Why Speech Delay happens in Two Year Olds?

Dr. K. Raja Meghanadh

How much should a toddler talk?

Generally, a child should start talking a few words by one year. A 2 year old must have enough vocabulary to communicate their thoughts, and a three year old child must speak in sentences. The below table gives an approximate number of words in a child’s vocabulary.

​Age	Normal development approximately
1 year old	10 to 20 words
2 year olds	50 to 60 words
3 years old	Around 150 words

Although speech development might differ from child to child, it should not vary by more than three months w.r.to. standards mentioned above.

Causes for speech delay in 2 year olds or older children

Children learn to speak by observing the lip and tongue movements of people around them. Children are quick learners and easily mimic people around them. Their ability to learn or mimic is high in the first two years, and this ability decreases as they age. When a baby is born deaf, an ENT doctor strictly suggests cochlear implant surgery during the ninth month, i.e., as soon as the baby is eligible for surgery. They expect a child to quickly pick up words and talk properly like an average person if they get ample time in the first two years. A profoundly deaf-born toddler who receives a cochlear implant before turning 2 years old has a high probability of leading a normal life.

Speech delay in non-deaf 2 year olds could be due to a problem with the child (low IQ) or the environment in which they are growing up. Most of the time, the issue lies in the environment. When there is a gap in interaction with elders or other kids, toddler talk gets delayed as they do not have a source to learn.

Pre-covid Dr. K. R. Meghanadh hardly saw one or two patients in 3 months with complaints of speech delay. In most cases, both parents have jobs and generally leave their child in a Nanny’s or a maid’s care. Nanny mostly left them alone to play with a few toys. However, now they get around five patients per month. Few parents have complaints that the child has unlearned words they previously learned. Although this 15 times increase has nothing to do with COVID-19 directly, it has everything to do with lifestyle changes COVID has brought.

toddler playing alone

Speech delay due to COVID-19 and lockdowns

Due to COVID-19 and lockdowns, children have lost access to school or playtime with friends or neighbors. The fright that unvaccinated children might contact the virus has kept them indoors, profoundly affecting their speech development. A child between 9 months and three years has lost social life, a crucial learning time. The lack of social mingling with other kids has spiked the number of parents who approach ENT doctors with complaints that the kid cannot talk, and a few complain that the child has forgotten the vocabulary they have learned before the pandemic.

Role of smartphones

The primary reason for most of these cases is smartphone addiction. When both parents work, generally, a child goes to a playschool or a daycare to interact with their peers. Due to lockdowns, work-from-home culture, and time crunch, adults give their children phones to keep them engaged to compensate for the missing playtime or school time. The same happens when parents feed their children with the help of smartphones or tabs. They are skipping the story or interaction time to make them eat quickly. Smartphones and tablets are too addictive and can pull a person’s attention from the world. The same is happening with children, and these kids are now more interested in videos or mobile games than playing. When toddlers between 9 to 24 months who are supposed to learn to talk by observing adults or their peers are addicted to smartphones and have no interest in people around them, how will they learn to speak when they do not interact or pay attention to people around them? Some kids throw tantrums to watch YouTube or play games and have lost interest in people around them and toys. They do not settle for anything less than a video.

Children usually watch cartoons, which are of no help because kids can hear the sounds and understand what sound or word means, but they will never know how to reproduce those words as lipsynching of words in cartoons are not close to reality. Live-action movies cannot help because the video and the audio are recorded separately. Although in our eyes, they look synched, they are not synched enough for kids to learn how to talk. Even if both are in perfect synch, the screen size and angles might not be suitable for kids to pick up the lip and tongue movements.

How to treat speech delay?

If the kid understands what you talk about but does not respond, you must follow these particular tips.

1. Ban smartphones and tablet

Do not let your child use a smartphone and tablets. They might throw tantrums but distract them with some interacting games.

2. Interact more with your kid

Try to spend more time with your kid. Make sure he feels the need to interact with you.

3. Exaggerate your lip movements while talking to kids

Try to grab their attention and speak to them, holding them near your face. It will help them observe your lip movements easily. When they pay attention, make sure to exaggerate your lip movements so that they grasp how to imitate.

4. Speech therapy for toddler not talking - optional

We recommend speech therapy for toddlers who are not talking, but will speech therapy alone work? How can an hour-long speech therapy replace 16 hours plus learning time they get by observing others. Both parents or guardians must also attend the speech therapy classes to learn the treatment. They must follow the guidelines and spend more time with the toddler to pull them to an average level of a toddler.

Dr. K. Raja Meghanadh

FAQs

Can too much TV cause speech delay?

Yes, too much TV can cause speech delay. Not only TVs but also gadgets like smartphones and tablets are too addictive and can pull a person’s attention from the world. Excessive TV and device use can lead to speech delay in children, as it can replace crucial real-world interactions needed for language development. Toddlers learn to speak by observing and interacting with others, so limited social engagement can hinder their speech skills.

When do babies start talking clearly?

Typically, children start uttering their first words before they turn one. By the age of two, they usually develop enough vocabulary to express basic needs and thoughts effectively. Around three years old, their language skills often progress, and they begin constructing more complex sentences, demonstrating an increased ability to communicate effectively.

It's important to remember that these milestones can vary among children. Some may achieve language skills earlier or later than the general guidelines suggest, but the difference shouldn't be more than three months. Anything beyond that is not normal. Parents play a crucial role in actively engaging in communication with their children and creating a supportive environment that encourages language development.

How can I encourage my baby to talk?   

As a parent, your active engagement and supportive approach are crucial in nurturing your baby's language development. To encourage language skills in your child, consider the following strategies:

• Spend quality time with your baby

• Actively initiate interactions with them

• Try to reduce their screen time

• exaggerate lip movements when speaking

• provide a supportive environment to encourage language development.

Should a 2-year-old be talking?

Yes, a 2-year-old should be talking, as they typically develop enough vocabulary to communicate their thoughts by that age, although they won't be able to speak sentences. While speech development milestones can vary, they generally should not differ by more than three months among children.

When should you worry if your child is not talking? 

Generally, a child should start saying a few words by one year. They should have enough vocabulary to communicate their thoughts when they reach two. By three, they should be speaking in sentences.

While individual differences exist, and some children may develop language skills at their own pace. If the difference is more than three months, then there is some problem. The problem could be related to the learning ability of the child or to the environment in which the child is being raised.

Thankfully, in most cases, the problem is not with the child but due to the lack of learning experience, they are getting in day-to-day life.

What is the earliest a baby can talk?

The earliest a baby can typically start talking is before one year of age. At this stage, a child may begin to utter a few words and express simple sounds. By age two, a child is expected to have developed enough vocabulary to communicate basic thoughts and needs effectively.