Late Blooming or Language Problem?
Parents are smart. They listen to their child talk and know
how he or she communicates. They also listen to his or her
playmates who are about the same age and may even remember what
older brothers and sisters did at the same age. Then the parents
mentally compare their child's performance with the
performance of these other children. What results is an
impression of whether or not their child is developing speech and
language at a normal rate.
If parents think that development is slow, they may check out
their impression with other parents, relatives, or their
pediatrician. They may get an answer such as "My son was
slow too. Now he won't shut up" or "Don't
worry, she'll outgrow it."
But suppose (s)he doesn't? I'd feel guilty waiting
and then finding out that I should have acted earlier. Waiting
is so hard, especially when I'm concerned and only want
what's best for my child. What's a parent to do? How
will I know for sure what to do?
You won't know for sure. Although the stages that children
pass through in the development of speech and language are very
consistent, the exact age when they hit these milestones varies a
lot. Factors such as the child's inborn ability to learn
language, other skills the child is learning, the amount and kind
of language the child hears, and how people respond to
communication attempts can slow down or accelerate the speed of
speech and language development. This makes it difficult to say
with certainty where any young child's speech and language
development will be in 3 months, or 1 year.
There are, however, certain factors that may increase the risk
that a late-talking child in the 18- to 30-month-old age range,
and with normal intelligence, will have continuing language
problems. These factors include:
- Receptive language:
Understanding language generally precedes expression and use.
Some studies that have followed-up late-talking children in
this age range have found, after a year, that age-appropriate
receptive language discriminated late bloomers from children
who had true language delays. Other researchers doing follow-up
studies included only children whose receptive language was
within normal limits because they believed that delay in this
area was likely to produce worse outcomes.
- Use of gestures:
One study has found that the number of gestures used by
late-talking children with comparably low expressive language
can indicate later language abilities. Children with a greater
number of gestures used for different communication purposes
are more likely to catch up with peers. Such a result is
supported by findings that some older children who are taught
non-verbal communication systems show a spontaneous increase in
- Age of diagnosis:
More than one study has indicated that the older the child at
time of diagnosis, the less positive the outcome. Obviously,
older children in a study have had a longer time to bloom than
younger children but have not done so, indicating that the
language delay may be more serious. Also, if a child is only
developing slowly during an age range when other children are
rapidly progressing (e.g. 24-30 months) that child will be
falling farther behind.
- Progress in language development:
Although a child may be slow in language development, he or she
should still be doing new things with language at least every
month. New words may be added. The same words may be used for
different purposes. For example, "bottle" may one day
mean "That is my bottle," the next, "I want my
bottle," and the next week, "Where is my bottle? I
don't see it." Words may be combined into longer
utterances ("want bottle" "no bottle"), or
such longer utterances may occur more often.
It should be re-emphasized that negative aspects of these
factors increase the risk of a true language problem but do not
mandate its presence. For example, one research group found that
one of their 25- or 26-month-old children with the worst
receptive language had the best expressive language outcome 10
months later. On the other hand, children on the positive side of
these factors may turn out to show less progress than predicted.
The research group found that the child with the poorest outcome
had the best receptive language and the largest vocabulary at the
beginning of the study.
One study has found that the number of gestures used by
late-talking children with comparably low expressive language can
indicate later language abilities.
Individual children may not behave like children in a group.
Group data can only be used to predict what most children who are
very similar to the children in a study might do. Predictions, by
their very nature, are not always correct.
So what's a parent to do?
Parents don't have to rely on the predictions of others or
to guess that their child will be just like a friend's and
eventually catch up in language development. If parents are
concerned about their child's speech and language
development, they should see a speech-language pathologist
certified by the American Speech-Language-Hearing Association for
a professional evaluation. The speech-language pathologist can
administer tests of receptive and expressive language, analyze a
child's utterances in various situations, determine factors
that may be slowing down language development, and counsel
parents on the next steps to take.
The speech-language pathologist may give suggestions on
stimulating language development, and ask that the parent and
child return if parental concern continues. Or, the
speech-language pathologist may want to schedule a re-evaluation
right then. In more severe cases, the speech-language pathologist
may want the parent and child to become involved in an early
intervention program. The programs typically consist of
demonstrating language stimulation techniques for home use, and
more frequent monitoring of the child's progress. In the most
severe cases, a more formal treatment program may be
Waiting to find out if your child will catch up will still be
hard, but you won't feel guilty that you did not do
everything you could.
ASHA ProFind to find a speech-language pathologist near you.