Speech and language delay
When words arrive later than expected: encouraging the development of speech and language.
Speech and language delay means a child's communication is developing more slowly than expected for their age. The child may understand well but say little; or say words but not join them into sentences.
It is among the most common reasons families come to a speech therapist. What matters to remember is that delay is not a final diagnosis - it is an observation that calls for assessment, because the causes can differ.
What parents notice
- The child does not use words appropriate to their age.
- Vocabulary grows very slowly, or has stalled.
- The child communicates more with gestures and pointing than with words.
- They do not join two words together when their age would expect it.
- They have difficulty understanding simple instructions.
- The family understands them, but others do not.
- The child avoids situations where they have to speak.
When to seek help
Language development has a wide band of normal - two healthy children can start speaking at different times. For that reason, comparison with a cousin or a neighbour's child is not a reliable measure.
What deserves assessment is a plateau: when vocabulary stops growing month by month, when the child does not respond to spoken language, or when they have lost words they used to say. The last of these should be assessed without waiting.
How the assessment works
The assessment separates two things that are often conflated: how much the child understands (receptive language) and how much they express (expressive language). This distinction matters, because the treatment plan changes entirely depending on the answer.
We also look at how the child communicates without words - eye contact, gestures, joint attention - because these are the foundation language is built on.
Where the history suggests it, the parent is also directed towards a hearing check. Hearing is a precondition of language development, and ruling it out is standard professional practice.
How therapy works
Therapy does not consist of repeating words after the therapist. With young children the work happens through structured play: we create situations where the child has a real reason to communicate, and their communication is encouraged and extended step by step.
Objectives are built in sequence: first encouraging communication and single words, then joining words, then the sentence and its use in conversation.
The plan is adjusted along the way according to progress. This is also why the duration is not promised at the outset.
The parent's role
The child spends far more time with the parent than with the therapist, and that is where most of the learning happens. Parents receive concrete guidance: how to leave space for a reply, how to extend a word into a sentence, how to name actions through the day.
These are not heavy homework tasks. They are small changes to the way everyday conversation happens, and they make a difference.
Frequently asked questions
- My child is 2 and does not speak. Should I wait?
- This is the question we are asked most often. The professional answer is to have it assessed rather than wait. An assessment does not commit the family to therapy - it gives a clear answer. If development is within expectations, you know for certain; if there is a difficulty, the work starts at the right time.
- Is every speech delay a problem?
- No. Some children start speaking later and then catch up with their peers. The problem is that from the outside this is indistinguishable from a difficulty that needs intervention. Making that distinction is exactly what the assessment does.
- My child understands everything but does not speak. Does that matter?
- It does, and it is useful information. When understanding is intact and only expression is lacking, the picture differs from the case where understanding is affected too - and the therapy plan changes accordingly.
The first step is a conversation.
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