Overview 

Human speech and language surpass that of other animals for their unlimited capacity for expression. While some dolphins click and whistle in an impressive array of repetitive patterns and parrots mimic human speech,¹ what sets humans and the rest of the animal kingdom apart is the distinctive difference in communication. Human communication embodies the creative and unpredictable nature that comes through the development of speech and language. Where speech drives communication by articulating vocal sounds to make words, phrases and sentences, language uses strings of vocal sounds to express a system of linguistic symbols so that they hold meaning or convey a message. Language can be divided into receptive and expressive where the former describes the ability to understand language and the latter the ability to use language.² In the prelinguistic stage, babies will cry and coo to express what they want; as they reach adolescence, they will be able to formulate full sentences that directly express those needs. However, speech and language development is far from straightforward. It is a unique balance of genetics and the environment, where one child’s milestones are not like the other.

Early milestones 

Understanding the early milestones of speech and language provides insight into the transitions between each stage of communication, particularly from a newborn to a toddler to an adolescent. In the prelinguistic stage, there is a limited capacity for speech and language. In a nutshell, babies will cry for food, diaper changes, gas, sleep, and maybe if you put them to bed before they have their nightly debate on how to take over the milk industry. Other reflexive sounds from birth include coughing and sneezing. After a few months, babies will make sounds that sound like vowels (cooing) as they start to pick up on patterns.³ At the age of 6 months,⁴ babies will start to put these vowels into a string with consonants to make short syllables like “dada” or “mama”, depending on whoever is the lucky parent. 

Between the years of age 1 and 2, toddlers will begin using full words.⁵ Now they may say “hungry” if they want food and “bed” or “night night” if they want a nap. Babies observe linguistic patterns from their family and environment and mimic the sounds they hear, often through positive reinforcement. It is a good habit to have one-on-one time with your baby, emphasising the movement of your lips slowly and repeating words to encourage speech. Sooner or later, toddlers grow into young children, and young children into young teenagers. Through a language-rich environment, young children will have expanded their vocabulary and the complexity of their expressive language. Regardless, they may abandon it all on a Sunday afternoon and cry for some ice cream. 

Factors influencing speech and language 

Speech and language are shaped by a multitude of interconnected factors. A systematic review of 23 randomised controlled trials showed that the main risk factors linked to speech and language delays included male gender and family history.⁶ Sex differences may be further explained by the difference in postnatal sex hormone levels. While the hormone estradiol had a positive impact on complex language tasks, the hormone testosterone had a negative impact.⁷ Both females and males produce estradiol and testosterone but the levels vary: females predominantly produce estradiol and males predominantly produce testosterone. 

However, recent studies have shown that socioeconomic status and relationships with parents have a strong association with speech and language development. A systematic literature review found that poor family dynamics had a negative impact, though it can be reversible through professional counselling.⁸ Additionally, children from lower socioeconomic status are exposed to approximately 30 million fewer words,⁹ substantially impacting their vocabulary acquisition and language processing skills. While risk factors may be demotivating for concerned parents/ guardians, understanding their impact should instead emphasise the potential of interventions and therapies to improve the progress of their child’s speech and language.

FAQs

What are the red flags for speech delay?

Certainly, there is no specific timeframe for when a child starts speaking; some children say their first words in their first year while some do later. Identifying if speech delay is a matter of concern can lead to earlier integration of speech therapy from a young age. Receptive language typically starts as a newborn as they react to sounds made around them; this progresses over the next months to respond to names, familiar voices and one-step commands such as ‘no’. While cooing and laughing are common in the first three months, expressive language in words may occur at around 10-18 months, forming pronouns and three-word sentences at the age of three.¹⁰ Red flags that should be checked by your GP include:

1. Disproportionate speech and language in comparison to peers
2. Limited or repeated vocabulary beyond their developmental age
3. Unresponsive to others i.e. when you call out their name or ask a question
4. Disinterest in social interactions and communication

However, at its root, it is crucial to determine the exact cause of the development delay. For instance, hearing loss in the first few years of life has a severe impact on speech development. If children learn speech through imitation and learning by hearing others speak, those with hearing loss lose exposure to language and face a communication barrier. Hence early intervention is essential so that the lack of exposure is reduced by the use of hearing aids. Hearing aids can be a powerful tool in the developmental stages of a child, but they are not compulsory. Speech and language come in many forms- like sign language. While it may be easier to communicate with a hearing aid, learning sign language can be empowering for the deaf and hard-of-hearing community. It is our responsibility to respect what makes them most comfortable, rather than what is convenient for us. 

How can I support speech and language development at home?

As a parent/guardian, it is natural to want to create a language-rich environment for your child to thrive in. Fortunately, there are many methods to support their speech and language. These are some you can implement from the comfort of your own home!

Storytelling

Regardless of age, we collectively agree that stories provide a digestible format for communicating just about anything. At first glance, stories can help parents/guardians to simplify complex ideas into fun narratives- like by personifying germs into villains and medicine into the superhero. However, the NHS has shown that storytelling can immensely encourage sequencing skills;¹¹ with a beginning, dilemma, and an end, children can chronologically sequence life events so that they can construct meaningful and logical sentences and open a window for them to express their thoughts through these experiences.

Singing

Music therapy is a well-received clinical practice to help people with a variety of psychological disorders. It is a fun and interactive method that has been shown to significantly improve social interactions and verbal communication in comparison to a placebo.¹² Singing offers a therapeutic approach for children with autism spectrum disorder, as it allows them to not only improve their pronunciation,¹³ but also encourage communication all whilst keeping the fun!

Does technology have an impact on speech and language development?

In the recent decade, technology has become inseparable from the youth. While it may have started as an iPod Touch in the early years for watching YouTube videos and playing games, the majority of the current generation of children have direct and constant access to social media and messaging apps. A 2022 review of a dozen scientific literature concluded that an earlier onset of screen time usage of mostly television correlates to negative cognitive effects on language development; particularly the all too common fast-paced videos with flashing images and little language are to be avoided. Several articles in the review reported that a higher screen time was associated with delays in receptive and expressive language.¹⁴ Though it is impossible to delete technology from your child’s life, it is instead recommended to limit screen time and encourage play-based activities. However, there are many commendable resources online to support speech and language- take Ms Rachel on YouTube for example. With a Master’s degree in Music Education, Ms Rachel implements sign language, enunciation and pronunciation techniques, and a gentle melodious voice to help speech development.

Summary 

Simply put, humans stand out as the odd bunch of the animal kingdom due to our distinctive and complex abilities in speech and language. In the early years, we cry to express our need for food, hugs, diaper changes and burps- all of which we articulate through structured combinations of vowels and consonants during infancy. While it is true that no child is the same as the other, scientific studies have shown that there is a rough estimation for when those cries and coos transition into babbles and words. Hence, it is advised for a parent to evaluate the progress of their child’s speech and language development, counting on the genetic and environmental factors, so that they can intervene where appropriate for any delays and disfluencies.