speech delay meaning in english

Language Delays in Toddlers: Information for Parents

Your baby is able to communicate with you long before they speak a single word! A baby's cry, smile, and responses to you help you to understand their needs. Learn how children communicate and what to do when there are concerns about delays in development.

Milestones during the first 2 years

Children develop at different rates, but they usually are able to do certain things at certain ages. Following are general developmental milestones . Keep in mind that they are only guidelines. If you have any questions about your baby's development, ask your child's doctor—the sooner the better. Even when there are delays, early intervention can make a significant difference.

By 1 year most babies will

Look for and be able to find where a sound is coming from.

Respond to their name most of the time when you call it.

Wave goodbye .

Look where you point when you say, "Look at the _________."

Babble with intonation (voice rises and falls as if they are speaking in sentences).

Take turns " talking " with you—listen and pay attention to you when you speak and then resume babbling when you stop.

Say "da-da" to dad and "ma-ma" to mom.

Say at least 1 word.

Point to items they want that are out of reach or make sounds while pointing.

Between 1 and 2 years most toddlers will

Follow simple commands, first when the adult speaks and gestures, and then later with words alone.

Get objects from another room when asked.

Point to a few body parts when asked.

Point to interesting objects or events to get you to look at them too.

Bring things to you to show you.

Point to objects so you will name them.

Name a few common objects and pictures when asked.

Enjoy pretending (for example, pretend cooking). They will use gestures and words with you or with a favorite stuffed animal or doll.

Learn about 1 new word per week between 11/2 and 2 years.

By 2 years of age most toddlers will

Point to many body parts and common objects.

Point to some pictures in books.

Follow 1-step commands without a gesture like "Put your cup on the table."

Be able to say about 50 to 100 words.

Say several 2-word phrases like "Daddy go," "Doll mine," and "All gone."

Perhaps say a few 3-word sentences like "I want juice" or "You go bye-bye."

Be understood by others (or by adults) about half of the time.

When milestones are delayed

If your child's development seems delayed or shows any of the behaviors in the following list, tell your child's doctor. Sometimes language delays occur along with these behaviors. Also, tell your child's doctor if your baby stops talking or doing things that he or she used to do.

Doesn't cuddle like other babies

Doesn't return a happy smile back to you

Doesn't seem to notice if you are in the room

Doesn't seem to notice certain noises (for example, seems to hear a car horn or a cat's meow but not when you call his or her name)

Acts as if he or she is in his or her own world

Prefers to play alone; seems to "tune others out"

Doesn't seem interested in or play with toys but likes to play with objects in the house

Has intense interest in objects young children are not usually interested in (for example, would rather carry around a flashlight or ballpoint pen than a stuffed animal or favorite blanket)

Can say the ABCs, numbers, or words to TV jingles but can't use words to ask for things he or she wants

Doesn't seem to be afraid of anything

Doesn't seem to feel pain in a typical fashion

Uses words or phrases that are unusual for the situation or repeats scripts from TV

Delays in language

Delays in language are the most common types of developmental delay. One out of 5 children will learn to talk or use words later than other children their age. Some children will also show behavioral problems because they are frustrated when they can't express what they need or want.

Simple speech delays are sometimes temporary. They may resolve on their own or with a little extra help from family. It's important to encourage your child to "talk" to you with gestures or sounds and for you to spend lots of time playing with, reading to, and talking with your infant or toddler. In some cases, your child will need more help from a trained professional, a speech and language therapist, to learn to communicate.

Sometimes delays may be a warning sign of a more serious problem that could include hearing loss , developmental delay in other areas, or even an autism spectrum disorder (ASD). Language delays in early childhood also could be a sign of a learning problem that may not be diagnosed until the school years. It's important to have your child evaluated if you are concerned about your child's language development.

What your child's doctor might do

Sometimes more information is needed about your child before your child's doctor can address your concerns. The doctor may

Ask you some questions or ask you to fill out a questionnaire.

Interact with your child in various ways to learn more about his or her development.

Order a hearing test and refer you to a speech and language therapist for testing. The therapist will evaluate your child's speech ( expressive language ) and ability to understand speech and gestures ( receptive language ).

Refer your child for evaluation through an early intervention program.

What to expect after the doctor's visit

If your child's doctor tells you not to worry (that your child will "catch up in time") but you are still concerned, it's OK to get a second opinion. You can ask your child's doctor for a referral to a developmental specialist or a speech and language therapist. You may also contact an early intervention program for an evaluation if your child is younger than 3 years, or your local school district if he or she is 3 or older.If what your child says ( expressive language ) is the only delay, you may be given suggestions to help your child at home. Formal speech therapy may also be recommended.

If both what your child understands ( receptive language ) and what he or she says are delayed and a hearing test is normal, your child will need further evaluation. This will determine whether the delays are caused by a true communication dis order, generalized developmental delays, an ASD, or another developmental problem.

When an ASD is the reason for language delays, your child will also have difficulty interacting with other people and may show some or all of the concerning behaviors listed previously. If there is concern your child might have an ASD, your child will usually be referred to a specialist or a team of specialists for evaluation and treatment of an ASD or a related disorder. The specialist(s) may then recommend speech therapy and may suggest other ways to improve social skills, behavior, and the desire to communicate.

