Health Tips

Is your 2-year-old not talking at all? Or maybe just a few words, but that’s it. You look at other children of the same age, or maybe younger, speaking tons of words.

You tell yourself your child will eventually outgrow it and start speaking.

So how long would you wait before seeking professional advice?

The Speech & Language Development Of A Child

Here’s a general idea of whether your child’s speech and language development are normal, or not.

Before 12 months

• Cooing.

• Babbling.

• Can start saying mama or dada but has no idea what the words mean.

• Able to recognize sounds and names of common objects.

12 month – 15 months

• Can produce sounds starting with letters b, d, p, m, or n. The word ball is a common favourite.

• Uses 5 words.

• Follow simple instructions like “Please get the ball for me”.

• Shakes head for “no” and nods head for “yes”.

15 months – 18 months

• Points and vocalizes that he wants something.

• Says “no”.

• Vocabulary expands to 10-15 words.

• Uses jargon (a word only he understands).

18 months – 24 months

• Uses 20 words. Mostly nouns.

• Speaks 2-word sentences. For example. Ball-gone, baby-crying, mama-big, etc.

• Able to identify pictures in a book.

• Able to point to specific body parts such eyes, nose, ears, head, mouth and belly when asked.

What Can Cause Speech Delay In A Toddler?

There are many factors that can cause speech delay. I am not going to list down all of them, but the important ones to give you an idea of what may the possible cause.

General delay

One of the more common cause as to why children have a speech delay. They generally needed just a little more time as compared to their peers.

With adequate guidance, they should be able to catch up relatively fast over a short period of time.

Hearing loss

You can’t learn to speak when you can’t hear in the first place.

In most hospitals, when a child is born, a hearing assessment will be performed to detect children with hearing difficulties.

However, in cases that a hearing assessment was not performed, a child may grow up not knowing that he has problems with his hearing.

Brain abnormality

The wiring within a child’s brain is not functioning correctly. The messages sent from the brain does not reach the vocal cords.

This medical condition is called apraxia. A child needs to be examined by a pediatrician before reaching a diagnosis.

Weakness in muscles

Apart from our vocal cords, we use other types of muscles on our face to produce words. The tongue, lips, facial muscles and throat are involved too.

Any weaknesses in these muscles delays speech. The speech of an affected child is usually unclear.

This medical condition is known as dysarthria and just like apraxia, a child needs to be assessed by a doctor too.

Autism

A medical condition which can be diagnosed as early as 18 months old. Children with autism have great difficulty communicating, expressing themselves and forming relationships with others.

They view the world from a different perspective compared to children with no autism and this condition is life-long.

Possible signs of autism in a toddler:

• Does not smile

• No joyful expressions

• No babbles

• No meaningful words

• No gestures (waving goodbyes, high fives, pointing, etc.)

• No response to name

• Avoid eye contact

• Likes to be alone

• Upset with changes

• Performs repetitive actions or movements

There are many more medical conditions that can cause delay, but I am not going to touch on those. The reason I stated the 5 causes above is to illustrate to you that speech delay can come in many forms.

From being normal (child just needed a little more time), physical disabilities (hearing loss, muscle weakness, brain abnormalities) to development disorder like autism whereby the child does not have any physical disabilities, to begin with.

The Professionals Involved In Speech Delay

Even though we know that there is a problem, many times we do not actually know whom we should go to.

Here’s a list to make things easier for you:

Pre-school Teachers

If your child goes to daycare, the teachers in school will be able to give you a clearer picture of what is happening, apart from the time your child is at home.

Paediatrician

When in doubt, speak to your child’s doctor. The paediatrician should be able to give you an insight of what type of speech delay your child is facing.

This will narrow down the cause. A problem is easier to be solved if the root cause of it is identified.

Speech Therapist

Also known as the speech-language pathologist. Multiple sessions are usually needed with the speech therapist to get your child back on track. They usually work alongside with doctors in managing your child’s condition.

Audiologist

An audiologist is involved in assessing your child’s hearing.

An important process to determine the level of deafness that is affecting a child.

A Child Psychologist/Psychiatrist

Both the psychologist and psychiatrist come into play when there is a developmental disorder from the social aspect is involved, like autism.

Not only do they help the child to adapt to the environment, but also to help parents understand their child better.

Speech Therapy For Toddlers In Malaysia

Now, before you jump to the conclusion that your child has a speech or language delay, why not see a doctor or a speech therapist/audiologist for assessment first?

