Common Speech and Language Concerns for Young Children

Developing language and communication skills is an important part of a child’s first years.  Children from birth to age five are learning to share their own thoughts and ideas (expressive communication) and understand the messages that others share with them (receptive communication).

As primary communication partners, parents and caregivers support speech and language development.  A good understanding of language development is an asset. The IEL resource lists Communication and Oral Language Development in Infants and Toddlers and Communication and Oral Language in the Preschool Years provide information on how children develop communication and oral language. 

Some children will have challenges with speech and language. Caregivers can work with professionals to address those concerns.  In doing so, a basic understanding of specific concerns is helpful.  This Q&A for parents and caregivers: 

• provides information about potential causes of speech and language disorders
• offers basic descriptions of common concerns
• identifies common strategies caregivers can use to support young children in their speech and language development

What are potential causes of speech and language disorders or delays?

Some children are more likely to experience speech delays or disorders. Those experiencing speech disorders and delays at higher rates include boys, children born prematurely or with low birth weight, and children with a family history of language or learning concerns. Growing up in a multilingual household is not a cause of speech and language disorders. Many times, the exact cause of a communication delay or disorder is unknown.

A few common causes are described below:

Hearing loss

Children learn language by listening to the language around them. For some children with hearing loss, their ability to hear the language in their environment is limited. This can be a cause of a language delay. In fact, caregivers often learn about an unidentified hearing loss because they notice their child is not talking yet or has limited words. However, hearing differences vary widely. For example, it can occur in one or both ears, can be present at birth or acquired later, and can be fluctuating or stable. Importantly, children who are Deaf or hard of hearing can develop strong language skills when they have early, consistent access to language. Hearing Loss in Children offers detailed information on causes, assessment, and treatment of hearing loss. 

Motor/neurological differences

Language delays or disorders can occur if a child’s brain has trouble processing and understanding language, organizing thoughts into words, or sending clear signals to the muscles needed for speech production (e.g., the mouth).

Physical differences

Speech difficulties may be due to differences in how parts of the body have formed. Differences in the lips, palate (roof of the mouth), and other oral structures can affect how certain speech sounds are produced and how clearly a child sounds. Examples include cleft lip, cleft palate, or orofacial anomalies.

Neurodevelopmental disabilities

Some children are born with developmental differences that affect how they learn, communicate, or interact with others. For example, children with certain genetic conditions (e.g., Down syndrome) or other neurodevelopmental differences (e.g., Autism) may develop speech, language, and communication in a different way or on a different timeline. 

Experiences and environmental conditions

Children’s language development is shaped by the experiences and opportunities available to children in their everyday environments. Rich, responsive language interactions can support and strengthen language growth. When children have fewer opportunities to hear language or interact with others, language development may progress more slowly. Environmental experiences may influence the pace of language development but are rarely the sole cause of a persistent language disorder.

What should caregivers know about common speech and language disorders in young children?

There are many speech and language delays and disorders. Children can experience them in isolation or along with other difficulties. Caregivers worried about their child’s language development may benefit from a basic understanding of some common concerns. Descriptions of late language emergence, speech sound disorders, developmental language disorder, social communication disorder, and stuttering are provided in this Q&A. These brief summaries can help caregivers describe concerns to professionals as they seek help.

Late Language Emergence

Late language emergence (LLE) is a delay, rather than a disorder. It is more likely in males and in twins. While their language development is delayed, children with LLE have no diagnosed disabilities or developmental delays in other cognitive or motor domains.  Children with LLE may be called “late talkers” or “late language learners”.  Children with LLE may have difficulty with expressive language or with expressive and receptive language. The most common measure of LLE is an expressive vocabulary of fewer than 50 words and no two-word combinations by the time a child is 24 months old.  Learn more in Late Language Emergence. 