Programs that help children and families

If your child has delays or suspected delays, your child's doctor will probably refer you to an early intervention program in your area. The staff there might do additional evaluations and reassure you that your child's development is normal or tell you that your child would benefit from some type of intervention. Your child does not need to have a diagnosis of a developmental problem to receive services through this program.

If your child is younger than 3 years , the referral may be to an early intervention program in your area. Early intervention programs are sometimes called "Part C" or "Birth to Three" programs. Early intervention is a federal- and state-funded program that helps children and their families. You may also contact the early intervention program yourself.

If your child qualifies for services , a team of specialists will work with you to develop an Individual Family Service Plan (IFSP) . This plan becomes a guide for the services your child will receive until 3 years of age. It may include parent training and support, direct therapy, and special equipment. Other services may be offered if they benefit your child and family. If your child needs help after 3 years of age, the early intervention staff will transition your child to services through your local school district.

If your child is 3 years or older , the referral may be to your local public school. You may also contact the local public school directly. If your child is eligible, the school district staff will, with your input, develop an Individual Education Plan (IEP) . This plan may provide some of the same services as the early intervention program but focus on school services for your child. The level of services also may be different. If your child continues to need special education and services, the IEP will be reviewed and revised from time to time.

As a parent, follow your instincts. If you continue to have concerns about your child's development, ask for a reevaluation or referral for additional formal testing.

Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of the resources mentioned on this page. Web site addresses are as current as possible, but may change at any time.

More information

• Ask the Pediatrician:  My baby is turning a year old this month. Should she be talking by now?​
• How to Raise Concerns About a Child's Speech and Language Development
• Language Development: 8 to 12 Months
• Language Development: 1 Year Olds
• Language Development: 2 Year Olds
• Family Voices
• Learn the Signs. Act Early.

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Home » Nonverbal Autism and Communication Skills » Speech Delay vs Autism: What’s the Difference?

Speech Delay vs Autism: What’s the Difference?

By   Leanne Sherred, MS, CCC-SLP

July 4, 2024

You may have noticed that your child isn’t speaking as fluently as other kids their age. Maybe they haven’t even said their first words yet. Your mind keeps thinking of two things: speech delay vs autism. Are they the same thing? Is speech delay one of the earliest signs?

Well, not necessarily. While speech delays, language delays , and learning differences are often a hallmark of ASD, a speech delay alone does not mean a child has autism. So, what are the main differences between speech delay and autism? Let’s start with the basics.

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What is a Speech Delay?

Speech and language delays are common among young children. A child may have a speech or language delay if they are not meeting appropriate developmental milestones typical for their age.

While speech and language delays are often confused and used interchangeably, there are distinguishing characteristics.

Speech refers to how children:

• articulate, and
• manipulate the sounds used in words.

For example, poor pronunciation of hard-to-say sounds like /s/ and /z/ can make it difficult for them to be understood.

Speech delays can be developmental, meaning your child is following typical speech patterns but at a slower rate than their peers. They can also be due to a speech motor disorder that affects their ability to coordinate their lips, jaw, and tongue.

What is a Language Delay? 

A language delay doesn’t necessarily affect “how” children say things but “what” they say. This is referred to as an expressive language disorder.

These children may be able to pronounce sounds and words perfectly but have trouble forming them into coherent phrases to communicate their ideas. Additionally, a receptive language delay can affect how children process information.

They often struggle with:

• comprehending what people are trying to say, 
• learning new vocabulary, and
• deriving meaning from verbal and written communication.

Is Speech Delay a Sign of Autism?

While speech delay can be a characteristic associated with autism spectrum disorder, it does not necessarily indicate autism on its own. There are various reasons for speech delays, which can be caused by factors such as hearing impairments, developmental issues, or environmental factors.

If you’re worried about your child’s speech or behavior, it’s essential to know that a speech delay doesn’t automatically mean autism. Talking to a healthcare professional or developmental specialist for a thorough evaluation and guidance is recommended.

Speech Delay vs. Autism: Is There a Difference?

Typical childhood development follows similar stages before a child’s first words are spoken. Children start experimenting with their voices in their toddler years by babbling and cooing.

They use nonverbal language to communicate their needs and establish strong social connections, such as making eye contact, pointing, and gesturing. Over time, they learn sounds and use them to form their first words.

Eventually, as they associate communication with positive results (i.e., getting what they want), they start to string words together in phrases and acquire more complex linguistic abilities.

A speech or language-delayed child typically follows the same developmental patterns as their peers but is slower to reach these milestones. However, social responses, like hugs and smiles, still strongly motivate them.

They desire to build strong social bonds with their parents and peers, respond positively to attention, and are inclined to mimic the actions of people around them.

In addition to speech and language delays, children with autism may experience additional challenges related to their communication , socialization, and behavior. These can disrupt their ability to build meaningful social connections and relationships with people. 

Here are some key differences between speech delay and autism spectrum disorder:

Autism and Other Communication Issues

How can you tell the difference between autism vs. late talker? Well, some communication-related challenges may be signs of autism , including:

•     Being non-responsive to their name
•     Trouble getting your child’s attention
•     Slower development of gestures to communicate their needs
•     Babbling in their first year and then stopping
•     Repetitive usage of a single word or phrase
•     Using a robotic-sounding speaking voice

If you notice your child struggling with any of these symptoms, it’s best to talk to a professional for a proper diagnosis.

