Abby Barnes, M.S., CCC-SLP
IMPORTANT SAFETY NOTE: If your child has just hit their head and is showing any of the following signs, call 911 or go to the nearest emergency room right now: loss of consciousness of any length of time, repeated vomiting, seizure, blood or clear fluid from the nose or ears, unequal pupils, an inability to wake, a bulging soft spot on the head (in infants), or increasing drowsiness, confusion, or irritability that’s not usual. This article covers what to expect in the days, weeks, and months after a diagnosed head injury—not what to do in the moment it happens. When in doubt about a fresh injury, call your pediatrician or a nurse line without waiting.
A head injury can cause a speech delay in toddlers, though it depends on the severity of the injury and the area of the brain affected. Mild traumatic brain injuries (mTBI) like a concussion may cause temporary speech and language problems that get better within weeks. Moderate to severe TBIs can cause longer-lasting speech, language, or cognitive-communication delays that respond well to early speech therapy. Below, we cover the warning signs, when to seek an evaluation, and how therapy helps.
Key takeaways
A head injury can cause speech, language, or thinking-and-talking (cognitive-communication) delays in toddlers. The risk and how long it lasts depend on how serious the injury was and which part of the brain was hurt.
The CDC calls most childhood head injuries mild TBI (mTBI or concussion). Most children with mTBI feel better within 2 to 4 weeks. A smaller group has symptoms that last longer and should be checked by a doctor.
Call 911 for loss of consciousness, vomiting more than once, seizures, fluid from the nose or ears, uneven pupils, or growing confusion or sleepiness. These are life-threatening warning signs.
Watch for changes in speech or language in the days and weeks after a head injury. Look for trouble finding words, slurred speech, trouble following directions, or the loss of skills your child had before.
A speech therapist can test cognitive-communication skills after a diagnosed TBI. Early speech therapy helps kids recover language, clear speech, and safe swallowing after a brain injury.
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Find a speech therapistCan a head injury cause a speech delay in a toddler?
The short answer: Yes, a head injury can cause a speech delay or other language problem in children. The brain is very fragile. A trauma to certain areas of the brain can negatively impact a child's ability to speak or understand language.
Head injuries can be mild, such as a bump to the head. They can also be major, such as a concussion. A brain injury can include a bruise to the brain, a cut or wound, a broken bone in the skull, or internal bleeding in the brain.
It helps to know how doctors sort head injuries. The CDC groups traumatic brain injuries (TBI) into three levels: mild, moderate, and severe.
A concussion is a mild TBI (mTBI). It is the most common type of head injury in toddlers. Most concussions do not cause a loss of consciousness and do not show up on regular scans. But they can still slow down how the brain handles language, focus, and speech for a while.
Moderate and severe TBIs mean a longer loss of consciousness, a skull fracture, or bleeding or bruising in the brain. They carry a higher risk of lasting speech or language changes.
Symptoms of speech delay due to a brain injury:
Difficulty using words to communicate
Difficulty producing speech sounds
Poor word pronunciation
Difficulty understanding spoken words
Difficulty understanding and using more complex sentences, language, and vocabulary
Does your child have a speech delay? Or are they just a "late talker"? Here are the 5 top signs of speech delay to look for.
What are the symptoms of a head injury in children?
In addition to those listed above, there are many types of symptoms that can show up after a brain injury. They can affect a child’s physical, mental, and emotional health. Cincinnati Children’s lists the following head injury symptoms to watch for:
Physical symptoms of a head injury in children:
Headache(s)
Sensitivity to light or sound
Nausea or vomiting
Fatigue or being sleepy
Dizziness
Loss of balance or trouble walking
Ringing in ears
Double or blurred vision
Numbness or tingling
Loss of consciousness
Cognitive (thinking) symptoms of a head injury in children:
Feeling foggy or confused
Slow thinking or slow processing
Memory problems
Poor concentration
Poor judgment
Difficulty in school
A traumatic brain injury like a concussion is a common injury in children. Learn about TBI symptoms in children and what to expect after a TBI.
Emotional symptoms of a head injury in children:
Irritability
More emotional than usual
Sadness or nervousness
Lack of interest or motivation in the usual things
Easily frustrated, angered, or tearful
Impatient
Bolder than usual
Having outbursts
Difficulty tolerating daily routine
Sleep symptoms of a head injury in children:
Change in sleeping patterns
Trouble falling asleep
Trouble staying asleep
Sleeping more than usual
Sleeping less than usual
"When a parent tells me their toddler seems 'off' after a head bump—quieter, more frustrated, losing words they used to have—I take it seriously,” says Alexis Irazoque, M.S., L/SLP, a speech therapist with Expressable. “Post-concussion speech and language changes are often subtle in young children and easy to miss. If your gut says something has shifted, ask for an evaluation. There is no downside to being early."
What to do if you think your child has a brain injury
Falling down or running into something isn’t uncommon for a busy toddler. But if you suspect your child has a head injury, you need to seek medical attention.
