Understanding speech delay in children


By the first birthday, babies should be using their voices to relate to their environment. / Net photo.

Normally, as children develop they pass through different stages and as with other skills, the age at which kids learn language and start talking can vary. Many babies start babbling ‘mama’, ‘dada’ well before they turn one; most toddlers can say about 20 words by the time they are 18 months old according to early childhood experts.

However, some children may reach kinder garden unable to talk or only put some syllables together. Many parents who encounter this remain baffled not knowing what they can do about it. Others may check out their impression with other parents, relatives or their pediatrician. They are likely to get answers such as, “My son was slow too. Now he won’t shut up”, or “Don’t worry, she’ll outgrow it.”

But suppose they don’t on for a parent to find out later that they should have acted earlier? To avoid regrets, experts explain how parents can know about speech development patterns for one to figure out if there is cause for concern or if their child is on the right course.

What are speech or language delays?

Marie Diane Uwamahoro, an early childhood development expert, says even though every baby is unique and learns to speak at their own pace, some children have development delays in speech and language in general.

She says early interventions can improve a child’s communication skills development. A baby who doesn’t respond to sound or who isn’t vocalising should be taken to a doctor early. But often, it’s hard for parents to know if their child is just taking a little longer to reach a speech or language milestone, or if there’s a problem that needs medical attention.

“The following guidelines can serve as red flags for parents who are wondering if they should be worried. For instance, there’s cause for worry if; by six months if the baby has no big smiles or other warm, joyful expressions during interaction with another person; no back-and-forth sharing of sounds, smiles, or other facial expressions by 9 months or not using gestures by 12 months such as pointing or waving bye-bye; prefers gestures over vocalizations to communicate by 18 months; and can only imitate speech or actions and doesn’t produce words or phrases spontaneously by 2 years. The presence of any of these concerns warrants an immediate search for an early intervention programme and/or speech-language pathologist for a complete evaluation of the child’s communication skills,” she says.

Uwamahoro adds that, with normal speech development, by the first birthday, babies should be using their voices to relate to their environment.

“Cooing and babbling are early stages of speech development. At around 9 months, babies begin to string sounds together, use different tones of speech, and say words like “mama” and “dada” (without really understanding what those words mean). Before 12 months of age, babies should also be paying attention to sound and starting to recognise names of common objects like bottle, binky, food, among others. Babies who watch intently but don’t react to sound could be showing signs of hearing loss,” she says.

What causes speech delays?

Dr Edigard Kalimba, a pediatrician at King Faisal Hospital, Kigali, says speech delay in an otherwise normally developing child might be due to an oral impairment, like problems with the tongue or palate (the roof of the mouth). And a short frenulum (the fold beneath the tongue) can limit tongue movement for speech production.

“Many kids with speech delays have oral mortar problems. These happen when there’s a problem in the areas of the brain responsible for speech, making it hard to coordinate the lips, tongue, and jaw to produce speech sounds. These kids also might have other oral-motor problems, such as feeding difficulties,” he says.

He adds that hearing problems are also commonly related to delayed speech. That’s why an audiologist should assess a child’s hearing whenever there’s a speech concern. Children who have trouble hearing may have trouble articulating as well as understanding, imitating and using language.

Kalimba warns that when a parent has concerns they should seek medical support. With proper therapy and timing, the child will be better able to communicate.

“The speech-language pathologist will evaluate the child’s speech and language skills within the context of total development. The pathologist will do standardised tests and look for milestones in speech and language development. Based on the test results, the speech-language pathologist might recommend speech therapy for the child,” he says.

However, Jeanne Uwamaliya, a psychologist at Gatagara School of Visually Impaired Children, says parental involvement is an important part of helping children to achieve normal speech milestones.

“Parents have to spend a lot of time communicating with their children even during infancy talking or singing, and encourage imitation of sounds and gestures,” she says.

Uwamaliya recommends parents to use everyday situations to reinforce the child’s speech and language development.

“Talk your way through the day. For example, name household utensils, explain what you’re doing as you cook a meal or clean a room. Ask questions and acknowledge your child’s responses even when they’re hard to understand,” she says.