Autism and Social Challenges

Some children with autism have difficulty relating to – and associating with – other people. Signs can include:

•     A general lack of social awareness
•     Being unresponsive to social cues, like waving “hi”
•     Inability to focus on the same object with someone else (called joint attention)
•     Difficulty with social skills , such as sharing, taking turns, and maintaining friendships
•     Avoiding eye contact
•     Limited or restricted interests in particular toys or activities
•     Decreased interest in engaging in play routines with others

Autism and Behavioral Challenges

A child’s inability to adequately express themselves can lead to a wide range of possible behavioral issues, including:

•      Repetitive behaviors or hand and body movements, like rocking his/her head back and forth or lining up their toys
•     Aversion to being touched or held
•     Getting easily upset for unknown reasons
•     Strong attachment to certain objects, like toys or a television show
•     Having trouble staying still
•     Being easily upset or distressed when there is a sudden change to their daily routine

When Should You Seek Professional Evaluation?

For children who aren’t developing critical speech skills or lagging behind their peers, it’s important to seek a professional evaluation from a doctor or speech-language pathologist. This is crucial, no matter if the child is dealing with speech delay or autism symptoms.

A developmental screening and evaluation can help you determine whether your child is speech-delayed, has ASD, or both. Understanding your child’s conditions and risk factors can bring you peace of mind and help you make the most informed treatment decision.

Until recently, ASD was rarely diagnosed before 3-4 years old. However, current research supports lowering the age of identification, mostly due to the effectiveness of early intervention.

Around the age of 18 months to two years, speech and language delays become most noticeable. While parents may be able to spot many important signs at home, this is generally the most ideal time to have your child professionally evaluated.

There are several tools and methods your doctor or speech-language pathologist will use to determine if a child’s speech delay is caused by autism or is unrelated.

These often include:

• testing and examining their social skills (i.e., eye contact, emotional cues, name recognition)
• physical responses (i.e., ability to point, using objects to play), 
• language comprehension (i.e., identifying objects and understanding basic directions).

Improving Autistic Children’s Communication with Speech Delay Treatment

It’s important to remember that no two children are the same. Communication issues, just like autism symptoms, can vary dramatically from person to person.

Speech-language pathologists and other care providers, such as teachers, counselors, and psychologists, play a key role in a child’s treatment plan. Speech therapists are experts at diagnosing and treating communication-related challenges that present with autism.

They help develop an individualized treatment plan specialized to each autistic child’s specific needs that can improve their verbal and nonverbal communication. They help individuals express themselves, improve their personal and social relationships, and better function in day-to-day activities.

Even if your autistic child is nonverbal or was diagnosed later in life, it’s important not to lose hope. This doesn’t mean they won’t be able to become a literate and articulate adult.

Studies have shown that autistic children aged four and five with severe language delays went from being nonverbal to acquiring language skills with proper treatment. Your child is destined for great things – they may need more help getting there.

With that said, here are some communication skills that can be improved with intervention from a speech therapist . They work closely with autistic children, their families/caregivers, and other providers to help improve many aspects of their communication, as listed below.

Verbal Communication

Speech therapists can help autistic children better articulate and verbalize sounds and words. This can give children the strategies and mechanisms to express their thoughts, ideas, and feelings. 

Social Pragmatics

Social pragmatic skills involve how and when children use communication in social settings. 

For example, while a child with autism may know how to say “hello,” they may not understand that this word is used as a greeting. Speech therapists can help children learn the appropriate social context to use certain words and phrases. 

Body Language

Facial expressions, hand movements, and gestures are some of the most expressive parts of language. Unfortunately, some children with autism may have trouble interpreting their meaning.

A speech therapist can help match emotions with proper facial expressions and recognize subtle signals indicating whether a person is happy, sad, or angry.

Prosody is the volume and intonation of our voices in conversation. When we talk, the sound of our voice naturally goes up and down.

Some children with autism have flat prosody , which can make their voices sound robotic and emotionless. A speech therapist can help children modulate the tone and volume of their voice when they speak.

Some kids with autism may frequently make grammar mistakes or refer to themselves in the third person. A speech therapist can help address these common issues and promote correct word tenses.

Social Skills

A lack of social cues and awareness can be one of the most obvious telltale signs of autism in young children. Speech therapists can help children recognize and build social communication skills.

Conversational Skills

While many children with autism can make simple and short statements, they may struggle to carry a conversation. This includes:

• responding to their conversational partner,
• not interrupting,
• initiating dialogue, and
• engaging in the natural back-and-forth of discourse.

Speech therapists can help children with their conversation skills so they can implement these practices in everyday situations.

Is It Speech Delay or Autism?

Although speech delay can go hand-in-hand with autism spectrum disorder, it is not always the case. There are crucial differences between speech delay vs. autism that can give you a better understanding of these two conditions.

A speech delay alone does not mean a child has autism, and by working with experts and doing the right research, you can ensure your child gets the best support.

Q: Is speech delay always a sign of autism?

A: No, speech delay can occur independently of autism. However, it can be an early indicator in some cases.

Q: What are common reasons for speech delays in a 3-year-old not diagnosed with autism?

A: Speech delays can be caused by various factors such as hearing problems, language disorders, or environmental influences. It’s crucial to explore these possibilities with the guidance of a pediatrician or speech therapist.

