We take a look at the speech milestones for infants and toddlers, as well as the causes and signs of speech delay and why there might be cause for concern with your 18-month-old’s speech development.
What is speech delay?
Speech delay is defined as a delay in how and when a child learns to speak. Speech delay generally refers to a child’s speaking ability, and ability to form words and sentences, rather than their ability to comprehend speech and how it works. A child with speech delay may have no language comprehension issues but will struggle to form words for speech.
Children develop their speech at different rates. As with many other development areas, some children are early speakers, and those who speak later. Several factors can influence how and when children develop their speech, including environmental and genetic.
Children who are not spoken to a lot, either at home or within their primary care environment, are more likely to develop their speech later than children exposed to a language-rich environment.
Generally, limited speech in a child before 3 years old should not necessarily cause concern. However, the more aware we are of the importance of early intervention in improving developmental outcomes for children, the more important it is that we identify speech delay or issues related to speech development as early as possible.
What are the speech developmental milestones for an 18-month-old?
At 18 months old, a toddler should be able to:
- Put together strings of sounds, ‘bada, lama.’
- Use physical gestures to communicate, including shaking their head to say ‘no’.
- Try to form actual words for familiar people or objects, the most common being ‘mama,’ ‘dada’ or a variation on these.
- Use their voice to gain their caregiver’s attention or to request something.
- Speak their first word and assign it to an object. In some children, this word might be the word ‘cat,’ but in others, it might be the sound ‘meow’ to name a cat. This is within expected speech development norms for this age.
When should I be concerned about my 18-month-old’s speech development?
There is conflicting information about what might constitute a cause for concern when it comes to speech development in an 18-month-old. Parents often wonder how many words by 18 months is considered typical. Some toddlers might speak up to 20 words, while others are still experimenting with just 1–2 words. For the most part, all of this falls within the range of normal speech development for a toddler this age.
However, a few flags might suggest evidence of a speech delay, regardless of how many words a child may or may not have by 18 months old.
These flags include:
- Compared to their peers and siblings, a child who is exceptionally quiet and who not only doesn’t speak words but also makes no babbling sounds and does not combine consonants and vowels to attempt communication through speech.
- A child who does not attempt to imitate or copy words.
- A child also shows difficulty in socializing with others and struggles with all areas of their communication, including expressing themselves nonverbally.
- A family history of speech delay, communication and language delay, and learning difficulties.
- A child who shows developmental delay, not only in the area of their speech development but in other areas too. There is a link between delays in diverse development areas, even if they do not seem naturally connected. Developmental delay in speech, and delay in physical development, can all indicate a single issue.
Speech delay as a symptom of a rare disease
In some instances, speech delay may be a sign of a rare disease or genetic syndrome. Several syndromes, including Angelman syndrome, have the development of limited-zero speech as a major symptom.
What should I do if I am concerned about my 18-month-old speech development?
The first step should be to raise your concerns with your family’s primary care provider. They may recommend further testing options to rule out a specific cause of the delay, or they may suggest ideas for therapies and exercises to help build your child’s speech development at home.
If you still have concerns about your 18-month-old’s speech development, and you noticed other possible symptoms, fast and accurate genetic analysis combined with genetic counseling might be one option in understanding better your child’s development and overall health.
