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Children With Delays in Language

Écrit par Randall Neustaedter OMD, LAc, CCH   
28 Avril 2009
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Children With Delays in Language
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Parents whose children talk late are justifiably concerned. They may worry when their children's language development does not conform to expected timetables of language skills (e.g. 4-6 words by 16 months and multiple word statements by 24 months). Their children's health care providers may also have concerns. When other developmental milestones are normal (comprehension, crawling and walking, social skills), then concerns about global development are usually allayed. Some children begin talking later than others and their development is normal. However, talking late may be one of the first indications of a developmental or other health problem. Parents need to have their concerns or fears allayed and clinicians need to ensure that children are developing normally or receiving appropriate interventions for developmental problems.

The age of language acquisition has historically been a subject of some debate, since many children who talk late develop perfectly normal language skills as they get older. Other children who do not speak may indeed have problems that will not resolve on their own. What are parents and clinicians to do when confronted with a child who is slow in learning to talk? This paper will examine the evidence from the relevant clinical studies and the commonly applied assumptions of clinical practice in an effort to reach a consensus opinion about the holistic pediatric approach to early language delays.

A study published in the April 2005 issue of Pediatric Neurology found that isolated delays in language development in children under five years of age without apparent other impairments are often followed by significant wide-ranging developmental difficulties by age 7-8 years (Shevell, 2005). This finding contradicts previous studies suggesting that early language delay is followed by eventual age-appropriate language outcome for a large percentage of children, a process identified as maturational lag. Others have identified a "syndrome" of highly gifted children who also display early delays in language acquisition.

Acquiring normal language skills

Several studies in the past have offered reassurance that children with an isolated delay in preschool language development where other cognitive functions appear normal would later catch up and develop normal language skills. In one study only 16 percent of children with expressive language delay at age 2 had language impairment by age 7 (Paul, 2000). In another study, 44 percent of language-impaired children assessed at age 4 who had normal nonverbal ability developed normal language skills by age 5 years. Their scores were then indistinguishable from the control group (Bishop, 1987b). It should be noted that these two studies suggest that children with language delays at age 2 are more likely to acquire normal skills than children identified with language problems at age 4. Whitehurst and Fischel specifically addressed the issue of age at diagnosis. They suggested that "poorer long-term outcomes are much more likely if language delay persists until the later preschool years, and if the delay is not specific to language and/or includes problems in understanding." In other words, a delay in talking in the early preschool years is also less worrisome if it is accompanied by normal receptive language skills (understanding) and normal development of other skills (motor, self-help, and social abilities). They go so far as to state that "most children with specific language delay recover to the normal range by five years of age (Whitehurst, 1994)." A more detailed analysis by Fischel determined that the size of a child's vocabulary at age 2 was a good indicator of the speed at which normal language would be achieved. A child with a large vocabulary was more likely to develop normal language during the third year than a child with poor vocabulary (Fischel, 1989).