Q: Can speech therapy help children with autism?

A: Yes, speech therapy is beneficial for children with autism. It can address communication challenges and improve their ability to express themselves.

Q: Does early intervention work for speech delay?

A: Early intervention can significantly improve speech and language development, improving a child’s overall well-being and quality of life.

Q: What are the behavioral challenges of autism?

A: Autism often presents various behavioral challenges, with common ones including repetitive movements, aversion to touch, sensitivity to unknown triggers, strong attachments to specific objects, difficulty staying still, and heightened distress in response to sudden changes in routine.

References:

Autism: Impairments in Social Interaction https://www.kennedykrieger.org/stories/interactive-autism-network-ian/impairments_in_social_interaction  

Differentiating ASD from DLD in Toddlers https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2940236/  

Speech and language delay in children https://pubmed.ncbi.nlm.nih.gov/21568252/

Speech and Language Developmental Milestones https://www.nidcd.nih.gov/health/speech-and-language  

Understanding Challenging Behaviors in Autism Spectrum Disorder: A Multi-Component, Interdisciplinary Model https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9324526/  

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Is Delayed Speech a Sign of Autism?

• How Speech Delays Differ
• Speech Delay Traits
• Red Flags by Age
• Related Traits

Speech delays are very common among children with autism , but they are also common in children without autism. While significant speech delays are always a cause for concern, they are not inherently an autism trait and may be due to other issues, such as hearing loss.

Speech delays in children with autism characteristically occur with other communication issues such as a lack of eye contact, social and emotional passivity, not gesturing or pointing to objects, or a fixation on objects.

This article will cover the reasons for speech delays and help you recognize when they are related to autism.

Verywell / Hugo Lin

How Speech Delays Differ in Autism

As most babies develop, they quickly learn that communication is the key to getting what they want. Long before they learn spoken language, they will make eye contact, pull on sleeves, babble, point, and physically or facially interact to get their point across.

Over time, neurotypical children (children without autism) learn to use spoken language because they get positive results from doing so. In addition, most neurotypical children:

• Are highly motivated by social responses such as smiles and hugs
• Are naturally inclined to imitate the actions of people around them
• Are likely to spend much more time observing people than observing things
• Tend to be social beings who become quickly bored or lonely when left alone

On the other hand, children with autism may have communication problems that make social connections difficult.

While high-functioning children who require lower levels of support may be more socially inclined than those with higher support needs, the same issues and challenges hold true across the autism spectrum .

For example, a child with autism may:

• Be more motivated by their own interests than by social responses
• Rarely or never imitate others' actions
• Be more interested in objects than in people
• Be content when left alone to pursue their own interests
• Be content with doing the same thing repetitively

All of these characteristics can lead to significant social challenges. This includes difficulty interpreting nonverbal cues like body language, having little interest in engaging with other kids or caregivers, or having heightened anxiety when faced with changes in routines.

Speech Delay Traits With Autism

The difference between speech delays in children with autism and those without is fairly easy to spot. Take the example of "Johnny" and "Bobby," two fictional children who exhibit significant speech delays:

• Johnny isn't talking at all at age 2. But while he isn't saying words yet, he's making babbling sounds and using body language to communicate with the people around him. He's pointing, pulling people toward things he wants, and engaging with other people. He actively enjoys playing with his parents and siblings. And he's frustrated when left alone to take a nap.
• Bobby is the same age as Johnny. Bobby does have a few words, but he doesn't use them to communicate. Instead, he repeats them over and over to himself. Bobby has not yet figured out how to use gestures, sounds, or words to ask for something he wants. His parents find it almost impossible to hold his attention for more than a few seconds.

Johnny may have a speech delay that requires other forms of intervention. Possibilities causes include:

• Hearing loss
• Apraxia of speech (a problem with the control of muscles used in speech)
• Cognitive impairment (problems with thinking, reasoning, memory, learning, and language skills)

Although Bobby is able to use a few words, he may be showing an early autism trait.

Red Flags Autism by Age

Speech development in children with autism can vary considerably. Some start using words earlier than neurotypical children, while others are nonverbal well into adulthood.

However, studies suggest that children with autism typically start producing words at 36 months, whereas a neurotypical child starts at around 12 to 18 months.

There are other red flags that point to the possibility of autism. These involve the absence of communication or social skills one would expect at certain ages, from 6 months to 2 years.

From 6 to 12 months of age, traits of autism include:

• Having little or no eye contact
• Failure to smile back when you smile at them
• Seeming emotionally passive
• Fixating on objects

By 12 months:

• Failure to respond to their name
• Lack of babbling
• Lack of gesturing or imitation

By 16 months:

• Having no single words
• Doesn't point to objects or show you objects
• No interest in sharing what they experience

By 24 months:

• Absence of spontaneous two-word phrases
• Lack of any language

Other Speech-Related Autism Traits

In addition to delayed speech, there are a number of other communication-related issues that could be autism traits.

In general, children with autism:

• Speak only in single words or repeat certain phrases over and over, seeming unable to combine words into meaningful sentences
• Repeat words or phrases that they hear (a condition called echolalia )
• Use words that seem odd, out of place, or have a special meaning known only to those familiar with the child's way of communicating

What if a Child Never Speaks?

