Delayed speech development (RAD) is a concept that reflects the slower pace of mastering the norms of the native language by children at the stage of early and middle speech ontogenesis. The speech therapy conclusion “delayed speech development” is valid for children under 3-4 years of age. The tempo lag concerns the formation of all components of speech: sounds of early ontogeny, vocabulary and grammar, phrasal and coherent speech. Delayed speech development occurs in 3-10% of children; in boys 4 times more often than in girls.

Delayed speech development negatively affects the development of mental processes, therefore, RRD and RRD are often observed in children in parallel and are referred to in the literature as a delay in psycho-speech development (RRP). Delayed speech development is a medical and pedagogical problem affecting aspects of pediatrics , child neurology , speech therapy and child psychology.

Organic causes

Delayed speech development can be caused by reasons of a biological and social nature. In about a third of cases, the reasons for delayed speech development remain unclear. Biological factors:

1. Minimal brain dysfunction . It is caused by perinatal brain damage ( perinatal encephalopathy ). In the anamnesis of children with delayed speech development, as a rule, intrauterine hypoxia and asphyxia during childbirth , birth trauma , intrauterine infections are traced; prematurity or postmaturity .
2. Diseases of an early age : TBI , malnutrition , neonatal meningitis and encephalitis , frequent or long-term illnesses that weaken the child, post-vaccination complications .
3. Hearing loss in a child . It is known that the formation and development of speech function occurs with the direct participation of the auditory analyzer, that is, with reliance on the information heard by the child, therefore, hearing impairment can also cause a delay in speech development.
4. Hereditary factors. Sometimes the slower rates of maturation of the nervous system are genetically determined: if one of the parents spoke late, it is likely that the child will also have a delay in speech development.

Social reasons

Socio-pedagogical prerequisites for delayed speech development most often lie in an unfavorable microsocial environment, leading to a deficit of speech contacts: lack of demand for speech (underdeveloped culture of communication in the family), “ hospitalism syndrome ” in frequently ill children ; pedagogical neglect . Bilingualism , an unfavorable speech environment, and emotional stress can have a negative impact on the rate of development of a child’s speech.

On the other hand, not only psychosocial deprivation, but also overprotection can have an inhibitory effect on the formation of a child’s speech function : in these conditions, speech communication also remains unclaimed, since the surrounding adults warn all the child’s desires without stimulating his independent speech activity.

It is extremely harmful for a young child to be in an overly informed environment, where he is faced with an excessive flow of information, which, moreover, does not correspond to the age of the baby. In this case, the child gets used not to listen to speech and not to comprehend the meaning of words; utters long, formulaic phrases that have nothing to do with the development of true speech.

In postnatal development, there are 3 critical periods (I – 1-2 years; II – 3 years; III – 6-7 years), characterized by the most intensive development of the speech system and at the same time – increased vulnerability of the nervous mechanisms of speech activity. During these periods, exposure to even minor harmful exogenous factors can lead to the occurrence of various speech disorders.

So, in the first critical period, when the intensive development of cortical speech zones occurs, under unfavorable conditions prerequisites can be created for delayed speech development and alalia . In the second critical period – the time of intensive development of coherent speech, mutism and stuttering may occur . During the III critical period, a “breakdown” of nervous activity can cause stuttering, and organic lesions of the brain – childhood aphasia .

For a correct understanding of which signs indicate a delay in speech development, it is necessary to know the main stages and conditional norms of speech development in young children.

The birth of a child is marked by a cry, which is the first speech reaction of the infant. The child’s cry is realized through the participation of the vocal, articulatory and respiratory sections of the speech apparatus. The time of the appearance of the cry (normally in the first minute), its volume and sound can tell a neonatologist a lot about the condition of the newborn. The first year of life is a preparatory (pre-speech) period during which the child goes through the following stages:

• humming (from 2-3 months);
• babbling (from 5-6 months);
• babbling words (from 8-10 months);
• first words (at 10-12 months).

Normally, at 1 year in the child’s active vocabulary there are about 10 words consisting of repeated open syllables (ma-ma, pa-pa, ba-ba, dya-dya, etc.); in a passive dictionary – about 200 words (usually the names of everyday objects and actions). Until a certain time, the passive vocabulary (the number of words the child understands) far exceeds the active vocabulary (the number of spoken words).

At about 1.6 – 1.8 months. the so-called “lexical explosion” begins, when words from the child’s passive vocabulary are abruptly merged into the active vocabulary. In some children, the period of passive speech can drag on for up to 2 years, but in general, their speech and mental development proceeds normally. The transition to active speech in such children often occurs suddenly and soon they not only catch up with their peers who spoke early, but also overtake them in speech development.

