Speech Delay :

Language delays are the most common form of developmental delay.

Essential Information

Language delays are the most common form of developmental delay in toddlers/preschool children.

The earlier the diagnosis, the earlier the therapy can begin and the better the final outcome.

Clinical Presentation

Not meeting speech/language milestones at a normal rate or at all

Using gestures rather than words

Displaying any of the red flags noted previously

Displaying difficulties initiating words or conversation

Evaluation and Diagnosis

Referral for Developmental/Speech Evaluation

Children who have no words by 18 months, no phrases by 2 years; children whose speech is unintelligible or does not meet milestones for intelligibility at ages 2, 3, and 4 years

Children who have echolalia persisting after age 3

Children whose parents express reasonable concern or worry about their child’s language delay

Children who have failed developmental or screening tests

Evaluate for disorders on the differential: hearing loss, intellectual disability, autism spectrum disorder, and environmental deprivation

All children with suspected speech delay should have a full audiologic evaluation


Once identified as having a speech delay, children proceed to speech therapy as well as occupational therapy, if indicated

Speech delays are characterized as expressive, receptive, or mixed expressive/receptive language delay

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