Around 25% of children do not develop the ability to speak. However, these children may be able to learn to communicate in one of several ways

• Sign language
• Picture Exchange Communication System (PECS), which uses symbols and pictures to teach communication
• Augmentative communication (AAC), which may use a speech-generating device or apps on a tablet or cellphone to communicate

Children with autism often have speech delays, but that alone does not mean your child has autism. Speech delays with autism usually occur along with other communication issues, such as not using gestures, not responding to their name, and not showing interest in connecting with people.

Other possible causes of speech delays include hearing loss and cognitive problems.

Mody M, Belliveau JW. Speech and language impairments in autism: insights from behavior and neuroimaging .  N Am J Med Sci (Boston) . 2013;5(3):157‐161. doi:10.7156/v5i3p157

Zengin-Akkuş P, Çelen-Yoldaş T, Kurtipek G, Özmert EN. Speech delay in toddlers: are they only `late talkers`?   Turk J Pediatr . 2018;60(2):165‐172. doi:10.24953/turkjped.2018.02.008

LaGasse AB. Social outcomes in children with autism spectrum disorder: a review of music therapy outcomes . Patient Relat Outcome Meas. 2017;8:23–32. doi:10.2147/PROM.S106267

Mayo J, Chlebowski C, Fein DA, Eigsti I-M. Age of first words predicts cognitive ability and adaptive skills in children with ASD . J Autism Dev Disord . 2013;43(2):253-264. doi:10.1007%2Fs10803-012-1558-0

Austism Spectrum Disorder Foundation. About autism .

National Institute of Deafness and Other Communication Disorders. Autism spectrum disorder: Communication problems in children .

National Institute of Deafness and Other Communication Disorders. Speech and language developmental milestones .

National Institute of Mental Health. Autism spectrum disorder .

By Lisa Jo Rudy Rudy is a writer, consultant, author, and advocate who specializes in autism. Her work has appeared in The New York Times and Autism Parenting Magazine.

JEDDA RUPERT, MD, PAMELA HUGHES, MD, AND DANIEL SCHOENHERR, MD

Am Fam Physician. 2023;108(2):181-188

Patient information: See related handout on speech and language delay in children .

Author disclosure: No relevant financial relationships.

Childhood speech and language concerns are commonly encountered in the primary care setting. Family physicians are integral in the identification and initial evaluation of children with speech and language delays. Parental concerns and observations and milestone assessment aid in the identification of speech and language abnormalities. Concerning presentations at 24 months or older include speaking fewer than 50 words, incomprehensible speech, and notable speech and language deficits on age-specific testing. Validated screening tools that rely on parental reporting can serve as practical adjuncts during clinic evaluation. Early referral for additional evaluation can mitigate the development of long-term communication disorders and adverse effects on social and academic development. All children who have concerns for speech and language delays should be referred to speech language pathology and audiology for diagnostic and management purposes. Parents and caretakers may also self-refer to early intervention programs for evaluation and management of speech and language concerns in children younger than three years.

Speech is the verbal production of language. Language is the processing of a communication system. Receptive language includes an individual's comprehension abilities. Expressive language includes conveying ideas in spoken, written, or visual forms. 1

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Wallace IF, Berkman ND, Watson LR, et al. Screening for speech and language delay in children 5 years old and younger: a systematic review. Pediatrics. 2015;136(2):e448-e462.

Peña ED, Gillam RB, Bedore LM, et al. Risk for poor performance on a language screening measure for bilingual preschoolers and kindergarteners. Am J Speech Lang Pathol. 2011;20(4):302-314.

Zubler J, Whitaker T. CDC's revised developmental milestone checklists [editorial]. Am Fam Physician. 2022;106(4):370-371.

American Academy of Family Physicians. Speech and language delay. Accessed June 20, 2023. https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/speech-language-delay.html

Jullien S. Screening for language and speech delay in children under five years. BMC Pediatr. 2021;21(suppl 1):362.

• Reilly S, McKean C, Morgan A, et al. Identifying and managing common childhood language and speech impairments [published correction appears in BMJ . 2015;350:h2851]. BMJ. 2015;350:h2318.

Law J, Dennis JA, Charlton JJV. Speech and language therapy interventions for children with primary speech and/or language disorders. Cochrane Database Syst Rev. 2017(1):CD012490.

American Speech-Language-Hearing Association. Speech-language pathology medical review guidelines; 2015. Accessed April 27, 2023. https://www.asha.org/siteassets/uploadedfiles/slp-medical-review-guidelines.pdf

O'Hare A, Bremner L. Management of developmental speech and language disorders: part 1. Arch Dis Child. 2016;101(3):272-277.

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Leung AK, Kao CP. Evaluation and management of the child with speech delay. Am Fam Physician. 1999;59(11):3121-3128.

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Does a Speech Delay Mean a Learning Disability?

If your child is a late talker or seems to be behind in their speech and language development, you may feel worried. You may wonder if your child will catch up, or whether their speech delay is a symptom of a learning disability or other problem. 

In this article, we explain the causes and signs of speech delay, the connection between speech delay and learning disabilities, and what to do if you’re concerned. The fact that you’re here learning more is a great first step!

Common causes of speech delay

A speech delay may mean that your child’s developmental timetable is simply a little different. In some cases, children eventually catch up on their own.

