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March 2014

What an Otolaryngologist Should Know About Evaluation of a Child Referred for Delay in Speech Development

Author Affiliations
  • 1Boston University School of Medicine, Boston, Massachusetts
  • 2Department of Otolaryngology–Head and Neck Surgery, Boston University School of Medicine, Boston, Massachusetts
JAMA Otolaryngol Head Neck Surg. 2014;140(3):259-265. doi:10.1001/jamaoto.2013.6368

Importance  Otolaryngologists are asked to evaluate children who a parent, physician, or someone else believes is slow in developing speech. Therefore, an otolaryngologist should be familiar with milestones for normal speech development, the causes of delay in speech development, and the best ways to help assure that children develop the ability to speak in a normal way.

Objective  To provide information for otolaryngologists that is helpful in the evaluation and management of children perceived to be delayed in developing speech.

Evidence Acquisition  Data were obtained via literature searches, online databases, textbooks, and the most recent national guidelines on topics including speech delay and language delay and the underlying disorders that can cause delay in developing speech. Emphasis was placed on epidemiology, pathophysiology, most common presentation, and treatment strategies. Most of the sources referenced were published within the past 5 years.

Results  Our article is a summary of major causes of speech delay based on reliable sources as listed herein.

Conclusions and Relevance  Speech delay can be the manifestation of a spectrum of disorders affecting the language comprehension and/or speech production pathways, ranging from disorders involving global developmental limitations to motor dysfunction to hearing loss. Determining the cause of a child’s delay in speech production is a time-sensitive issue because a child loses valuable opportunities in intellectual development if his or her communication defect is not addressed and ameliorated with treatment. Knowing several key items about each disorder can help otolaryngologists direct families to the correct health care provider to maximize the child’s learning potential and intellectual growth curve.