Guide to Speech Delays

Overview

We eagerly await our children's first words, so it can be disappointing  -- and worrisome  -- if they're slow to come. But the good news is that most kids who seem to talk "late" catch up without any problems by the time they're around 2. About one in four children is a late talker  -- and most don't need special help to get them on track. Here's what to expect with your child's speech development, and how to tell if you need to see a specialist.

What's normal

Though speech develops pretty much the same way for all children, the pace can vary considerably from child to child. As a rule of thumb, children should be able to say one word at about 1, two-word combinations at 18 months to 2 years, and three-word sentences before turning 3. When speech specialists evaluate delayed speech, they care as much about a child's understanding as they do about how much he speaks. For instance, although a typical 18-month-old can say 50 to 100 words, he can understand far more. Making gestures and following directions indicate that your child is understanding and communicating, and there's likely little reason to worry. The American Speech-Language-Hearing Association offers a detailed chart of language development. Find out how you can gauge your child's progress.

Reasons behind speech delays

Heredity and temperament can make for a linguistic late bloomer, as can a parent's anticipating a child's every need ("Do you want your bottle?") rather than letting her speak for herself. Some kids who tend to be late talkers include:

Boys: They often develop speech later than girls, though there's usually only about a one- to two-month lag. At 16 months, boys use an average of 30 words, while girls tend to use around 50.

Preemies: Babies born early often take longer than others to reach milestones, but by age 2 they usually catch up to their peers. Pediatricians say that when gauging a preemie's development, parents should begin counting from the child's due date, not her birth date. A child born three months early can seem like a later talker but might be progressing just fine.

Multiples: Speech pathologists estimate that as many as 50 percent of all multiples have some language delay. Prematurity, low birth weight, and medical intervention at birth  -- all of which occur more often among multiples  -- can contribute to language delays.

Children with chronic ear infections: If fluid in the ear persists for months at a time  -- especially during the first year, when a child is starting to process language  -- it can result in poor hearing, and thus delayed speech.

Kids who are focused on other skills: If a child is late to talk but her overall development is progressing on schedule, she may just be trying to perfect one skill, like walking, at the expense of speaking.