However, speech or language delays can also signal something about your child’s overall physical and intellectual development.

What is delayed speech a symptom of? Here are some common causes of speech delays:

Oral impairment: Many kids with speech delays have oral-motor problems, which is a problem in the areas of the brain responsible for speech. This makes it hard to coordinate the lips, tongue, and jaw to make speech sounds. These children also might have other oral-motor issues, such as feeding problems .

Developmental speech and language disorder: Some speech and language disorders involve brain function and may be a sign of a learning disability. Your child may have trouble producing speech sounds, using spoken language to communicate, or understanding what other people are communicating. Speech and language problems are often the earliest symptom of a learning disability.

Hearing loss: A toddler who can’t hear well, or hears distorted speech, is likely to have difficulty forming words. Hearing loss is often overlooked, but fortunately it’s also easily identifiable. One sign of hearing loss is that your child doesn’t acknowledge a person or object when you name them, but does if you use gestures. However, signs of hearing loss may be very subtle. Sometimes a speech or language delay may be the only noticeable sign.

Autism spectrum disorder: Speech, language, and communication problems can be early signs of autism .

Lack of stimulation: We learn to talk from the people around us. So it’s hard for children to naturally pick up speech if they’re not actively engaged with other people, hearing them speak and playing together . Lack of verbal stimulation can keep a child from reaching developmental milestones.

Common signs of speech delay

How do you know if your child has a speech delay? Let’s look at some specific, early signs of a speech delay : 

By 12 months :

Your child isn't using gestures, such as pointing or waving goodbye

Has trouble imitating sounds

By 18 months :

Your child prefers making gestures over vocalizations (sounds) to communicate

Has trouble understanding simple verbal requests

By 24 months :

Your child can only imitate speech or actions and doesn’t say words or phrases spontaneously

Says only some sounds or words repeatedly, and can't use words to communicate more than their immediate needs

Can't follow simple directions

Has an unusual tone of voice (such as raspy or nasal sounding)

By 36 months :

Your child doesn’t use at least 200 words

Doesn’t ask for things by name

Is hard to understand , even if you live with them

If my child has a speech delay, will they also have a learning disability?

Just because a child has a speech delay does not mean they have a learning disability. However, a speech delay can be an early sign of a learning disability. 

ASHA, the American Speech-Language-Hearing Association, has identified signs that a child may have a learning disability . One main sign is that the child has trouble talking about their thoughts and ideas. It may seem like the words they need are on the tip of their tongue, but they have trouble getting the right words out. They might use vague words like "thing" or "stuff," or pause while talking to find the words they need.

Other signs of a learning disability include children having problems with: 

Learning new words that they hear or read

Understanding questions they’re asked and following directions

Remembering numbers in order, as in a phone number

Remembering the details of a story plot or what the teacher says

Understanding what they read

Learning words to songs and rhymes, like nursery rhymes

Telling left from right, which can make it hard to read and write

Learning the alphabet and numbers

Matching sounds to letters, which causes difficulty reading

Writing, such as mixing up the order of letters in words while writing

Doing math, such as mixing up the order of numbers

Memorizing multiplication tables

Telling time

Some examples of learning disabilities are:

Dyslexia , or trouble with reading

Dyscalculia, or trouble with math

Dysgraphia, or trouble with writing 

Does speech delay mean low intelligence?

It’s important to understand that having a speech delay or a learning disability does not automatically mean a person has low intelligence. Most people with a learning disability have average or even above average intelligence. The learning disability may “get in the way” of being able to demonstrate these skills.

What should you do if you think your child has a speech delay or learning disability?

If your child seems to be behind in their speech and language, make an appointment with a speech therapist. The speech therapist can perform an evaluation to assess your child's current skills and determine if speech therapy is needed.

With speech therapy, many toddlers and children who are behind in their communication development grow in leaps and bounds. The right speech therapist will show you how to support your child day to day, as well as how to practice speech and language at home. Not only will your child be able to communicate more clearly with their family, they’ll eventually benefit in the classroom as well.

If you think your child might have a learning disability, talk with their teachers and pediatrician about any testing and evaluation that might be helpful. Your school should be able to do the testing or provide guidance throughout the process.

How to support your child at school

Whether your child has a speech delay, a learning disability, or both, they may need special support and accommodations at school .

In public schools in the U.S., kids with a learning disability are eligible for an IEP plan. This is a legal document developed for each child with special needs. The IEP is created by a team of teachers, specialists, therapists, and parents/guardians to document the goals of the child and how they will be completed in public school. An IEP might include special education services and accommodations, or changes to the child’s learning environment

You’ll also want to learn about Section 504 of the Rehabilitation Act of 1973. This is a civil rights law that bans discrimination on the basis of disability. 504 was created to protect children with special needs. Under this law, schools must produce a formal plan for accommodating a student with a disability, such as providing extra time on tests. 504 plans are not part of special education. They are different from IEPs because they are covered by different laws and work in different ways. The main goal is the same, however: to help students be successful in school.

As your child’s parent or caregiver, you have an important role to play as their advocate ! And as your child grows, you can teach them how to speak up and advocate for themselves as well. A good way to start is to learn all about your child’s diagnosis. The goal is to be able to explain your child’s way of learning and communicating to the people involved in their care. 

