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Children’s Speech Development: What Is Typical and What Is Not?

Dec 21, 2023
doctor working with patient on speech

If you’ve ever wondered if your child’s early speech development is on track, you are not alone. It can be difficult to know what is typical for a child’s age and when to be concerned.

First, it’s important to clarify the difference between language and speech. Language includes what words mean, how to put words together, and what words are best to use in certain situations. Language includes both receptive (what we understand) and expressive (what we say) aspects. Speech includes how we say our sounds and words. Speech disorders can include difficulties with pronunciation (articulation) and clarity (intelligibility), differences in voice quality, or stuttering.

How common are speech problems in children?

Approximately 1 in every 12 children in the United States has a speech and/or language disorder.  Boys are almost twice as likely to be affected than girls.

Is it normal that my child’s speech is hard to understand?

It is not unusual to have difficulty understanding some of your child’s words when they are 2-3 years of age; however, they should be understood essentially all the time by about age 4. If a child is frustrated by not being understood, even prior to age 4, this may mean that they are struggling to communicate, and referral to a Speech-Language Pathologist (SLP) should be considered.

The main reason children are hard to understand is usually due to difficulties with articulation. Current studies suggest that children should be able to pronounce all their sounds correctly by around age 7, however certain sounds are expected to be correct at different ages during development.

Will teaching my child two languages cause her speech to be delayed?

Exposure to multiple languages does not cause a speech or language delay or disorder. The most common causes of delays in speech are developmental (or neurodevelopmental), as well as hearing loss, genetic disorders, neurological disorders, and craniofacial conditions (e.g., cleft palate). In many cases, the cause may be unknown.

Should I worry if my child’s voice always sounds raspy or nasal?

Some children may temporarily “lose their voice” after prolonged yelling or an upper respiratory illness, and then experience recovery of their typical voice. However, if your child’s voice consistently sounds hoarse, breathy, strained, rough, or scratchy, there may be other causes, and they might need to see a pediatric otolaryngologist (ENT) and SLP with expertise in voice disorders.

If a child’s speech sounds nasal, like they are talking through their nose, or air is heard coming out of their nose during speech sounds, this is not typical. A variety of causes of nasal speech require special testing that will determine if medical or surgical treatment and/or speech therapy are needed. A referral to a cleft/craniofacial team (including both an SLP and a surgeon) for evaluation of speech nasality (resonance), should be considered.

My preschooler stutters and gets frustrated – how can I help them?

It is not uncommon for young children to repeat some sounds or words through ages 3-4; however, approximately 1 in 20 children will develop a persistent stuttering disorder that requires speech therapy. Red flags which indicate higher concern for a stuttering disorder include: the child’s speech looks “blocked” or they display grimacing of their face, tightened jaw or fists, or eye blinking when they try to speak. Stuttering disorders also occur four times more often in boys than girls. Children with any of the above risk factors, as well as those with a family history of stuttering, those who stutter for 6 months or longer, or frequently stutter beyond age 4, should see an SLP for evaluation.

What should I do if I’m worried about my child’s speech?

Talk with your child’s pediatrician about a referral to an SLP that can best address your specific speech concerns.

Speech Pathology at Nationwide Children's Hospital
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Featured Expert

Nationwide Children's Hospital Medical Professional
Adriane Baylis, PhD, CCC-SLP
Plastic and Reconstructive Surgery

Adriane Baylis, PhD, CCC-SLP, is a speech scientist, craniofacial speech pathologist and director of the Velopharyngeal Dysfunction Program. She is also an assistant professor of clinical plastic surgery, speech and hearing science, and pediatrics at The Ohio State University.

Meagan Horn
Meagan Horn, MA
Speech Pathology

Meagan Horn, MA, CCC-SLP, is a bilingual speech-language pathologist at Nationwide Children's Hospital at the Main Campus Outpatient location. She received an M.A. in both Hispanic Linguistics and Speech Language Pathology from The Ohio State University.

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700 Children’s® features the most current pediatric health care information and research from our pediatric experts – physicians and specialists who have seen it all. Many of them are parents and bring a special understanding to what our patients and families experience. If you have a child – or care for a child – 700 Children’s was created especially for you.