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- 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