The worry with words: Why speech delays need more attention

Nabid, a toddler, loves to mimic animal noises. But he's a person of few words. 

He loves saying the names of colours out loud and even recites his ABCs really well. Though he does choose to express himself, something about it worries his mother a little. 

Robina Rashid, Nabid's mother, said her son does like to speak out in single words but then there came a time, she realised, that the progress slowed along the way. Her son was not picking up on talking points as much as she had hoped. 

"He could still babble and use baby talk to communicate with us. But he was yet to produce meaningful words. He often uses sign language effortlessly. He would just point at things or take me by my hand to show me something," she said. 

She began to get concerned, noticing how other kids would talk their mothers' ears off at times, but her child was developing a bit differently. Her friends and relatives would often tell her it was nothing to worry about. So, she decided to leave it to time and hoped that one of these days, Nabid would begin chattering away. 

"People said things like how boys take time to start speaking, or they would tell me anecdotes of children they know who started speaking late but turned out fine after the age of four or five," Robina said. 

However, she felt like she was perhaps indulging in wishful thinking. "These are said to make mothers feel better, which is fine, but it was not helping my child in any way," she said.

She suspected her son was actually experiencing some sort of speech delay, which needed immediate attention. 

Speech delay in children occurs when language development is significantly slow, considering the child is not reaching the typical speech and language milestones expected for their age.

The Covid-19 pandemic had more consequences that could be explored beyond the death or economic toll. A BBC analysis from 2021, the year after the pandemic, showed that the number of five and six-year-olds who needed speech and language support at schools rose by 10% in England. This increase was substantial compared to previous years. 

Lockdowns limiting social interactions were identified as the critical reason.

This phenomenon was not restricted to just England.

The next course

Instead of waiting it out, Robina decided to address the issue head-on and took an appointment with a specialist when Nabid was just over two years old. 

The doctor explained that toddlers being isolated and confined in homes, especially those born during the Covid-19 pandemic, leads to minimal social contact, which can affect their natural progression to speaking.

As isolation could be a major factor here, the doctor suggested enrolling Nabid on a preschool. 

And in his case, speech therapy was also the way to go. When Nabid was not showing satisfactory development in speech and doctors could not do much besides prescribing tests and suggesting some exercises to do at home, Robina reached out to other mothers on social media who were going through the same problem. 

"I soon found out about speech therapy and how it can be helpful for the child. Soon after, I went to a speech therapy centre and the therapists there assessed my son and told me what type of therapy he needs," Robina said.

There is still a long way to go but with preschool and regular therapy, Nabid is now starting to show a lot of improvement in speaking, she said. 

Understanding a child's cognitive and developmental stages

Parents can play a key role in helping a child develop language, according to Burrhus Frederic Skinner, a psychologist and behaviourist. 

Skinner theorised that language acquisition is dictated by our social environment and the positive or negative reinforcement we receive from it. So, when a caregiver uses child-directed speech (baby talk), shows enthusiasm in their voice or helps a child correct utterances and mispronunciations, it is likely to be imitated by the child and thus reciprocated.

In the case of speech delay, it is also important to note the stages of language development children go through. As explained by another psychologist Jean Piaget, who developed the theory of cognitive development, a child goes from cooing and babbling to slowly forming words and by a certain age, is able to even invent their own thinking and say it aloud.

In this regard, speaking to The Business Standard, Yafa Rahman, cofounder of Kids Castle and vice principal of Adroit International School, said, "There are some benchmarks, like around one to two years of age, a child would start speaking basic words like mama, baba, dada."

By around three years, they start speaking short, choppy sentences like "I want this" or "I will eat that".

At around four years old, they would develop a more advanced level of speaking, asking questions and answering them. Some children may develop much faster than the benchmark and some slower.

"But if a child crosses age two and still cannot speak single words, or crosses age three but still struggles with forming sentences, then the parents need to be concerned," she added. 

So, when to seek professional help?

Yafa emphasised the need for a language acquisition support system in a child's life wherein adults and siblings around them can create a stimulating environment.

"As children had less social contact during Covid-19, they started showing signs of speech delay. As a result, we are seeing children around three years old facing this issue more prevalently."

Yafa, who is also a mother of two, went on to say, "There are signs that parents need to be aware of to detect speech-related problems in children. Eye contact is an important aspect when speaking. If a child fails to make proper eye contact by three years old, parents should take notice. They need to be observant of little signs like these and should seek professional help.

"Most parents who come to our preschool to enrol their children, mainly come in after receiving a recommendation from a doctor or a therapist who suggests that this is where a child can interact with others and their teachers," she added.

The interaction actually helps the children within a very short time, say six months to a year, that is, if the child has no other critical problem, she also said.

However, not all children can get back to having a normal progression in speaking even after mixing with other kids and being socially active.

"Our job is to develop the skills of the children. We can't provide medical treatment or therapy. We follow the recommendations from doctors and therapists on how we, as educators, can help the children and keep them engaged in helpful activities," Yafa said.  

Speaking to The Business Standard, Dr Kazi Ashraful Islam, assistant professor of Paediatric Neurology at Bangabandhu Sheikh Mujib Medical University, said children may lack stimulation for speaking from their surroundings. 

One of the causes could be too much screen time.

"There are various contributing factors that can lead to speech delay in children, that is if they do not have problems hearing or speaking. They may be on the autism spectrum, or have neurological conditions," he said.  

Highlighting the urgency on the part of parents in addressing the factors that lead to lack of stimulation – such as less social interactions – he said children could largely benefit from speech therapy.

In today's society, children, especially those being raised in urban areas, get very little social stimuli. Those born during or just before the Covid-19 pandemic, have not had much scope to interact with people other than their parents.