Language Delay? Understanding Communication Skills for Parents

baby and mom

As a pediatric speech-language pathologist, I often get referral information for a child with the primary concern listed as “speech delay” or “communication delay.” These are often catch-all terms that can mean a child is not saying as many words as other babies his age, is talking but is hard to understand, doesn’t follow directions, or is even in his own world and is not interacting well with his parents.

The word “communication” encompasses all of these areas. It includes toddler’s ability to understand and produce words. It includes a baby’s ability to use gestures, such as pointing and facial expressions, to convey his message. To a greater degree than you may realize, it also includes how curious he is about his world, how he plays, and how he tries to interact with others. All of these communication skills can be broken down into smaller, more specific areas. These areas are listed below, along with various terms you might also hear or read concerning communication skills. Each of these categories is important in determining your baby’s overall ability to communicate.

Speech-language pathologists typically separate communication skills into speech skills (actual sound production skills) and language skills (the vocabulary one uses and understands.) When referring to early communication skills, language is usually the area emphasized – and rightly so. While sound production skills are necessary to eventually speak (you have to be able to produce sounds to say words) elevating their importance above language is usually a mistake with toddlers. More commonly than not, it’s a child’s language delays that account for his not talking or understanding, rather than his ability to produce sounds. Focusing on speech sound production for a baby who is trying to talk, but doesn’t speak perfectly yet, can also be a mistake. For example, a child who says “mi” for milk at one year old, and even to age two, should not be overtly corrected for not producing the ending sounds on the word, but more about that in a later post.


Language skills are generally broken down into two broad categories: receptive language and expressive language.

Receptive Language

Receptive language can also be referred to as “Language Comprehension” or “Auditory Comprehension Skills.”  This means how your baby understands the language he hears. Examples of receptive language include how well your baby follows directions such as “Give me your cup” or how he might start to walk toward the bathroom when you announce, “It’s time for a bath. “ These skills begin from birth when your baby begins to purposefully look at you and enjoy your attention and continue as he starts to notice environmental sounds, such as the neighbor’s dog barking or a loud fire engine. It progresses when he begins to pay attention to what you’re talking about so that he looks around when you announce “Daddy’s home!” or watches as you point to a bird outside the window. He begins to understand early games such as “Peek-a-boo” well enough to cover his head himself and lights up when he pulls the blanket off and you yell “Boo!“ It includes being able to point to body parts when you ask, “Where’s your nose?” and find pictures in books when you say, “Show me the dog.”

Receptive language is closely tied to a baby’s cognitive – or thinking – skills. Until a child is age 3 or older, it is very difficult to separate receptive language and cognition. In fact, most of the skills listed on early developmental charts are actually the same or similar for both domains. Some children may demonstrate cognitive strengths, such as a good memory or exceptional visual skills, so that they recognize written words or can match colors.  However, more often than not, poor language comprehension skills are linked to at least the potential for future academic problems. This is why language skills are believed to be the most reliable predictor for future success in school.  Problems with language skills are also the number one reason kids aren’t ready for kindergarten.

When assessing receptive language at home, it is very important to be sure that your child is responding to the words you’re saying and not the nonverbal cues you might be giving. For example, when you’re asking your child, “Give me the block,” he may be responding to your outstretched hand as he gives it to you, or he may see the juice box you’re getting out of the refrigerator rather than understand, “Are you thirsty?”

Expressive Language

Expressive language means what your child communicates with words he says or gestures he uses. This is most often what parents are referring to when they are concerned about their baby’s ability to communicate. Again, skills in this area develop much sooner than when your baby says his first words. They begin when he cries during the middle of the night for a feeding, and when he gurgles back at you when you are holding him close and calling his name. These skills progress to how he excitedly kicks his arms and legs when you sing to him. As an older baby, he expresses himself when he fusses and pushes you away when you are interrupting his play to change his diaper. This expands to a whine and persistent “Uh uh uh” when he reaches up to the counter for his cup. He learns to wave when grandma leaves usually before he begins to echo, “Bye bye.” These early gestures are an essential prerequisite for expressive language development.


Speech skills are the sounds a child produces and combines into words. Speech-language pathologists (SLP) can take a couple of different approaches to analyzing a child’s speech sound skills, or articulation skills, as more commonly noted in evaluation. Clinicians analyze the specific consonant and vowel sounds a child produces correctly alone, or in isolation, and then further assess a child’s ability to correctly combine these sounds into syllables and words at the beginning (initial), middle (medial), and ending (final) positions in words.

An SLP may take a broader look and analyze the patterns a child uses to form words, or phonological processing. This might include leaving off syllables in words such as “na” for banana, or leaving off all ending sounds so that “ba” means ball, box, and bottle, depending on the context.

