- Speech delay is delay in the acquisition of spoken language.
- Language is a system of symbols through which humans communicate thoughts, feelings, and ideas. It has 3 components—receptive, expressive, and visual language.
- Receptive language is the ability to process and understand language.
- Expressive language is the ability to communicate through speech, written, or formal sign language.
- Visual elements include eye contact, pointing, and gestures.
- Speech delay can be primary as in specific language impairment (SLI) or developmental language disorder (DLD), or secondary to another condition such as a syndrome or neurologic disorder. SLI is impaired speech/language in an otherwise normally developing child who lacks signs or stigmata of other conditions.
- Constitutional language delay, a retrospective diagnosis, is language delay associated with eventual achievement of normal speech and language milestones by school age. There are no subsequent difficulties with learning to read or write.
- Expressive language disorders include the following:
- Verbal dyspraxia: little speech produced with great effort, very dysfluent, single words most commonly
- Speech programming deficit disorder: poorly organized, difficult-to-understand speech
- Mixed receptive and expressive disorders
- Verbal auditory agnosia: impaired ability to decode speech, resulting in a severe expressive impairment. Can often learn language visually
- Phonologic/syntactic deficit disorder: most common type of DLD. Comprehension exceeds spoken ability. Speech is dysfluent, grammatically incorrect with short utterances.
- Most frequent causes of speech delay:
- Hearing loss
- Autism spectrum disorder
- Intellectual disability (formerly mental retardation)
- Up to 15% of 2-year-old have speech and language delays.
- 5% of school-aged children have speech and language delays.
- 3:1 male-to-female ratio in DLD
- Family history of speech/language delay or disorder
- Male gender
- Low maternal education
- Maternal depression
- Birth weight <1,000 g
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Cabana, Michael D., editor. "Speech Delay." Select 5-Minute Pediatrics Topics, 7th ed., Wolters Kluwer Health, 2015. 5-Minute Clinical Consult, www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14165/all/Speech_Delay.
Speech Delay. In: Cabana MDM, ed. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14165/all/Speech_Delay. Accessed June 3, 2023.
Speech Delay. (2015). In Cabana, M. D. (Ed.), Select 5-Minute Pediatrics Topics (7th ed.). Wolters Kluwer Health. https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14165/all/Speech_Delay
Speech Delay [Internet]. In: Cabana MDM, editors. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. [cited 2023 June 03]. Available from: https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14165/all/Speech_Delay.
* Article titles in AMA citation format should be in sentence-case
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