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If your 3- or 4-year-old doesnt speak much or doesnt show any interest in speaking, they may have a speech delay or other developmental issue. Talk to your childs doctor or teacher.
Speech delay occurs most often in those with an athetoid type of cerebral palsy. The following factors, alone or in combination, may account for the speech delay: hearing loss, incoordination or spasticity of the muscles of the tongue, coexisting mental retardation or a defect in the cerebral cortex.
Often, children who have a hoarse voice or inability to control volume may need early intervention. They also may have trouble emphasizing the correct syllable of a word, even though they pronounce a word correctly (such as saying BA- NAN-A instead of ba-NAN-a).
Also call the doctor if your childs speech is harder to understand than expected for their age: Parents and regular caregivers should understand about 50% of a childs speech at 2 years and 75% of it at 3 years. By 4 years old, a child should be mostly understood, even by people who dont know the child.
Many conditions can hinder a childs use of verbal speech, including Autism, Cerebral Palsy, Dyspraxia, learning difficulties and selective mutism. Communication is bigger than speech, though. You can help your nonspeaking child communicate in many ways, using gestures, signs, assistive technology and words.
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There can be several reasons why your 4-year-old child is not talking. Some possible reasons can be hearing loss, neurological disorders, intellectual disability, lack of language stimulation at home, cognitive delay, and delayed motor and speech and language development.
There are several things that can cause speech delays, such as hearing loss, physical problems in the roof of the mouth, learning disabilities, or certain diagnosable conditions like autism spectrum disorder or cerebral palsy.
If your child is over two years old, you should have your pediatrician evaluate them and refer them for speech therapy and a hearing exam if they can only imitate speech or actions but dont produce words or phrases by themselves, they say only certain words and only those words repeatedly, they cannot follow simple
Every child works at their own pace. If your child is not talking yet, chat to your GP or a Speech and Language Therapist so that they can assess your childs communication skills. There may be many different causes to your speech delay. For example, they may just be a late talker.
A 3-year-old who can comprehend and nonverbally communicate but cant say many words may have a speech delay. One who can say a few words but cant put them into understandable phrases may have a language delay. Some speech and language disorders involve brain function and may be indicative of a learning disability.

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