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Health & Pregnancy

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Helping Your Late-Talking Children

If your child seems to be a late talker, when is the time to seek help? What's normal?

Speech/Language Milestones continued...

Though some children seem to lag a little behind in their spoken (or "expressive") language, their "receptive" language may be better -- that is, they may appear to understand much of what is being said to them. "When a child is not using a lot of words but seems to comprehend what you're saying and can follow commands, there is less reason for concern than if a child lags in both expressive and receptive language," says Paul-Brown, a speech-language pathologist. "Receptive language is a useful predictor to differentiate late talkers from those children with developmental delays."

Growing Numbers

The number of cases of late-talking children appears to be on the rise, says Marilyn Agin, MD, a developmental pediatrician in New York City and co-author of The Late Talker: What to Do If Your Child Isn't Talking Yet. This increase parallels the growing incidence of chronic ear infections, which can impair hearing and, in turn, contribute to speech delays. As more children spend time in child-care settings, say pediatricians, they're exposed to the illnesses of playmates that could lead to more ear problems.

"Chronic ear infections may negatively impact early learning experiences, especially if there are other risk factors present," says Paul-Brown. "The preschool years are a critical period for speech and language development."

Though many children appear to be genetically predisposed to develop speech later than others, environmental factors might play a role as well in late-talking children. For example, research is under way on whether exposure to substances such as mercury could cause neurological damage, which in turn might affect speech and language, says Agin.

What to Expect

Although children develop language skills at different rates, it is important that their progress is steady and that they reach certain milestones within accepted windows of time. Here are a few indicators of what's normal and what should raise concerns:

  • Most babies begin cooing and babbling in the first year of life. "They should be babbling all of the consonant sounds, but if they're limited in this regard, it may be a red flag," says Agin.
  • Babies should begin to imitate the sounds spoken by their parents. When mom or dad says, "Mama" or "Dada," and the baby doesn't imitate it, that's a warning sign, says Agin.
  • Don't become overly troubled if a young child doesn't clearly say "l," "r," and "s" sounds. The ability to form these particular sounds tends to develop with time, although perhaps not until the age of 7 in some children, says Debora Downey, MS, a speech-language pathologist at the University of Iowa's Center for Disabilities and Development. Generally, no speech-language therapy is necessary, although there may be an exception if these sounds are in a child's own name (e.g. Robert or Rhonda). "These children may become self-conscious, may be reluctant to tell you their name, and could withdraw socially," says Downey.

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