When is a child thought to have late speech development?
Many children can say a few words clearly by their first birthday. During the second year, many toddlers begin to talk intelligibly and after the second birthday they chatter away with increasingly more complex sentences, ideas and questions. Girls tend to speak a bit earlier than boys but other factors such as genetics, birth order and socio-cultural phenomena play a role in speech development. In evaluating how well a child speaks, the physician must distinguish between speech and language. Speech is the production of understandable sounds whereas language is the underlying mental function including both expressive (speaking) and receptive (understanding) speech. The most common causes of speech dysfunction are hearing loss, developmental delay, and lack of verbal stimulation and communication disorders such as the autistic spectrum. Physicians should begin investigating children by age 2 years if any of the following red flags are present: • the child is making no effort to speak •