However, looking for a speech therapist in Malaysia is no easy task but thankfully, there is an association called MASH or Malaysian Association of Speech-Language & Hearing that exists to gather all qualified speech therapists available.

MASH is a professional body registered with the Registrar of Societies

It represents the speech-language pathologists and audiologists in Malaysia.

I am sure you don’t want some mumbo-jumbo fellow to be treating your child.

You can search through their directory to look for a qualified speech-language pathologist in your area.

How To Help Child With Speech Delay At Home?

Getting help is one thing, but as a parent, it is natural for us wanting to help our child too.

There are activities to encourage speech and language development in 2-year-olds.

Here’s how.

Spend time playing with your child

By playing, I don’t mean giving your child a toy and that’s it. You have to play with your child.

To stimulate speech, there has to be a 2-way communication. Bath time itself is the simplest way to start. It also helps to build the bond between you and your child.

Talk and talk

Talk to your child throughout the day. Not just specific hours of a day.

Be it when you are feeding your child,  bath times, diaper changing times or any other opportunities that you can find to talk to your child.

Also, avoid speaking at the same level as your child. If your child uses one word, you use two. If he uses two words, then you use three. You get the point.

Use simple flashcards

Who does not like flashcards? Be interesting. Get your child engaged in creating interesting stories accompanied by flashcards.

Stories and pictures make learning process more fun as compared to just only words alone.

Drink using straws

If your child is drinking from a bottle, maybe it is time to up your game.

Get him a sippy cup, or at least a cup with a straw and let him drink with it. This helps to strengthen his mouth muscles, which can help his speech.

Turn off the TV

This is not much of an activity, but having the TV turned on all the time disrupts speech development in many instances.

The average words used in a household is tremendously reduced when the TV is switched on. Why would one want to talk when the TV is on all the time, right?

You are more focused on watching rather than talking. As a result, fewer words will be spoken. How do you expect your child to speak when there are fewer words spoken? Common sense, really.

Sing with your child

Nursery rhymes? Ring a bell? Nursery rhymes are generally designed to be catchy, with words that sound similar to one another. Use this to your advantage.

However, do not just turn on the music and walk away. You will actually get the opposite effect and speech will be delayed even further. Remember, communicate.

Put your child’s favorite toys out of reach

When your child wants his favorite toys and he can’t reach for them, what will he do? He will definitely want to get your attention and help him get his toys.

Use this opportunity to get him to speak, or at least verbalize certain words to indicate that he wants it. This encourages your child to speak in the long run.

In the meantime, you can also teach your child words like “please”, “thank you”, “may I”, “help”, etc.

Take-home points

• A toddler not being able to speak at the age of 2 is totally not normal.

• Do not assume that the speech delay is normal unless your child has been evaluated by professionals.

• Seek help from the right professionals (doctors, speech therapists, audiologists, pre-school teachers).

• Speech delay can be caused by many factors like muscle weakness, hearing impairment, brain abnormalities or even autism.

• You can do your part too by helping your child out.

• However, do remember that every child is different. There are variations in every child. As a parent, it is encouraged to provide a healthy environment for your child.

Download our Doc2Us app from Google Play Store or Apple Store and chat with a doctor now.

References:

1. Learn The Signs of Autism | Autism Speaks

2. Delayed Speech or Language Development | KidsHealth

3. Helping Your Late-Talking Children | WebMD

Image credit:

1. https://www.hearingsolutions.in/wp-content/uploads/2017/04/early.jpg

2. https://assets.babycenter.com/ims/blog/uk/311.jpg

3. https://hellodoktor.com/wp-content/uploads/2017/03/autistic-children-1024x682.jpeg?x13626

4. https://www.straitstimes.com/sites/default/files/articles/2016/03/14/ST_20160314_XAMDYS_2136300.jpg

5. https://s3-us-east-2.amazonaws.com/hackensackmeridianhealth/wp-content/uploads/2017/03/20164446/Pediatric-Audiology.jpg

6. https://www.youngparents.com.sg/wp-content/uploads/2016/05/26902069_m.jpg

7. https://www.iq-test.net/File/Images/love-talking-high-iq.jpg

8. https://allaboutkiids.com/wp-content/uploads/2018/10/speech-delay-fea.jpg

A collaboration with Ethissa.

Written By

Eric Siew

Reviewed By

Doc2us Medical Board