On this note, it’s important to get to know your child’s teachers and therapists. You’ll want to build a good relationship with them and keep an open door of communication. They can update you on how your child is doing in class or therapy, and you can talk about any accommodations you think could be helpful. 

No matter what differences your child may have, your child’s school and therapy team should be there to support them. You can help that process go smoothly by being your child’s biggest cheerleader! 

Discuss your communication needs with a specialist for free

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Politics latest: Chancellor under more pressure over cut to winter fuel payment

Chancellor Rachel Reeves has faced questions from MPs about her plan to cut the winter fuel payment for millions of pensioners, and continued speculation about which taxes she might raise in the October budget.

Tuesday 3 September 2024 23:01, UK

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• Chancellor won't rule out hiking pensions tax
• Labour deny outdoor smoking ban is 'nanny state multiplied'
• Channel crossings 'will get worse before they get better', says No 10
• Jon Craig: Even Tories can't help being 'savage' about Liz Truss
• Live reporting by  Tim Baker

Politics Hub With Sophy Ridge highlights

• 'Just wrong': Chancellor under pressure on winter fuel cut
• Watch: Most of the cabinet 'not over the moon' with decision
• Sophy Ridge: Things are depressing - but it may be part of the plan
• Watch live Monday-Thursday at 7pm here and on Sky News

Explained: Our latest essential guides

• Labour's plan to stop the boats
• Who's running to be Tory leader
• Tax rises: What might go up | How council tax could change | What chancellor could do to pensions

Here's your 10pm bulletin, to let you know what happened in politics today.

• Chancellor Rachel Reeves  has refused to rule out  raising pensions tax  when her first budget comes round on 30 October;
• Facing questions from MPs in the Commons, she would only say  "I'm not going to speculate"  and repeated her assertion it would be a budget that fixes the  "foundations of the economy" ;
• It comes less than 24 hours after  Housing Secretary Angela Rayner  told the Commons while  council tax  wouldn't go up, there was  no guarantee the discount for singles wouldn't be scrapped .
• Downing Street has admitted small boat crossings will likely "get worse before they get better" ;
• It comes after at least 12 people died in an incident in the Channel today , which the home secretary described as "deeply tragic";
• She reiterated her vow to "dismantle" smuggling gangs "cramming more and more people on to increasingly unseaworthy dinghies".
• Elsewhere, the Conservative leadership race continued to ramp up, with the first round of voting taking place tomorrow ;
• All the candidates spoke at a hustings for Tory MPs - with chief political correspondent Jon Craig saying Kemi Badenoch was left unimpressed after an " ambush" from Robert Jenrick supporters ;
• It followed Tom Tugendhat launching his campaign earlier in the day - saying he wanted to be prime minister , not leader of the opposition.
• And in Scotland, the SNP government said it needed to cut £500m in spending to balance its books.

We'll be back tomorrow with the latest in UK politics.

At 12pm is the first Prime Minister's Questions of the new term, with Sir Keir Starmer facing down against Rishi Sunak - and the rest of the House of Commons.

We're ending our live coverage here for today.

Join us again tomorrow.

By Paul Kelso , business correspondent

Senior business leaders have welcomed discussions with Angela Rayner over proposals to improve workers' rights as "positive", but warned the "devil will be in the detail" of legislation due to be put before Parliament next month.

The deputy prime minister and business secretary, Jonathan Reynolds, met the bosses of major employers including John Lewis, Octopus, BT, McDonald's and Sainsbury's in Whitehall on Tuesday, at the start of a consultation over the new government's plans.

Labour's manifesto promised to overhaul employment rights, with measures including the right for all "zero hours" workers to be offered a contract in line with their normal hours, and the extension of full employment rights to all workers from day one.

The meeting comes amid concern among employers and business groups that a reduction in flexibility as employers could increase costs and hamper their ability to drive growth.

Several businesses present told Sky News the atmosphere was constructive and friendly, with the emphasis on Ms Rayner and Mr Reynolds explaining what they have planned, and listening to the concerns of employers.

Business leaders are understood to be concerned over how the phasing out of zero-hours contracts will be achieved. It's a key issue in the hospitality and retail sectors which employ large numbers of younger and part-time workers.

Ministers have proposed that every worker must be offered a contract reflecting typical hours worked over a 12-week period, but there is concern that metric could lock employers into hours irrespective of seasonal fluctuations.

By Jenness Mitchell , Scotland reporter

The Scottish government has confirmed spending cuts of up to £500m.

Finance Secretary Shona Robison said the "direct savings" were necessary to support the Scottish government's 2024/25 budget.

In a pre-budget fiscal update to the Scottish parliament on Tuesday, Ms Robison said: "Prolonged Westminster austerity, the economic damage of Brexit, a global pandemic, the war in Ukraine, and the cost of living crisis have all placed enormous and growing pressure on the public finances."

Pay was said to be a "significant driver" of in-year pressures, with potential costs of up to £0.8bn beyond the Scottish government's budget in this financial year alone.

A number of cost-saving measures have previously been announced, including the reintroduction of peak ScotRail fares, axing universal winter fuel payments for pensioners, and scrapping a free bus travel scheme for asylum seekers.

The cuts have been made ahead of the UK government's budget in October, which Sir Keir Starmer has warned is going to be "painful".

