What Is a Speech Delay and How Is It Diagnosed?

In our article "How to Tell If Your Child Has a Speech Delay," we reviewed some common signs that your child may have a speech delay. Here, let's dive deeper into what a speech delay is (and is not), and how speech delays are diagnosed by a speech therapist.

What is considered delayed speech?

Speech and language skills begin with the slightest cooing of an infant. As the months pass, toddlers eventually begin to babble which soon progresses into one of the most joyous moments for a parent--their child’s first understandable words. A typical 2-year-old can say about 50 words and speak in two- and three-word sentences. By age 3, their vocabulary increases to as many as 1,000 words.

A speech delay is when a toddler doesn’t meet these typical speech milestones. It is a common developmental problem that affects as many as 10% of preschool children.

Because all children progress on their own timeline, it can be difficult for caregivers to tell whether their child is just a late talker (and will soon be chatting a million miles a minute), or whether there’s a serious problem that needs professional treatment.

This is why assessment and diagnosis by a certified speech-language pathologist, or speech therapist, is so important. Speech delays can be effectively treated, and research has shown that earlier interventions lead to better outcomes.

Is there a difference between a speech delay and a language delay?

While speech delays and language delays are often confused and difficult for untrained professionals to tell apart, there are important differences.

Speech is the physical act of producing sounds and saying words. A child with a speech delay is often difficult to understand. While they may use words and phrases to express ideas, they often have trouble forming the correct sounds. The inability to interpret your child can be frustrating and disheartening for a parent.

Conversely, a toddler with a language delay may make the correct sounds and pronounce some words, but they can’t form phrases or sentences that make sense.

Some children have either a speech delay or a language delay, and some have both. Distinguishing between the two is important as it will inform treatment decisions. If you think your child may have a speech or language delay, it’s important to seek help from a speech therapist. They’re the most qualified professional to administer an evaluation and diagnosis.

How are speech delays diagnosed?

If your child might have a problem, it's important to see a healthcare provider or speech-language pathologist. During the initial evaluation, they will ask about your toddler’s speech and language capabilities, as well as other developmental milestones and behaviors to make the appropriate diagnosis.

More specifically, your speech therapist will evaluate:

• What your child understands (called receptive language)

• What your child can say (called expressive language)

• Your child’s sound development and clarity of speech

• Your child's oral–motor status (how the mouth, tongue, palate, etc., work together for speech as well as eating and swallowing)

The speech therapist will also review your child's medical history and talk with you about your concerns. Based on the results, the speech therapist may recommend speech therapy for your child. Remember, the earlier treatment can begin, the sooner your child will make progress!