Researchers believe that the transition to phrasal speech is possible when the child’s active vocabulary contains at least 40-60 words. Therefore, by the age of 2, simple two-word sentences appear in the child’s speech, and the active vocabulary grows to 50-100 words. By the age of 2.5, the child begins to build detailed sentences of 3-4 words.

In the period from 3 to 4 years old, the child learns some grammatical forms, speaks in sentences combined in meaning (coherent speech is formed); actively uses pronouns, adjectives, adverbs; masters grammatical categories (changing words by numbers and gender). Vocabulary increases from 500-800 words in 3 years to 1000-1500 words in 4 years.

Experts admit a deviation of the normative framework in terms of speech development by 2-3 months in girls, and by 4-5 months in boys. Only a specialist ( pediatrician , pediatric neurologist , speech therapist ) who has the opportunity to observe the child in dynamics can correctly assess whether the delay in the timing of the appearance of active speech is a delay in speech development or an individual feature .

WARNING SIGNS

Warning signs are those that should serve as a reason to seek specialized help from otolaryngologists , speech therapists, pediatricians, pediatric neurologists and speech therapists. Are they:

At any age:

• Children who do not react to sounds or who do not babble or produce sounds with their voice.

Between 1 and 2 years of age:

• Difficulty understanding sentences or verbal requests
• Not trying to imitate sounds or words
• Prefer gestures over voice to communicate

After 2 years:

• Not producing semantic unit of a text. In other words or phrases spontaneously
• Repeating nonsense semantic unit of a text. In other words for communication
• Abnormal or nasal tone of voice
• Difficulty understanding what the child says most of the time he speaks.

Signs of delayed speech development at different stages of speech ontogenesis can be:

• abnormal course of the pre-speech period (low activity of humming and babbling, soundlessness, vocalizations of the same type)
• lack of reaction to sound, speech in a child at the age of 1 year;
• inactive attempts to repeat other people’s words ( echolalia ) in a child aged 1.5 years;
• the inability to perform a simple task (action, show, etc.) by ear at 1.5-2 years;
• lack of independent words at the age of 2 years;
• inability to combine words into simple phrases at the age of 2.5-3 years;
• complete absence of his own speech at the age of 3 (the child uses only memorized phrases from books, cartoons, etc.);
• the child’s predominant use of non-verbal means of communication (facial expressions, gestures), etc.

A child with delayed speech development should be consulted by a group of specialists, including a pediatrician, a pediatric neurologist, a pediatric otolaryngologist , a child psychiatrist , a speech therapist, and a child psychologist . The task of the pediatrician at the stage of examination is to assess the somatic status, preliminary determination of possible causes of delayed speech development and referral of the child to a specialist of the appropriate profile.

1. Medical block. Neurological diagnostics ( EEG , EchoEG , duplex scanning of the child’s head arteries ) is required to detect microorganisms in the brain. A visit to a pediatric otolaryngologist is necessary to exclude chronic otitis media , adenoids , hearing loss in a child.
2. Speech therapy examination . It includes the study of anamnestic data and conclusions of medical specialists, motor development of children, the state of the speech apparatus, auditory and visual orienting reactions, the specifics of the child’s communicative activity. In children under 1 year old, vocal and pre-speech activity is monitored in natural and provocative situations. In the presence of words, the time of their appearance, the volume of the active and passive vocabulary, the general speech activity of the child, the presence of phrasal and coherent speech, etc. are determined.
3. Psychological diagnostics. For the diagnostic examination of speech and the assessment of the general mental development of young children, speech therapists and child psychologists use the Denver test of psychomotor development, the Griffiths scale of psychomotor development, the early speech development scale, the Bailey scale, etc.

Delayed speech development must be distinguished from general developmental disorders ( autism , elective mutism , oligophrenia), general underdevelopment of I-IV level speech .

The amount of corrective assistance to children with delayed speech development depends on the factors that caused the lag in the formation of speech skills. So, for reasons of a socio-pedagogical nature, first of all, it is necessary to organize a favorable speech environment, stimulate the child’s speech development, correct selection of speech material, demonstrate samples of correct speech, “speech” (pronunciation) of all the child’s actions.

If the basis for delayed speech development is brain dysfunction, correctional and pedagogical work should be accompanied by treatment prescribed by a pediatric neurologist: taking nootropic drugs, massage , transcranial micropolarization, magnetotherapy , electroreflexotherapy , etc.

In parallel with medical procedures and family education, children with speech retardation need classes with a speech therapist and a child psychologist on the development of speech and cognitive processes. In early childhood, special attention is paid to the development of fine motor skills , finger and outdoor games, productive activities (drawing, modeling, applications), didactic games (speech therapy lotto, special speech games and exercises, etc.), the development of visual and auditory attention, passive vocabulary and active speech, coherent speech.