By Elissa Benjamin, Speech-Language Pathologist
In our previous post, we shared five milestones expected to see before babies start using words. The following list contains five red flags of language delay. This list is not exhaustive, but it should help you get a sense of what is expected from the perspective of a speech-language pathologist. If you are concerned about language delay, speaking to a speech-language pathologist can put your mind at ease.
Red Flag #1: Not Joining Your Attention (by 9 months)
Joint attention, or your child’s ability to share focus with you, is a stepping stone to the development of language and social communication. When you and your child can focus on the same object or activity together, a solid foundation for language is set in place. On the flip side, limited joint attention can indicate that a child’s social communication is not developing in an expected way.
Red Flag #2: Not Babbling Enough…Or At All (by 12 months)
By 12 months, babies should be making lots of different noises. This is the culmination of many months of practice and experimentation with their voice, as well as their social interaction. If baby is not babbling or making syllable-like sounds, this may indicate that language is not developing in an expected way. Limited babbling could mean a variety of things, and language delay is just one of them.
Red Flag #3: Not Gesturing Enough… Or At All (by 12 months)
As babies develop, so does their ability to use the different parts of their body to communicate. Often, a child with an expressive language delay (delay in speaking as opposed to understanding) will be quite capable at getting their needs met using gestures. Gesture use in babies and toddlers can become quite complex, so a limited gesture inventory or delayed onset of gesture use is often an indicator that something in the communication system may not be developing on the expected timeline.
Red Flag #4: Not Using Language Appropriately (by 18 months)
Language use, which we also call pragmatic language, refers to the functions we have for communication: asking for help, requesting, refusing, greeting, showing, etc. Even before first words appear, babies and toddlers use communication for a multitude of functions. So, when the baby is not communicating intentionally to have their needs met (with words, gestures, eye contact, etc.), it is a red flag. If language is being used in an atypical way, such as repeating long strings of language for no outwardly apparent reason, this can also be a red flag that something is not developing as expected.
#5 Not Understanding Simple Commands (by 18 months)
The assumption is that comprehension is usually greater than production when it comes to developing language. Children can often understand much more than they are able to express as they are learning how to communicate. In babies and toddlers, their ability to understand simple 1 and 2 step commands increases as they approach 18-24 months. If the child is not able to follow directions without significant support from another adult, or at all, this is a red flag that there may be language delay.
When you are worried about language development, it is perfectly fine to be patient and see what happens… but if you are deeply concerned, it does not hurt to speak with an expert. Voicing your concerns to your pediatrician is always a recommended first step. When it comes to concerns about language delay, speaking to licensed speech-language pathologist can also help put your mind at ease. Enjoy these precious moments of your child learning to speak. They are extraordinary and make up a once in a lifetime experience.