Language Delay

Children are considered to have a language delay if they fall behind certain milestones for their age. Milestones may include the onset of babbling, first words, or first sentences.

Some children fit the classic pattern of first speaking one word “sentences,” such as “truck,” then joining two words “truck fall,” and then three, “my truck fall.” This called a referential style, because it also correlates with attention to names for objects and event descriptions.

In contrast, some children speak in long, unintelligible babbles that mimic adult speech cadence and rhythm, so the listeners think they are just missing some important pronouncement. This is called expressive style, and has less clearly demarked sentence parts than referential style. A child who speaks in expressive style is quite imitative, has a good rote memory, and is often engaged in language for social purposes—songs, routines, greetings, and so forth.

The expressive child seems to be slightly slower at cracking the linguistic code than the referential child, but the long-term differences between the two styles seem insignificant.

A child growing up with two or more languages is often slower to talk than a monolingual child. This is not surprising given the amount of analysis and codecracking that is necessary to organize two systems simultaneously. The lifelong advantage of knowing two native languages, however, is usually considered an appropriate balance to the cost of a potential delay. In fact, bilingualism in children and adults is the norm throughout the world; and monolinguals are the exception.

The learning of each language proceeds in the bilingual child in much the same way as it does in the monolingual child, although the bilingual child may use blended words or inflections from the two languages in one utterance. Some researchers report that the bilingual child initially resists learning words for the same thing in the two languages: For instance, a child in a Spanish and English household may learn leche, but would not say the English equivalent of milk, or a French/English bilingual may use bird, but refuse to use the French equivalent of oiseau.

Children with a hearing loss, either from birth or acquired during the first year or two of life, generally have a serious delay in spoken language development, despite very early diagnosis and fitting with appropriate hearing aids. However, in the unusual case that sign language is the medium of communication in the family rather than speech, such a child shows no delay in learning to use that language.

Hearing development is always one of the first things checked if a pediatrician or parent suspects a language delay. The deaf child exposed only to speech will usually begin to babble in “canonical syllables” (e.g., baba, gaga) at a slightly later point than the hearing child. However, the child often experiences a long delay before speaking his or her first words, sometimes not until age two years or older.

Depending on the severity of the hearing loss, the stages of early language development are also quite delayed. It is not unusual for the profoundly deaf child (greater than 90 decibel loss in both ears) at age four or five years to only have two-word spoken sentences. It is only on entering specialized training programs for oral language development that the profoundly deaf child begins to acquire more spoken language, so that the usual preschool language gains are often made in the grade school years for such children. Many deaf children learning English have pronounced difficulties in articulation and speech quality, especially if they are profoundly deaf, though there is great individual variation.

As might be suspected, a child who has hearing for the first few years of life has an enormous advantage in speech quality and oral language learning over a child who is deaf from birth or becomes deaf within the first year. In addition, hearing aids can improve language development among children who are hard of hearing.

Apart from speech difficulties, deaf children learning English often show considerable difficulty with the inflectional morphology and syntax of the language that marks their writing as well as their speech. The ramifications of this delayed language are significant also for learning to read, and to read proficiently. The average reading age of deaf high school students is often only at the fourth grade level.

For these reasons, many educators of the deaf now urge early compensatory programs in signed languages, because the deaf child shows no handicap in learning a visually based language. Deaf children born to signing parents begin to “babble” in sign at the same point in infancy that hearing infants babble speech, and proceed from there to learn a fully expressive language. However, only 10% of deaf children are born to deaf parents, so hearing parents must show a commitment and willingness to learn sign language, too. Furthermore, command of at least written English is still a necessity for such children to be able to function in the larger community.

Intellectual disability can also affect the age at which children learn to talk, however, most children with intellectual disability nevertheless develop some language.

Considerable variation exists among children with intellectual development issues and different language patterns can arise with different syndromes. In cases of hydrocephalus-caused issues, for instance, children who are otherwise quite impaired intellectually may have impressive conversational language skills. Sometimes called the “chatterbox syndrome,” this linguistic sophistication belies their poor ability to deal with the world. In other groups, including Down syndrome, children may experience more delay in language than in other mental abilities.

Most intellectually disabled children babble during the first year and develop their first words within a normal time span, but are then slow to develop sentences or a varied vocabulary. Vocabulary size is one of the primary components of standardized tests of verbal intelligence, and it grows slowly in children with intellectual disabilities. Nevertheless, the process of vocabulary development seems quite similar: children with intellectual development issues also learn words from context and by incidental learning, not just by direct instruction.

Grammatical development, though slow, does not seem particularly deviant from children with normal IQs. Conversation, however, may be marked by more repetition in children with intellectual development issues. Speech therapy can be a considerable aid for these children.

Children who are blind from birth sometimes have other neurological problems, which can make it difficult to assess the effect of blindness itself on cognitive and linguistic development. In the cases where blindness seems to be the only condition affecting the child, however, some initial language delays are noted. On average, blind children seem to be delayed about eight months in the onset of words. In general, though, detailed longitudinal studies have revealed that the blind child learns language in much the same way as the sighted child, with perhaps more reliance on routines and formulas in conversation. Linguists are interested in the process by which blind children learn to use words such as “see” and “look” given their lack of experience with sight, but these words were found to come in quite normally, with the appropriately changed meaning of “touch” and “explore tactilely.”