Therapy for Preschool Speech and Language Delays

Frustration with talking and acting out may be signs

Young children play with their teacher.
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The differences in speech between children and their peers may seem more pronounced as they begin to interact with one another in a formal learning environment like preschool. Some will speak in simple sentences while others can string multiple words together in more complex sentences. Meanwhile, others struggle to pronounce specific sounds or may stutter when they are speaking quickly.

When these differences become evident, parents naturally worry that their children are not developing at the appropriate rate. If your preschooler's speech and language development seems to be behind or different from their peers, you may find yourself wondering—and worrying—that they might need therapy to catch up. But many times, the differences you are noticing are normal.

Remember that a lag in communication skills does not necessarily mean a speech or language disability is inevitable. Instead of assuming the worst, watch for signs of speech delays and talk with your child's pediatrician if you're concerned. Here's an overview of some of things you should be watching for.

Speech Development Milestones

When it comes to determining whether or not your child has a speech or language delay, watch to see if they are hitting certain milestones based on their age. Remember though, specific speech and language skills occur within a range of time rather than by exact ages.

So, even if your child is slightly outside of the timeframe provided, their development could still be normal. These milestones are only meant to be guidelines for when the majority of children develop certain language skills.

In fact, according to the National Institute on Deafness and Other Communication Disorders, these milestones were developed to help doctors and other healthcare workers determine if your child is on track or if they might need extra help. Here's an overview of the milestones your child should reach between the ages of 2 and 5.

Speech Milestones

Ages 2 to 3 Years

  • Uses k, g, f, t, d, and n sounds
  • Speaks in a way that is understood by family and friends
  • Has a word for almost everything
  • Asks for objects by name or to bring attention to them

Ages 3 to 4 years

  • Answers simple “Who?” “What?” “Where?” and “Why?” questions
  • Hears the TV at the same level as the rest of the family
  • Forms sentences with four or more words
  • Speaks easily and doesn't need to repeat syllables
  • Hears you when you call from another room

Ages 4 years to 5 years

  • Pays attention to a story and answers questions about it
  • Names some letters and numbers
  • Uses rhyming words and adult grammar
  • Communicates easily with other children and adults
  • Says most sounds correctly
  • Uses sentences that provide details
  • Tells stories and stays on topic
  • Hears and understands what is said in school and by others

If you find that your child is not meeting these milestones, talk to your pediatrician about what you're witnessing at home. They can conduct an evaluation and refer you to a specialist for more in-depth testing if needed.

Signs of Speech Delays

Aside from not meeting milestones, there are some other signs of speech or language issues that you should be watching for. To start, listen to what your child says and how they say it.

For instance, if they are speaking mostly in single words or short phrases rather than speaking in full sentences this could be a cause for concern. Likewise, a preschooler with delays may make grasping gestures toward a toy truck and say, "truck" rather than saying, "I want the truck."

Children with speech delays and possible hearing concerns also may leave off beginning sounds of words or slur over words with more than one syllable.

They also may substitute similar sounds like saying "toof" instead of tooth or "parm" instead of "farm." These types of speech differences are sometimes a result of frequent middle ear infections during early language development.

In other instances, these kinds of speech errors may be caused by a lack of coordination of the tongue and muscles in the child's mouth. Speech pathologists refer to this as oral motor coordination. In either case, speech therapy can usually improve speech in these conditions.

Behaviors to Watch For

Speech and language delays also may manifest themselves in your child's behavior. Sometimes when a child is easily frustrated with activities that involve talking to others, listening to instructions, or following directions, this is a warning sign for a speech issue.

Likewise, if your child's speech seems very different from other children in their preschool or if teachers and other children have difficulty understanding your child, those could be signs of a delay as well. And if your child seems inattentive to others and not interested in classroom activities or playing with others this could be a warning sign too.

Take notice if your child finds speaking challenging and becomes angry, bites, or hits other children rather than using their words. These actions are often the result of frustration and an inability to communicate with words.

Meanwhile, children who point to or grab at objects or people and make noises to indicate their responses rather than calling objects or people by their names also may be showing signs of a language delay. The same goes for children who have difficulty following instructions or directions involving one or two steps.

How to Find Help

When it comes to language delays, as many as 20% of children between the ages of 2 and 7 years old will experience some sort of a delay. Sometimes simple speech delays are temporary and will resolve on their own with a little extra help from you and your family and other times your child will need intervention from a trained specialist.

The key is determining what is impacting your child's struggles with language and go from there.

In the case of a simple language delay, it's important to spend extra time playing with and reading to your child as well as encouraging them to "talk" to you when they need to communicate something. If you always respond when they grunt or point to things, you are inadvertently allowing them to delay using words. Instead, pause for a minute and ask them to find the right words. It's OK to help them if they are still struggling.

Also, if your child is diagnosed with a speech or language delay and is younger than 3 years old, your pediatrician may refer you to a speech-language pathologist for further evaluation. Or, you may receive a referral for an early intervention program in your area. These programs are sometimes called "Birth to Three" programs and are federally- and state-funded programs.

If your child is 3 years old or older, you may be referred to your local school district. Many times, the school district will work with you to develop an Individual Education Plan (IEP), which will tailor a speech program to your child with school services in mind. You also can contact the school district directly and ask for an evaluation.

A Word From Verywell

If you discover that your child has a more significant issue like hearing loss, a processing disorder, stuttering, or another speech issue, it's important to get them the assistance they need as soon as possible. Delaying intervention or just hoping they will outgrow it or get better on their own is rarely a wise choice. Early treatment and intervention can help kids master the skills they need to be successful in school.

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  1. National Institute on Deafness and Other Communication Disorders. Specific language impairment. Updated October 21, 2019.

  2. American Family Physician. Speech and language delays in children.