More often than not, a parent’s chief concern regarding his or her child’s speech skills is simple. They want to be able to know what their child is saying, and often more importantly, they want the all-important others (grandparents, sitters, neighbors, and friends) to be able to understand him too. This is often referred to as how “intelligible” a child is.


As mentioned in the opening paragraph, there are other essential skills a baby needs to be able to communicate. A child must be social, or have a desire to be with and interact with others. A toddler must be learning throughout his day and want to explore a variety of play interests. He should not be stuck in such spinning all his toys, repetitively pushing buttons on and off his light and sound toys, or preferring to watch TV to the exclusion of other types of play. A baby must have learned important cognitive concepts such as object permanence (something doesn’t go away just because I can’t see it) and cause-and-effect (if I push this button, the jack in the box opens.)  He must be able to pay attention to something and more importantly, someone, for more than a fleeting few seconds. This includes consistently making and maintaining eye contact and enjoying back and forth play with adults. Play skills are also important. Early pretending and playing with two toys together, such as feeding a doll with a spoon, are important precursors to language. Imitation is HUGE skill for babies to master because imitation is the way we learn just about everything we know in our lives. Imitation includes learning to hold up hands during a game of “So Big,” learning to clap when we’ve done something great, and babbling back to Mom as she says “Mama, mama.”

How do all these skills work together?

All of these skills are essential to helping kids learn to communicate. While child specialists tell you that all kids develop differently, generally language development follows the same pattern.  There is some variance here and there on the rate or when a specific skill is obtained. For example, on most checklists, skills are listed for an age range, say six to nine months, rather than a certain date like seven months. This is how all of those charts were developed in the first place, and how tests are standardized. Thousands of children are studied to determine when a certain skill is mastered, and then it’s listed on the chart in a range.

There are also some other factors that are fairly predictable. Receptive language generally precedes expressive language. Which means that if a child has a receptive language delay, he’s going to have an expressive delay too. Most of the time, we have to understand something before we can talk about it. There are, of course, exceptions to every rule. This does not include children who mimic everything they hear or when speaking seems to be a child’s gift – for instance, when she can recite lines from a movie, but not understand how to ask for what she needs. The ability to babble or vocalize using a variety of sounds generally comes before a child begins to say real words. Usually a child is speaking in words before they begin to combine them to phrases and sentences.

Don’t even get me started on the Einstein theory that a child can be non-verbal one day and wake up speaking in full sentences the next. This may happen RARELY, but please don’t count on it! There are only a FEW folks with even the genetically predetermined possibility of reaching the cognitive capacity to be Einstein, so unless your family tree is full of Noble-prize winning physicists and world-renowned surgeons, this is probably not going to be the case for your little one. That’s not to say that intellectually mediocre parents can’t produce whoppingly intelligent children, but this is truly the exception rather than the rule.

Speech or Language Delay?

When your child’s language skills are moving along at a slower rate than would be expected, but the same skills are achieved in the same expected order, it is called a speech delay or language delay. When your child is not acquiring skills in the same way as expected (for instance, he may have some skills at higher age levels with many skills absent at a younger age level) or if there is no pattern per se in his development or if there are a typical characteristics present, it is called a speech delay or language disorder. Speech delay or language delay are typically easier to overcome and eventually catch up. A disorder is generally something a child will struggle with for a while, perhaps his entire life.

Now after reading all of this you may feel overwhelmed, defeated, or even scared out of your mind. Take a deep breath and realize that your child has his whole life ahead of him, and so do you as his parents. Many, many, many parents have felt this same way and experienced these same feelings. Some have lapsed into depression or let their fears immobilize them. Some have wasted countless hours on evaluation after evaluation searching for answers to the inexhaustible question, “WHY DID THIS HAPPEN TO US?”

But many have risen to the occasion and used this information as fuel to propel them to explore.  They don’t just look to specialists to tell them what’s going wrong with their children, but to wholeheartedly pursue interventions that work to make their babies better. Sometimes it takes years, loads of money on therapy, and tons of parental blood, sweat, and tears to finally hear their little ones whisper “I love you.”

For many parents, it just takes making a firm decision to commit to using simple strategies day in and day out and an on-going belief that things will get better. Which kind of parent are you? I trust that since you are still reading this, you are one of the ones who will choose to make a difference.

As I say at the end of every piece of information I write for parents and at the ends of visits with parents who look like they are at the ends of their ropes, YOU CAN DO THIS! YOU CAN! YOU! You are your kid’s best hope. YOU! YOU CAN DO THIS!

