As you’re trying to assess your child’s language development, it’s important to recognize the difference between speech and language. Speech is pronunciation; it refers to how clearly a child talks. Language means expressing and receiving information in a way that is meaningful; in other words, it’s understanding and being understood through communication.

A child with a language problem may be able to pronounce words well but be unable to put more than two words together meaningfully.Conversely, another child’s speech may be difficult to understand, but he may use words and phrases to express his ideas well. Problems in speech and language differ but frequently overlap.

What Causes Speech and Language Delays?

There are many reasons for delays in speech and language development. Speech delays in an otherwise normally developing child are rarely caused by physical oral problems, such as abnormalities of the tongue or palate. They are more commonly caused by hearing problems. If a child has trouble hearing, he may have trouble understanding, imitating, and using language. Ear infections, especially recurrent infections or chronic collections of fluid behind the eardrum, can affect hearing ability temporarily or, less often, permanently. Simple ear infections that have been adequately treated, though, should have no significant effect on a child’s speech and language development.

Some children with speech delays have oral-motor problems, which means that there are problems in the way the brain communicates with the physical structures involved in speech. These children may have difficulty using the lips, tongue, and jaw to produce speech sounds. A speech or language delay may also be a sign of a more generalized developmental delay in a child.

Speech development is a mixture of nature and nurture. A child’s genetic makeup will in part determine his intellect and capacity for speech and language. Certain medical conditions, such as chronic ear problems, can also have a major impact. However, much depends on his environment. Is the child adequately stimulated at home or in child care? Does he have the opportunity for communication exchange and participation? What kind of feedback does he get? These factors can have an important influence on a child’s speech and language development.

How to Encourage Language Development

To encourage language development, you should begin communicating with your child from birth. One of the ways to do this is to read to her! You don’t have to finish a whole book; in fact, an 18- to 24-month-old probably won’t sit still for it. Start with a short book such as Dorothy Kunhardt’s Pat the Bunny, where your child imitates the patting motion. Use high-pitched sounds as you read—babie are known to respond to these. Then go on to nursery rhymes, which have rhythmic appeal. Progress to predictable books where your child can anticipate what happens and understand why it happens, such as in Margaret Wise Brown’s Goodnight Moon.

A Speech/Language Evaluation

If you find that your child is not meeting developmental milestones for language, you should talk with your child’s doctor about the need for evaluation by a specialist. If speech, language, hearing, or developmental deficits do exist, early intervention can help your child get the help he needs to avoid or lessen the severity of future learning problems. We recommend that you speak with your child’s doctor if any of these conditions exist:

• Your two- to three-year-old can only imitate speech and does not produce words or phrases spontaneously.
• He says only certain sounds or words repeatedly.• His voice quality seems unusual, or it is very difficult for others to understand his speech.
• He cannot use oral language to communicate more than his immediate needs.
• He cannot follow simple directions.

If your child’s doctor thinks there is reason for concern, he or she may refer your child to a speech-language pathologist. If speech therapy is recommended for your child, you should be involved in the process. By observing the professional therapy sessions, you can learn what your child is being taught and reinforce those concepts at home. It’s important for you to learn what you can do to encourage development of language skills.