Language Delay In Children: Types, Symptoms And Causes

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Language delay in children occurs when they experience problems while learning or saying new words, using the words to create sentences, and understanding words or sentences that others speak (1). The condition is a communication disorder and often indicates that the child is learning a language but at a slower pace than other children of their age (2).

Despite the concerns associated with it, the condition is not uncommon, with one out of the five children learning to use words and talk later than other children of their age (3). Read this post to know the various causes, risk factors, treatments, and prevention options for language delay in children.

Types Of Language Delay In Children

Language delays are mainly of two types (4).

  • Primary language delay: No other associated developmental difficulty like walking, fine motor or visual skills is identified in primary language delays.
  • Secondary language delay: Conditions such as autism, hearing impairment, and global developmental delay impact language skills.

Language problems can be of the following types (5).

  • Expressive language problems: When the child has difficulty in verbal communication.
  • Receptive language problems: When the child has difficulty in understanding the language.

Causes And Risk Factors For Language Delays In Children

The exact cause of language delay is not known. However, as language delays run in families, a genetic or biological component could cause language delays in children.

The following factors increase the risk for language delays (1).

  • Boys
  • Family history of language delays in children
  • Developmental disorders such as Down’s syndrome or autism spectrum disorder (ASD).
  • Ear infections or hearing problems.
  • Environmental factors like too much of screen time or multilingual atmosphere (people using different languages) at home

Symptoms Of A Language Delay In Children

The following are the common characteristics of language delay (4).

  • May begin talking late than peers.
  • May not be saying their first words by 15-18 months.
  • May say a few first words but not learn other new words quickly.
  • May use less than 50 words and may not use a combination of two words by two years of age.
  • Not speaking sentences by three years
  • May have problems understanding or following instructions.
  • The language may seem immature for their age.
  • Might experience difficulties in attending group activities at school or kindergarten.
  • May exhibit difficulties in eye contact, attending to activities and speech or using sounds or gestures.
  • Can have problems answering questions, forming sentences, forming spellings, and reading and writing.
  • May not be able to convey their message across.
  • Cannot use grammar correctly.
  • May have difficulties in interacting with peers.

Signs To Seek Medical Help For Language Delay In Child

You may consider seeing a healthcare provider if you notice the following signs in your child at different ages (1).

By 12 months

Unable to communicate using sounds, gestures, or words, especially when they need help or want something.

By two years

  • Not saying about 50 different words
  • Not combining two or more words to form phrases such as “more food,” and “mum up.”.
  • Not producing words spontaneously but is only copying words or phrases that others say.
  • Unable to follow simple instructions or questions, such as “want more snack?,” “get your jacket,” or “where is Mumma.”

By three years

  • Not combining words to form sentences.
  • Unable to understand longer instructions or questions, such as “get your books and put them in the bag” or “what do you want to wear for the picnic tomorrow?.”
  • Has little or no interest in books
  • Does not ask questions

From four to five years and older

Some children continue to have language difficulties by the time they start preschool or school. If these difficulties cannot be explained by conditions, such as ASD or hearing loss, it might be a developmental language disorder.

At any age

  • Diagnosed with hearing loss, developmental delay, ASD, Down syndrome, fragile X syndrome, etc.
  • Stops doing things they already knew, such as stops talking.

Diagnosis Of Language Delay In Children

A comprehensive medical assessment can help identify language delay. The healthcare providers may conduct several interviews with the child, the parent, and the caregiver. They will ask questions regarding the child’s medical history and engage the child in unstructured play to determine how well the child uses and understands the language. The doctor may perform several standardized tests to find the cause and impact of language delay in the child (5).

Treatment For Language Delay In Children

The treatment of language delay is unique for each child. The healthcare team might comprise a pediatrician, physician, audiologist, psychologist, occupational therapist, social worker, and child and family health nurse.

  • The primary goal of the treatment is to teach the child strategies for understanding spoken language and communication.
  • Most important is for every child to undergo a hearing assessment. If hearing is impaired, speech will definitely be compromised. Early use of hearing aids might save unnecessary trouble for the child as well as parents.
  • The speech-language pathologist can help the child learn different ways to communicate. They also help the parents learn different ways of encouraging the child to talk at home.
  • For children with elective mutism, psychotherapy may be suggested. Hearing aids, auditory training, lip reading instructions, etc., might help children with hearing loss.
  • Speech therapy may happen in various settings, including SLP clinics, homes, schools, or classrooms. It includes naming objects, discriminations tasks, individual or group play, reading, conversations, modeling and prompting (6).

Overcoming language disorders can take time and effort. Parents need to be patient through the process. Timely diagnosis and early intervention are important because language delay may leave a child frustrated as they cannot convey their emotions. The right help influences and develop the child in all aspects of life.

Key Pointers

  • Language delays in children are mainly of two types – primary and secondary.
  • Begin talking late than peers, not saying their first words by 15-18 months, and not learning new words are a few characteristic symptoms to notice.
  • Their exact cause is unknown, though genetic and biological factors may play a role.
  • A detailed assessment of the medical history and language problems helps the doctor decide on a suitable treatment.
  • Treatment involves a multidisciplinary approach where experts, such as a pediatrician and psychologist, work together to help the child outgrow the issue.


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Dr. Anuradha Bansal

Dr. Anuradha Bansal is a pediatrician and neonatologist working as assistant professor in the Department of Paediatrics at PIMS Jalandhar. She has done her MBBS and MD Pediatrics at GMCH, Chandigarh. Thereafter, she polished her skills as senior resident at MAMC, Delhi. She has also done IAP Fellowship in Neonatology at GMCH, Chandigarh and obtained the membership of the prestigious... more

Dr. Ritika Shah

Dr. Ritika Shah is a dental surgeon with more than seven years of clinical experience across various cities in India. During her clinical practice, pediatric dentistry was her particular area of interest, and she constantly thrived to inculcate the latest advancements in the field of dentistry into her practice. She also holds a certificate in lactation counselling from iNational Health... more