Request a hearing test and refer you to a speech-language therapist for testing. The therapist will evaluate speech (expressive language) and your child's ability to understand speech and gestures (receptive language). If you've noticed one or more of these warning signs in your child, it's important to take steps right away to make sure they get the help they need. Normal speech progresses through stages of cooing, babbling, echolalia, slang, words and word combinations, and sentence formation.
If the child is bilingual, it is important to compare their language performance with that of other bilingual children from similar cultural and linguistic backgrounds. The medical history should include any maternal illnesses during pregnancy, perinatal injuries, infections or asphyxiation, gestational age at birth, birth weight, health history, use of ototoxic drugs, psychosocial history, language (s) spoken to the child, and family history of significant illnesses or delays in speaking. In addition, speech delay can have a significant impact on personal, social, academic and, later on, vocational life. However, delayed maturation is a much more common cause of speech delay than expressive language disorder, which accounts for only a small percentage of cases.
You can ask your child's doctor to refer you to a developmental specialist or to a speech-language therapist. Specialists may then recommend speech therapy and may suggest other ways to improve social skills, behavior, and the desire to communicate. A child with speech delay has speech development typical of a normally developing child at an earlier chronological age; the skills of a child with delayed speech are acquired in a normal sequence, but at a slower rate than usual. The concern is well-founded, because a number of developmental problems accompany the delay in the onset of speech.
Not only is the speech of these children delayed, but it is also scarce, agrammatic and indistinct in its articulation. Speech is the motor act of communication through the articulation of verbal expression, while language is the knowledge of a system of symbols used for interpersonal communication. A comprehensive developmental evaluation is essential, because delayed speech development is the most common early manifestation of global intellectual decline. However, the understanding of both languages by a bilingual child is normal for a child of the same age and, generally, the child gains command of both languages before the age of five.
Abused children who live with their families don't seem to have speech delays, unless they are also subject to neglect.