Skip to main content

What causes speech delays in toddlers? Here’s what might be going on

Between 10 and 20 percent of two-year-olds are behind with speech, but what causes speech delays in toddlers? There are many different causes, and your first step should always be asking your child’s pediatrician about any of your concerns. If you do suspect that your toddler has a speech delay, don’t panic and assume there is some serious problem.

Your child’s doctor will be able to diagnose what’s really going on. In the meantime, if you’re doing your own research while you wait for your appointment, here are six common causes of toddler speech delays.

Iulian Valentin / Shutterstock

What causes speech delays in toddlers?

A speech delay can be caused by many different reasons. Finding out the cause is important to figure out how to treat it. Some causes are physical, some are intellectual, some are neurological, and so on. Here are some of the main causes:

Recommended Videos

Kids are on their own timeline

Some kids just meet milestones at their own pace and that’s OK. Not every speech delay is caused by a disorder that needs treatment. Sometimes kids will catch up on their own and will just focus on physical or emotional development instead of verbal development for a bit.

Babies born prematurely understandably may take a bit longer with many developmental milestones, and speech is no different. Premature birth can sometimes cause developmental delays, and the treatment is often patience and time.

Tongue-tie

The small bit of skin that connects the bottom of the tongue to the bottom of the mouth is sometimes too tight causing difficulty with moving the tongue like it should be able to. It’s a condition that kids are born with called ankyloglossia, better known as a tongue-tie. A simple procedure can cut this skin so the tongue is free to move as it needs to for proper speech and eating.

Tongue ties are often caught in infancy because they can cause difficulty with a breastfeeding latch or, less often, with drinking from a bottle. If they aren’t corrected in infancy, they can cause trouble with speech and eating later on. Your pediatrician can refer you to an ENT doctor for this diagnosis and corrective procedure.

Childhood apraxia of speech

One physical disorder that can cause a speech delay is childhood apraxia of speech (CAS). This disorder doesn’t affect language comprehension or nonverbal communication, but it makes it hard for the child to form sounds in the right order to make words. They’ll know what to say but can’t get it out because their brain isn’t sending the right signals to the mouth.

For this diagnosis and treatment, you would see a speech-language pathologist. This isn’t a disorder children outgrow without treatment, sometimes as many as therapy sessions five days a week.

Image used with permission by copyright holder

Hearing issues

If you can’t hear language, you’ll have trouble verbalizing it. Have your child’s hearing tested if you are unsure of the cause of their speech delay. Sometimes the hearing loss is so subtle that a speech delay is the only sign.

Ear infections, especially chronic ones, can cause hearing issues that can lead to speech delay. Talk to your child’s pediatrician about treatment for frequent ear infections if that’s an issue for your child.

Autism spectrum disorder

Speech and language issues are a common sign of autism. Other language-related signs include speech regression, difficulty with nonverbal communication in addition to verbal communication, and repeating phrases. Talk to your pediatrician if you think you’re seeing other signs of autism in your child like avoiding eye contact, not showing facial expressions, not looking where you point, not showing much interest in other kids, constant repetition, flapping hands, rocking body, hyperactivity, and others. These signs have usually appeared in a child by their second birthday.

Neurological or intellectual issues

There are many different disorders from cerebral palsy to muscular dystrophy that can cause speech delay in toddlers. While you would likely already have a diagnosis for some, there are others that your pediatrician may want to look into. Speech delays can also be one of many delays across the board in a child with an intellectual disability.

The bottom line

Finding the cause of the speech delay is the only way to improve speech since the treatments vary so greatly depending on the reason for the delay. Treatment may look like surgery to put in ear tubes, physical therapy, speech therapy, clipping a tongue-tie, or something else. Sometimes, the cause is not a concerning issue and you just need to wait for your child to catch up in their own time. Whatever the reason, involve your pediatrician along the way for guidance.

Sarah Prager
Sarah is a writer and mom who lives in Massachusetts. Her writing has appeared in The New York Times, The Atlantic, National…
Should you be concerned if your toddler walks on their toes? Experts weigh in
When to call your doctor about your toddler's toe-walking
Toddler sitting down with toes pointing towards camera

Walking is a developmental milestone that is exciting not just for parents but for your little one as well. There's a sense of independence your child will gain once they begin walking that opens up a whole new world of exploration. And once your little one has gone from crawler to walker and has their legs firmly beneath them, you may notice another development — toe-walking.

While it may seem like your new walker is destined for stardom as a ballerina, there could be an underlying physiological or developmental cause for why toddlers walk on their toes; instead of just a quirky preference. Here are just a few reasons your little one might toe-walk and what you can do about it.
Why toddlers walk on their toes

Read more
Baby refusing solid foods? Here’s why, and what you can do about it
Understanding your baby's resistance to solid foods
Woman feeding baby in a high chair

Introducing solid foods to your baby is an exciting time. It's a milestone that may go smoothly for some, but not quite as simple for others. If your little one wants nothing to do with these new foods, you may desperately be looking for answers as to why they're refusing solid food options.
We know that sourpuss not-having-it face all too well. And if that mini-me of yours wants nothing to do with the spoon, the bib, or the puree in front of them, a power struggle will ensue -- and, spoiler alert: You are not going to win. Nevertheless, it can be distressing for parents when their little bottle-chugging sweetheart goes on a solids strike (or incessantly spits, gags, and cries!). Fortunately, it's usually not a cause for concern: there could be several factors at play to cause the issue of baby refusing solid foods. Here are a few common reasons why your baby might be rejecting your feeding attempts -- and some gentle ways to coax them to eat a bit more.

Baby is just not ready yet

Read more
6 signs of teething in toddlers that parents should be aware of
Your baby may be cutting those first teeth
Toddler sucking on the back of their hand

It's exciting when your little one starts to cut their first teeth, but it's also heartbreaking as they suffer through the pain of teething. Teething doesn’t just occur when your little one is still in diapers either, as their teeth will continue to emerge for the better part of 2 years after the first one erupts through your kiddo’s gum line. Contrary to what some parents may think, their child’s teeth will continue to develop for quite some time after the first few "chompers" break through.

If your toddler is experiencing teething symptoms, now could be a good time to break out those teething rings and whip up a few homemade teething pops. However, there may be a few symptoms your little one is experiencing that even veteran parents may not be aware of. Here are some signs of teething in your toddler you'll want to be on the lookout for.
Signs of teething in toddlers

Read more