Last week, experts at independent economic forecaster the Scottish Fiscal Commission (SFC) said while UK government policies contribute to pressures on the Scottish budget, "much of the pressure comes from the Scottish government's own decisions".

By Alix Culbertson , political reporter

The government's "black hole" could be bigger than the £22bn it has claimed as cabinet ministers are being pressured to scrap projects immediately to fill it, Sky News understands.

After Labour won the election in July, Chancellor Rachel Reeves accused the previous government of leaving a £22bn shortfall in public finances they had not disclosed.

She promptly cancelled several projects, including 40 new hospitals, reforms to adult social care charges, a new Advanced British Standard qualification, and several road and train projects - and reduced the number of pensioners who will get the winter fuel allowance.

But because the black hole is for this year alone, it has to be filled quickly - which poses the question of how…

One of the Labour Party's manifesto promises was to nationalise the UK railways.

They are planning to do this through the Passenger Railway Services (Public Ownership) Bill.

Instead of buying out the various franchises, this bill aims to bring railways under government control once current private contracts lapse.

MPs tonight voted to pass its third reading in the House of Commons - so the bill is now moving to the House of Lords, where peers will consider it.

Attempts by Conservative MPs to amend the bill were rejected by the Labour majority.

Shadow Great British Railways

Labour's plan is to create a body called Great British Railways to run the trains for the government.

The real body cannot be spun up while the legislation is trundling through parliament, but Transport Secretary Louise Haigh has set up a "shadow Great British Railways" in the meantime as a sort of replacement service.

She says it will "bring together the department [for transport]'s passenger services, Network Rail and the operator of last resort".

This means the "railways will begin to act as one coherent system with a political backing to make decisions in the public interest" for the "first time in 30 years".

Yesterday, Foreign Secretary David Lammy announced the UK would suspend 30 of the 350 export licences it had granted for weaponry to be sent to Israel.

Stephen Flynn, the Westminster leader of the SNP, is now calling for Mr Lammy to publish the legal advice which led to the decision.

He told Sky News: "In order to justify what he has done, I think it's only fair and reasonable for the foreign secretary to publish the evidence, publish the advice, allow us to scrutinise it and to scrutinise him and his decision-making."

Watch foreign secretary's announcement:

SNP wants 'blanket ban'

The MP highlighted Mr Lammy had called for legal advice on the subject to be published when the Conservatives were in power.

The SNP has long been critical of Israel's conduct in the Middle East, including in the current conflict sparked by the 7 October attacks by Hamas.

Mr Flynn said a "blanket ban" on weapons exports is needed due to the "mass destruction of a civilian population in an area they cannot escape" being carried out by Israel.

He also challenged the notion that the UK's action's yesterday sent a message on the world stage as it did not go far enough.

One of the most controversial proposals by the new government is to scrap the winter fuel payment for 10 million pensioners.

Speaking to Sophy Ridge , Labour peer Baroness Ayesha Hazarika says: "I'm pretty saddened about this policy. 

"I think lots of Labour MPs, I think Rachel Reeves is, I think most of the cabinet are, not over the moon about this policy decision."

She adds: "I think MPs are not going out and having public spats, but behind the scenes, I know there are a lot of conversations being had because there are concerns."

She is joined in the studio by Conservative peer Baroness Sayeeda Warsi.

The former Tory minister agrees there are wealthy pensioners who do not need the fuel payment - but the threshold set by the current government is too low.

She notes the policy of reducing support was also considered by the Conservative-Lib Dem coalition - and at the time Labour opposed it.

Liberal Democrat leader Sir Ed Davey tells Sky's  Sophy Ridge  the government made a mistake by announcing it would abolish the winter fuel payment for millions of pensioners.

He acknowledges "a huge problem" with the country's finances and they need fixing, but says "this is not the way to do it".

"The idea we should remove winter fuel payments from millions of pensioners as we go into winter, as we see Ofgem raising the cap on energy fuel prices over 10% - this is just wrong."

Sir Ed says the Lib Dems would instead look to plug the apparent gap in the public finances by asking social media companies, oil and gas giants, and "very wealthy billionaires" to pay more tax.

He also notes scrapping the winter fuel payment was not in the Labour manifesto and pensioners "shouldn't really be the first target".

The Lib Dems will vote against the policy, he adds.

Sophy Ridge begins her conversation with Sir Ed Davey on the UK's relationship with Europe.

It follows Sir Keir Starmer's recent trips to Paris and Berlin, seeking a "reset" with the continent, but also the deaths of at least 12 people crossing the Channel in a small boat on Tuesday.

Labour should 'get round the table' with Europe

Sir Ed says the government should be working more closely with EU allies to tackle boat crossings, to take down the smuggler gangs, and says previous Tory policies hadn't worked.

"The Liberal Democrats think the government should be getting around the table, being active [with Europe]," he says. 

"That didn't happen under the Conservative government. It's one of the reasons why the asylum immigration system is in such a mess."

Youth mobility scheme 'would be brilliant'

But Sir Keir has stopped short of reversing any aspects of Brexit, like rejoining the single market or allowing freedom of movement.

Sir Ed says it's not "the right time" for such aspirations, but believes the prime minister should embrace the EU's desire for a youth mobility scheme allowing easier travel for people to work and study.

"I think it would be brilliant for British young people, to be able to get back that freedom to travel and to work and study - and I think our economy would benefit too."

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