Don't wait, thinking “Boys talk late”!

Attributing speech delay in children to gender, family history, or bilingualism can delay the assessment and intervention process. Stating that "Being a boy does not make late talking 'normal'," Speech and Language Therapist Dr. Seçil Aydın Oral emphasized that a child understanding what is said and expressing their wishes with gestures does not solely mean there is no problem in language development. Dr. Oral reminds that if a one-year-old does not respond to their name, a one-and-a-half-year-old does not use any words, does not make eye contact, or does not react to sounds, a speech and language therapist should be consulted without saying 'let's wait a little longer'.

Asst. Prof. Seçil Aydın Oral from the Department of Speech and Language Therapy, Faculty of Health Sciences, Üsküdar University, evaluated common beliefs regarding language and speech development in children and explained the signs families should pay attention to, as well as supportive methods they can apply in daily life.

Gender is not a reason to wait

Asst. Prof. Seçil Aydın Oral stated that the idea "boys talk late" is common among families, but the slightly more frequent occurrence of late talking in boys is not a reason to postpone assessment.

Asst. Prof. Seçil Aydın Oral stated that the risk of late talking and the child's potential to catch up with peers later on should be evaluated separately. She said, "Scientifically, there are two separate questions: Who has a higher risk of late talking, and will a late-talking child catch up later? Gender plays a role in the first question but is not decisive in the second. In other words, being a boy does not make late talking 'normal'."

Asst. Prof. Seçil Aydın Oral reported that in follow-up studies with large groups, a significant portion of language difficulties observed at age two persisted into preschool years. She warned, "Therefore, waiting with the idea 'a boy will speak eventually' can delay assessment and intervention."

Saying "His father also talked late" should not be reassuring

Asst. Prof. Seçil Aydın Oral stated that approaches like "His father also talked late," "He'll talk when he starts kindergarten," and "His language will open up one day anyway" can reassure families, but they do not align with scientific evidence. She emphasized that family history should be handled with care.

Asst. Prof. Seçil Aydın Oral said, "A family history of late talking is not reassuring information; on the contrary, it may indicate an increased risk. Kindergarten can be beneficial by offering the child opportunities for speech and play, but it does not spontaneously resolve a language problem. Some children who talk late catch up with their peers, while others do not, and it is difficult to distinguish this at first."

Pointing out that assessment should not be postponed due to this uncertainty, Asst. Prof. Seçil Aydın Oral stated, "Another common misconception is 'It will get better when they start school.' School age is often too late a period for intervention."

Tongue-tie is not the sole explanation for speech delay

Asst. Prof. Seçil Aydın Oral stated that one of the beliefs frequently expressed by families is "If they don't talk, the reason is tongue-tie," and she explained that tongue-tie is a structural difference that can restrict tongue movement.

Asst. Prof. Seçil Aydın Oral stated that word learning and sentence formation skills should be distinguished from tongue-tie, adding, "There is no evidence that tongue-tie delays language development, which enables a child to learn words and form sentences. The best-known effect of tongue-tie is difficulty with breastfeeding and feeding in infants."

Emphasizing that tongue-tie should not be accepted as the sole explanation in a child with delayed speech development, Asst. Prof. Seçil Aydın Oral noted that a speech and language therapist and an ENT specialist can conduct a joint assessment when needed.

Don't wait if a one-and-a-half-year-old doesn't use any words

Asst. Prof. Seçil Aydın Oral stated that in children's language development, one or two meaningful words are generally expected around one year of age, and an increase in word count and two-word sentences around two years of age. She added that some symptoms require assessment.

Asst. Prof. Seçil Aydın Oral said, "If any of these symptoms are present, a speech and language therapist should be consulted without saying 'let's wait a little longer': if a one-year-old does not respond to their name, if a one-and-a-half-year-old does not use any words, if they do not make eye contact, or if they do not react to sounds."

Emphasizing that assessment is not based solely on spoken words, Asst. Prof. Seçil Aydın Oral explained, "We do not assess language development solely by word count. A child's understanding of what is said, their desire to communicate, and their social interest are at least as important as their speech."

Saying "He understands everything but doesn't talk" is not enough

Pointing out that the belief a child understands what is said can create a tendency in families to observe speech delay by waiting, Asst. Prof. Seçil Aydın Oral stated that language has two aspects: comprehension and expression.

Asst. Prof. Seçil Aydın Oral said, "'Understanding everything but not talking' does not indicate that there is no problem." She continued:

"Good comprehension skills are good news because they are one of the best predictors of future speech. However, some children who talk late also struggle to understand sentences, and this can be a sign of a more persistent language problem. Therefore, we do not rely solely on the phrase 'they understand'; comprehension skills must also be measured separately."

Expressing with gestures is positive, but it does not replace speech

Asst. Prof. Seçil Aydın Oral stated that a child communicating their wishes with gestures is a positive finding, adding that gestures used in the pre-speech period, especially pointing, provide information about subsequent vocabulary development.

Asst. Prof. Seçil Aydın Oral reported that children with delayed language development tend to use fewer gestures than their peers. She said, "Nevertheless, gestures do not replace speech. We should support gestures and combine them with words. If the child is still not talking at all, they should be referred to a speech and language therapist."

Screens can replace opportunities for reciprocal conversation

Evaluating the idea "If they watch cartoons, they will learn to speak," Asst. Prof. Seçil Aydın Oral stated that observational studies have shown that as screen time increases, conversation between a child and an adult decreases.

Asst. Prof. Seçil Aydın Oral stated, "The problem is not so much the screen itself, but that it replaces opportunities for conversation. It should also be noted: these studies show a correlation, but not a definitive cause-and-effect relationship."

Emphasizing that not only the total duration but also the conditions of use are important for screen use, Asst. Prof. Seçil Aydın Oral noted that having the television constantly on during meals is a more significant risk indicator.

Bilingualism should not be seen as a justification for delay

Asst. Prof. Seçil Aydın Oral stated that the language skills of bilingual children should be assessed by considering both languages.
Asst. Prof. Seçil Aydın Oral said, "When the words a child knows are counted across both languages, bilingual children do not lag behind their monolingual peers." She added that differences observed in assessments based on only one language do not automatically imply a disorder.
Asst. Prof. Seçil Aydın Oral said, "Bilingualism should not be accepted as an explanation for delay. To distinguish between the two, we should assess the child in both languages and also inquire about screen time."

Respond by expanding the child's sounds and words

Asst. Prof. Seçil Aydın Oral stated that definitive judgments should be avoided regarding constantly prompting the child with "Come on, say it, repeat it" or meeting their needs without waiting for them to speak, adding that there are no strong studies directly examining the effects of these behaviors.
In contrast, Asst. Prof. Seçil Aydın Oral reported findings on the benefits of teaching families language-supporting interaction methods. She explained, "When parents are taught language-supporting methods they can use in daily interactions, children show moderate improvement in their communication and language skills."

Listing methods families can apply in daily life, Asst. Prof. Seçil Aydın Oral concluded her words as follows:

"Describe what the child is doing with words. After asking something, pause and wait for an answer. Repeat the sound or word they make, expanding on it slightly. Read books together every day. Watch screens together and talk about them. Family support is very valuable, but for some children, it may not be enough on its own; speech and language therapist support may also be needed."