Language delay should not be underestimated

Author: Xu Mingyu, deputy chief physician of Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine

Reviewer: Li Fei Chief Physician of Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine

1. Language delay should not be underestimated

Language is a symbolic system organized with specific rules to express ideas. It is a unique communication tool for humans and needs to be learned through repeated learning and practice in daily life. Infancy is the budding and outbreak period of language development. Although there are rules to follow, the trajectory of language development of each child is different.

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There is an old Chinese saying that "noble people speak slowly", and people often "invite" the great scientist Einstein to prove it, but individual cases cannot be generalized into universal "axioms". Language is one of the most important milestones in children's early development. "Late speech" - children's language disorders are a "stumbling block" in the early cognitive, behavioral and emotional development of young children, and may lead to psychological abnormalities. Parents need to pay attention to it and detect and intervene as early as possible.

Language disorder refers to difficulties in understanding or using spoken, written language or other symbol systems, and language development deviates from the normal order. The incidence rate can be as high as 15% to 20% at the age of 2, of which only 50% reach normal language development at the age of 3 to 4.

2. What are the reasons that may cause babies to speak late?

1. Hearing impairment

When babies learn to speak, they must first be able to hear adults speak and gradually form concepts in their minds. As their pronunciation organs mature, they gradually imitate and further learn to speak. The speech that children with hearing loss can perceive depends on the degree of hearing loss and the audio range. With the popularization of hearing screening technology, children with severe and profound hearing loss can be identified early in their development, and cochlear implants can significantly improve their language function.

It is very important to do a good job in newborn hearing screening. Newborns who fail the initial screening should have both ears rescreened within 42 days. Those who fail the rescreening can be transferred to a designated hearing impairment diagnosis and treatment institution for further diagnosis within 3 months of birth.

2. Neurodevelopmental diseases

Including intellectual disabilities, genetic diseases, neurological diseases, autism spectrum disorders, idiopathic language disorders, childhood apraxia of speech, etc.

3. Diseases of the vocal organs

Abnormalities in the organs of pronunciation, including the mouth, larynx, facial muscles, and respiratory tract, may also cause language development disorders, including cleft lip, cleft palate, velopharyngeal insufficiency, oral motor dysfunction, etc.

4. Environmental factors

A good language environment is an important condition for children's language development. With the development of technology, smartphones and touch screens have become necessities in daily life. Excessive use of screens by parents will lead to a decrease in the amount of adult language, and babies will lack effective language stimulation and repeated language reinforcement. Domestic and foreign studies have suggested that premature and excessive screen exposure of infants and young children can significantly affect their language development. The 2016 American Academy of Pediatrics guidelines recommend that infants and young children under 18 months should not use any electronic devices; children aged 18 months to 2 years can watch appropriate programs when accompanied by their parents; children aged 2 to 5 years should not use screens for more than 1 hour a day.

3. How to detect abnormalities in baby’s language development in time?

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The above warning signs remind parents that their baby may have abnormal language development and needs to go to a specialized medical institution for comprehensive evaluation and clear diagnosis, and early intervention.

4. Help parents become their baby’s language “coach”

Many times, parents we receive in the clinic hope that the doctor can "make" their baby "speak" after seeing the doctor, but they don't know that parents themselves are the best therapists for their children. In the United States, babies can only receive 1-2 professional speech rehabilitation treatments a week. Babies, especially those aged 0-3, spend most of their time at home.

Don’t underestimate every moment in our daily life. Every word you say is a clue for your baby to learn language. If parents master the methods of language promotion, increase communication and interaction with their babies on weekdays, and treat their babies as equal dialogue partners, it will not only promote the baby’s language development, but also achieve twice the result with half the effort! “It is better to teach a man to fish than to give him a fish.” As a developmental behavioral pediatrician, I hope to help parents become the best language “coaches” for their babies, and help “delayed” babies open a door to “fluent speech.”

5. What conditions are needed for a baby to learn to speak?

1. Rich environment, diverse life experiences.

2. Listen to others more.

3. Have the opportunity to repeat or imitate words and phrases heard.

4. Have the need and desire to communicate.

This opportunity and experience is even more important for babies who start talking late.

6. Three principles to promote baby's language development

1. Follow your baby’s interests

Pay attention to your baby's gaze, gestures and body movements, wait patiently, and listen to the sounds your baby makes to capture the messages your baby conveys and discover what your baby is interested in. Observing carefully is the most important beginning to understanding your baby. For example, if you are playing with your baby and he or she is looking at the car next to you, it means you need to change the toy in time.

2. Face to face and keep the same level with the baby

Try to sit on the floor with your baby, or squat down so that you can face your baby and maintain eye contact. When you talk to your baby, you can bring food or toys that he/she is interested in close to your face to promote eye contact.

3. Make sure the event is fun and interesting

Don’t blindly regard games as “teaching”. Playing is the most important “job” for babies, and only interesting and happy activities can keep babies immersed in the activity for as long as possible.

7. When is the “good” time to teach your baby to speak?

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1. Daily Activities

Daily activities are things that happen every day, including getting up, eating, getting dressed, going to school, taking a bath, sleeping, etc. They happen frequently and are predictable. Babies can hear certain words repeatedly during these activities and can better associate these words with objects or actions.

2. Game time

During the play process, babies can increase their experience, cognition and problem-solving abilities. At the same time, during the game process, babies can also be exposed to rich vocabulary, such as the names of toys, characters, and objects, allowing babies to learn while playing.

3. Reading time

Choosing picture books suitable for your baby's age and making him fall in love with reading will benefit him throughout his life.

8. How to "share" more language with your baby during activities

1. Imitate your baby’s movements and sounds.

2. Translate what the baby wants to express.

3. Comment on what is happening.

4. Ask appropriate questions to keep the conversation going.

5. Take turns speaking.