Potential Reasons for Speech and Language Delays

“Why does my child not talk but understand everything I say?” “Why isn’t my child responding to their name and/or following simple directions?” 

These are a few of the common questions Speech-Language Pathologists (SLPs) hear when it comes to speech and language delays in children. 

“Why will my child only express themselves with gestures, not words” Why is my child ignoring me? “Why is my child becoming frustrated when their needs aren’t met even though they haven’t expressed a need even with a gesture?”  

To answer these questions about speech and language delays, we first need to understand the two parts of our language system, receptive language, and expressive language. Receptive language refers to our understanding of language. Expressive language is our use of language (verbal or not yet verbal). 

When you notice that your baby does not seem to respond to their name or look for familiar people/objects when named (should occur by 12 months), this may indicate hearing acuity is not intact OR the auditory system is not yet processing information coming in accurately. If your child does not imitate sounds and word approximations back to you, or attempt to by 12 months, this may indicate a delay in the ability to reproduce the information coming in. Many babies and toddlers experience a little bit of both. Some reasons for this may be:   

1. Hearing acuity is not intact. It is important to seek out an audiologist to rule this in/out.  
2. The sensory system is reduced in processing/integrating, including the auditory system (different from hearing acuity).  
3. Decreased awareness of oral abilities with a lack of confidence that they can produce the words, so you understand them. Many children try word approximations at an early age and we as “perfect speakers” miss it. We get “Mama” and “Dada” but what about when they only use “Ma” instead of “Mama”? We still get it, don’t we? What about when they say “ba.” This can represent “bottle,” “ball,” “bubble,” “bath,” etc. They lose confidence and motivation to keep trying when we do not make associations. Pay close attention to the sounds they make along with the gestures. The words take time to fully develop. Also, they may have decreased awareness of their mouth and how to make different sounds due to a variety of reasons.  
4. Structural abnormalities: high palate, enlarged tonsils and/or adenoids, undetected tongue tie, small jaw but large tongue, protruding top teeth, etc. Your pediatrician may be able to determine this or refer you to an ENT or pediatric dentist for further investigation.  
5. Opportunities to practice “talking” back and forth are limited. Talking does not always come naturally for some children. We need to ensure we give them time and multiple opportunities to practice skills in a loving, fun way. Just like it takes practice to walk, it takes practice to talk. Talking is a motor act also! It also requires our respiratory system to coordinate with our sensory-motor system and voice!   

Community Care Connections provides Early Intervention to families within their county of residence. Families will receive an assessment following a detailed intake of pertinent information working first with a Service Coordinator. The standardized assessment, by an Early Intervention therapist, will provide results for any areas of delay. The team will determine eligibility, along with recommendations for an Early Intervention therapist. Services are provided in the child’s natural environment, either at home or in a childcare setting. It provides families and caregivers with resources, information, and support to assist their children with developmental skills so they can participate in their family’s routines and activities.  

Early Intervention can help families and caregivers embed learning opportunities throughout the day so that their children grow in their abilities to engage and become independent within their family and the community. There is so much opportunity to practice a LARGE variety of skills in everyday routines. It gives parents and caregivers the ability to help their children with speech and language delays learn the skills they need for everyday life.