ability. Simple ear infections that have been adequately treated, though, should have no effect on speech. delayed speech or language development


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