Speech Sound Disorders

Speech sound disorders (SSDs) refer to difficulties with producing speech sounds accurately. More likely to affect males, SSDs can be caused by: 

• motor/neurological disorders such as apraxia (a “planning” problem that makes it difficult for a child’s brain to coordinate the actions needed for language)
• structural abnormalities in the body such as cleft lip or cleft palate
• sensory disorders such as hearing loss

Speech sound disorders include the following speech errors:

• Omissions—certain sounds are omitted (e.g., leaving off the “s” in “spoon”)
• Substitutions—certain sounds are replaced incorrectly (e.g., “wabbit” instead of “rabbit”)
• Additions—extra sounds are added into a word (e.g., “puh-lay” instead of “play”)
• Inconsistent word production – the same word is pronounced in different ways at different times. 

However, many of these patterns are developmentally appropriate until a certain age. This can make it difficult to separate normal speech development from a speech sound disorder. Learn more in Speech Sound Disorders-Articulation and Phonology and Childhood Apraxia of Speech. 

Developmental Language Disorder

Children with developmental language disorder (DLD) have difficulty producing and understanding language. DLD is sometimes known as a hidden condition. It is more common than autism spectrum disorder (ASD), yet fewer people are aware of it.

Signs of DLD can be missed. In toddlerhood, it is often seen as a language delay. In early childhood, it is often masked by other concerns such as challenging behaviors, social anxiety, trouble with attention, or academic difficulties. However, for children with DLD, these challenges are often linked with their persistent difficulty with language. Examples of these language difficulties may include:

• comprehending language
• learning new words
• combining different types of words into phrases and simple sentences
• including grammatical information so sentences sound more adult-like
• producing complex sentences and understanding multistep directions 

Learn more in Developmental Language Disorder (DLD) and Raising Awareness of Developmental Language Disorder (RADLD).

Social Communication Disorder

Through social communication, individuals share experiences, thoughts, and emotions. Young children encounter a variety of social situations, and communication expectations vary from occasion to occasion.  For example, telling jokes with a friend at recess is a different social experience than going out to a quiet dinner with grandparents. Social aspects of communication (e.g., eye contact, facial expressions, and body language) vary by individual, family, and culture. 

The primary cause of social communication disorder is not known. SCD can exist on its own or as a defining characteristic of another condition, such as autism. Learn more in Social Communication Disorder.

Stuttering

Stuttering is a fluency disorder. It is an interruption to the flow and rhythm of speech and includes repetitions of sounds and words. 

Stuttering is common in young children. Many children experience stuttering if they feel excited, tired, or rushed to share ideas. Stuttering often goes away on its own. Boys, children who begin stuttering at an older age (4 years), and those with a family history of stuttering are more likely to experience stuttering that continues past a few months. Stuttering in Toddlers & Preschoolers: What’s Typical, What’s Not? offers a table that distinguishes typical language development from predictors of long-term stuttering.  For example, repeating phrases is often part of typical development, but repeating beginning sounds is more often associated with stuttering.  

Children may experience a negative reaction from others if they stutter.  This can then cause a child to feel discouraged and prompt them to hide their stutter. Parents can help by describing stuttering in open and positive ways. “It’s okay to have ‘bumpy’ speech.”

How can caregivers support children with speech and language disorders?

All families, not just those with concerns about language, can support their child’s ongoing language development.  Learn more about general strategies in the IEL tip sheets: 

• The Gift of Words: Conversations and Routines
• Talk, Listen, and Learn

Families who are concerned about their child’s speech and language development can reach out to their pediatrician for an initial appointment. They may be referred to a more specialized doctor or therapist, such as an audiologist or speech-language pathologist. These professionals work in a variety of settings, including early intervention agencies, schools, hospitals, universities, or private therapy clinics. 

Many children with speech and language disorders are eligible for services under the Individuals with Disabilities Education Act (IDEA).

• For children ages birth through three, services are provided through Early Intervention (EI).  The tool kit Early Intervention: Resources for Families, Childcare, and Early Childhood Teachers explains the EI system in Illinois. 
• For children ages three to five, services are provided by the local education agency, most commonly a school district.  Learn more in the tool kit Special Education Assessment and Eligibility.

Medical professionals, early intervention providers, and special education teams collaborate with families to support children’s speech and language development. Families should expect support that acknowledges and respects their culture and values, as described in Cultural Responsiveness. Below is a list of commonly used strategies, along with IEL resources on those strategies:

IEL Resources

Web Resources