Nemours Children’s Health says that if a child has the following signs, you should call 9-1-1 right away for immediate help:
Loss of consciousness (the child passes out)
Can’t respond to you
Has changes in vision
Has a serious wound that bleeds a lot
Has blood or clear fluid coming from their nose or ear
Has changes in behavior, such as agitation, confusion, or being very sleepy
Is dizzy or stumbling
Has seizures
Throws up more than twice, or throws up hours after the injury
Has weakness or numbness/tingling in both arms or legs
Has neck pain or tenderness
If your child isn’t showing any of the symptoms above, but you’re remembering a time when they got hurt and wondering if it was a head injury, call your pediatrician. They will explain what to do next. If your child is showing signs of a speech delay or other language problem, your pediatrician will likely recommend speech therapy. Speech therapists treat children with a variety of diagnoses and conditions, including brain injuries.
When to seek speech therapy after a head injury
Once your child has been medically cleared, Irazoque recommends asking your pediatrician for a referral to a speech-language pathologist (SLP) if any of these are true:
Your toddler has been diagnosed with a concussion or TBI of any level and shows changes in how they talk, listen, or use words.
Words, phrases, or skills your child had before the injury are now gone.
Your child seems to grope for words, mispronounce sounds they used to say, or struggle to follow simple directions.
It has been more than 2 to 4 weeks since a mild TBI and speech, language, or attention symptoms are not getting better.
The injury was moderate or severe. In that case, a speech-language evaluation is standard care, even if symptoms look mild. For a diagnosed TBI, insurance usually covers speech therapy as medically necessary. Children under 3 also qualify for a free evaluation through their state's Early Intervention program—no pediatrician referral needed.
How does online speech therapy work? Learn how virtual speech therapy helps children and adults improve communication skills from the comfort of home.
How does speech therapy help children after a head injury?
Speech therapy begins with an evaluation. The speech therapist will perform assessments in order to identify where your child needs support. They will also review your child’s medical history and talk with you about how they communicate. All of this information will help determine what types of goals will be targeted in speech therapy.
Your speech therapist will set goals for your child and work on them in each session. They will measure the percentage of accuracy that your child shows toward these goals each week. This helps the speech therapist track progress and understand how your child is responding to treatment. They can make adjustments to the treatment plan as needed.
“Parents should know that speech therapy for children is typically play-based and child-led. This helps keep kids engaged and excited about speech therapy,” Irazoque explains. “Sometimes they don't even realize all the hard work they're doing!”
If a child is not talking yet, or isn’t using many words, the speech therapist will use activities to help the child practice naming items or using words to ask for things.
If a child needs to work on pronouncing speech sounds or words, the speech therapist will teach them ways to move their mouth muscles for clearer speech.
Some kids may not be ready to focus only on verbal communication. In these cases, AAC (augmentative and alternative communication) is often the best route to go. “Research has shown that using AAC can help support verbal development in children with a speech delay. It does not prevent them from learning to talk,” Irazoque notes.
Learn how a speech delay is diagnosed and treated, along with how speech therapy can help kids with a speech delay.
Expressable is here to help
If you’re wondering if your child has a speech delay, reach out to us today. Our speech therapists have treated thousands of kids with speech delay around the country. You can learn more about our clinical approach to treating speech delay in our treatment guide.
We know that navigating the effects of a brain injury can feel worrisome. But rest assured, our licensed speech therapists can help. Click here to get matched with a speech therapist who's right for your family.
Frequently asked questions (FAQs)
A minor bump with no other symptoms is very unlikely to cause a lasting speech delay. Toddlers bump their heads all the time as they learn to walk and climb. The skull, scalp, and fluid around the brain (cerebrospinal fluid) help soak up small hits. A speech delay would only be likely if the bump was hard enough to cause a concussion (mild TBI) or a worse brain injury. Warning signs to watch for include changes in your child’s behavior, being unusually sleepy, throwing up, or losing words they used to say. If any of those show up—or if you’re not sure how bad the hit was—call your pediatrician.
It depends on how bad the injury was. Following the CDC's mild TBI guidance, most children with a concussion feel fully better within about 2 to 4 weeks. Any short-term changes in speech, language, or attention usually clear up along with the other symptoms. A smaller group of children have post-concussion symptoms lasting for weeks to months and do well with speech therapy.
For moderate or severe TBI, recovery can take months to years. Kids often work with a speech-language pathologist on cognitive-communication, clear speech, or safe swallowing during that time.
If your toddler has been diagnosed with a concussion or TBI and you notice any changes in how they talk, understand words, or follow directions—yes. Ask your pediatrician for a referral to a speech-language pathologist. You should also ask for an evaluation if mild TBI symptoms have not improved after about 2 to 4 weeks, or if speech skills your child had before the injury are now gone.
For moderate or severe TBI, an evaluation is standard care, even if symptoms look mild. Under age 3, your state's Early Intervention program offers free evaluations without a pediatrician's referral.
How Expressable Can Help
Concerned your child isn't reaching age-expected milestones? Looking for communication support from a professional? Expressable is a national online speech and occupational therapy practice serving children and adults. We treat all major areas of communication, feeding, and developmental skills, offer flexible hours including evenings and weekends, and accept most major health insurance plans. We’re proud to have earned more than 4,500 5-star reviews from our clients (4.83/5 average).
Our therapy model is centered on parent and caregiver involvement. Research proves that empowering caregivers to participate in their loved one’s therapy leads to better outcomes. That’s why we combine live, 1-on-1 speech and occupational therapy with personalized education and home practice activities for faster progress.
