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<p>Many parents with toddlers who are just beginning to speak often worry about <span style="color: #00826e;"><strong>‘their child’s delayed speech problem’</strong></span> because they may have an inherent expectation to hear their child speak soon. Moreover, if they meet friends’ children of the same age who have already started talking, they might compare them to their own child who <span style="color: #00826e;"><strong>‘rarely speaks, speaks slowly, does not form words, or speaks without meaning’</strong></span>, causing concern about whether their child’s condition is abnormal.</p>
<p>&nbsp;</p>
<p>In fact, <span style="color: #00826e;"><strong>speech delay problems</strong></span> are not only related to development but may also be associated with other abnormalities such as brain disorders or intellectual disabilities. These groups may also have delayed muscle development. Additionally, children with autism also have problems with speech and communication.</p>
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<h4><span style="color: #00826a;">How can parents tell if their child’s speech delay is abnormal?</span><strong><br />
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<p>The way to observe whether your toddler has delayed speech can be seen from two aspects: Does the child understand language? And how does the child use language?</p>
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<p>Normally, when a child is about 15 months old, parents should frequently observe whether their little one makes meaningful sounds, such as “yum-yum” when hungry or tries to communicate or invite, like “pa-pa.” Regarding language comprehension, the child should start to look at or point to things they want or are interested in. However, if at 15 months the child still does not say any meaningful words and does not respond to simple questions like this, parents should suspect that there might be an abnormality.</p>
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<p>Another way to observe is to watch in advance during the age of 6-9 months, which is the period when the child can perceive or communicate, such as playing peekaboo or laughing with others. If the child refuses to play or follow simple commands because they do not understand, parents can begin to suspect that something abnormal may be occurring.</p>
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<h4><span style="color: #00826a;">At what level of speech delay should you take your child to see a doctor?</span></h4>
<table style="border-collapse: collapse; width: 99.949%; height: 223.958px;" border="1">
<tbody>
<tr style="height: 22.3958px;">
<td style="width: 48.4715%; text-align: center; height: 22.3958px;"><strong>Age</strong></td>
<td style="width: 48.4715%; text-align: center; height: 22.3958px;"><strong>Language Development Behavior</strong></td>
</tr>
<tr style="height: 22.3958px;">
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">Newborn – 4 months</td>
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">Does not respond to sounds when the child is fully awake</td>
</tr>
<tr style="height: 22.3958px;">
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">5-7 months</td>
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">Makes few sounds or does not babble, does not respond to caregivers</td>
</tr>
<tr style="height: 22.3958px;">
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">9-12 months</td>
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">Does not turn toward sounds, does not imitate consonant sounds other than “ah”</td>
</tr>
<tr style="height: 22.3958px;">
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">15 months</td>
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">Does not say at least one meaningful word</td>
</tr>
<tr style="height: 22.3958px;">
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">18 months</td>
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">Does not understand or follow simple commands<br />
Does not say 3 meaningful words</td>
</tr>
<tr style="height: 22.3958px;">
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">2 years</td>
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">Does not say two different meaningful words consecutively, vocabulary less than 50 words</td>
</tr>
<tr style="height: 22.3958px;">
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">2 years and a half</td>
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">Does not speak in 3-4 word phrases, still makes non-language sounds</td>
</tr>
<tr style="height: 22.3958px;">
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">3 years</td>
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">Does not speak in complete sentences, others mostly do not understand the child’s speech</td>
</tr>
<tr style="height: 22.3958px;">
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">4 years</td>
<td style="width: 48.4715%; height: 22.3958px; text-align: center;">Cannot tell short stories, others do not understand more than 25% of the child’s speech</td>
</tr>
</tbody>
</table>
<h4><span style="color: #00826a;">How to treat a child who does not speak to help them speak?</span><strong><br />
</strong></h4>
<p>When you feel that your child has an abnormality, it is recommended that parents take the child to see a doctor for an examination to determine if there is any physical abnormality. If the results are normal, then the doctor will assess development in various areas, such as “hearing development” — whether the child turns when called, likes to look at faces or mouths when communicating, or may play loudly because they cannot hear. The way to help is to see an ear, nose, and throat specialist for a hearing test and receive therapy from a multidisciplinary team (physical therapy, occupational therapy, speech therapy) to continue speech training. All of this depends on the child’s condition and the doctor’s judgment. Some children may need medication if emotional problems, aggressive behavior, or hyperactivity are found.</p>
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<p>However, in cases where the child’s speech delay is due to other causes such as brain disorders or developmental delays, as in children with autism who have impaired social skills, the child needs treatment to increase interaction with others. The child must undergo developmental stimulation or occupational therapy through various activities and be continuously monitored so that at least the child can help themselves.</p>
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<h4><span style="color: #00826a;">Speech delay may be caused by parents talking too little to the child</span><strong><br />
</strong></h4>
<p>When a child lacks language stimulation, this may be because parents talk or communicate too little with the child or do too much for them, anticipating all their needs, so the child does not need to ask or speak. This causes the child to lack language stimulation skills. Additionally, parents often misunderstand by turning on the TV for the child to keep them still, but in reality, the TV and mobile phones are constantly moving. If the child spends too much time with these, it increases the risk of delayed speech because there is no need to communicate with others. At the same time, it can also trigger attention deficit symptoms.</p>
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<h4><span style="color: #00826a;">3 simple ways to help stimulate your toddler to speak</span><strong><br />
</strong></h4>
<ol>
<li>Parents should try to talk more with their child, ask and answer briefly using simple and short words, and praise the child when they cooperate.</li>
<li>Do not leave the child alone with the TV or phone for too long.</li>
<li>Encourage the child to do activities such as talking about things they are interested in, telling stories, and looking at pictures, with close parental supervision.</li>
</ol>


The problem of delayed speech in children, besides being related to development, may also be associated with other abnormalities such as brain disorders, intellectual disabilities, and children with autism who may have delayed speech or refuse to speak.

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What should parents do when their child speaks late or refuses to speak?

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