I recommend these speech therapy manuals for late talkers to all my new families…

For my best help working with a young toddler when you first begin to worry about language delay is Teach Me To Play WITH You. It’s filled with easy, fun routines to do with your baby to help him begin to talk. When you see signs of speech delay in your toddler, you don’t have to worry! Take action and get going today.

If your child is over 2 and understands language well but still isn’t talking, get Building Verbal Imitation Skills in Toddlers for a step-by-step plan for teach your child with speech delay to talk.






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Teach Me To Talk Testimonials

Happy Therapists, Teachers, Parents & Children

Dear Laura,

Thank you for your generosity in sharing so much knowledge in such a clear and enthusiastic way.

As a retired audiologist with a fabulous and language delayed grandson, I used your podcasts and outstanding publication, The Autism Workbook, to inspire and guide me over the past year.

It works!! He went from barely verbal, no gestures, didn't respond to his name etc etc to a verbal, social, curious, ready to imitate anything, fill in the blanks on familiar "set" speech, generate his own totally appropriate and mostly understandable sentences...not just short phrases anymore... full little paragraphs...about imaginary things, what he did during the day, what he wants. True communication!

You make a powerful difference in this world! ❤

With gratitude,

"Laura Mize, you are a Godsend. I don’t know how one human can have so many helpful things to say in a beautifully organized way, so often. Always amazes me when another super helpful email comes from you, and for free. With free YouTube videos and cheap CEUs. THANK YOU!!!"

Sheila, Canada

"I purchased the book on autism and have watched the #400s series podcasts. Laura Mize has been more effective in teaching autistic tendencies, than many professors, shadowing professions, and the 100s of books, articles and classes or videos, or live workshop speakers, have been at teaching effective practices for a child with ASD. Some of the many lessons she has taught, which I will now use, to be a more effective Interventionist, include but are not limited to: red flags, typical behaviors, self-stimulating behaviors, not taking away toys, rather showing child to play with toy appropriately. She gives examples of child's actions, "inappropriate," explains the reason for: why the child is engaging in these behaviors and how they can be replaced with more appropriate, effective fuctional and age-appropriate skills."

"I’m sure Laura gets these messages all the time, but I thought I’d share. I stumbled across Laura‘s "Autism or Speech Delay?" YouTube video when I really needed it. This video finally listed and explained some of the red flags my son was showing for autism. I share the link anytime a parent is questioning in my FB autism group. This mother I don’t even know said Laura's video changed her life. I know exactly how she feels because It changed families too. Thank you to everyone at Teach Me To Talk."


"Good Morning Laura,
I received your book (The Autism Workbook) yesterday and it is absolutely amazing! As I evaluate young children (0-3) for developmental delays and write plans for them with their parents, there are a ton of ideas that are ready to use. Others that reinforce what I have been doing, and saying, all along. Thank you so, so much for writing this incredible book and pulling everything together in one place!"


"Thank you very much for sharing your knowledge, experience, and guidance.
I’m a parent who bought the autism workbook and it’s the only clear resource I found to make a change in my son. I’m really thankful to Ms. Laura for helping out people like us all over the world."

"Laura Mize, all I have to say is that ALL YOUR STRATEGIES WORK."

ANNE, YouTube viewer

"We have 7 SLPs in our preschool (public) program for special needs children (ages 3-5) and we use your courses, books, and techniques every day! :-) We have seen our preschoolers make such great gains!"


"I just received Teach Me to Play With You, and it is ALREADY WORKING! WOW!

Girl…my son is 3 years old, and he NEVER asks for something using words. We were playing “Get Your Belly” (from Teach Me to Play WITH You), and after several times, he laughed and screamed "BEWIEEE!!!"  It was a hoot. And I can't believe he said it! I have played with him like this before, but this time I took your advice and acted CRAZY!! I will act like a total lunatic if it will get him to talk to me!  Now I can give him "the look" from across the room, and he will say it. That manual is so amazingly practical, and it is a GODSEND right now! Thank you SO MUCH!”

"I wanted to send you a quick email to say thank you. I started watching your videos/podcasts about 4 months ago. My son has gone from losing words he previously used, only having about 7 words at his 2 year check up in August (assessed at a blended 10 month language level) -- to now having so many words, increased social engagement, following commands, spontaneously requesting things, and naming letters & numbers (not in order) as well as colors. We had our monthly meeting with our SLP through the state infants & toddlers program and it felt like we were just bragging the whole time, but I knew in the back of my head it was because I have been using strategies you taught me.

We still have so much work to do with our sweet boy, but I know in my heart he would not have succeeded without the education you provided. I will continue to read your emails & watch videos as we go along this journey and face challenges, but credit is due to you, Laura.

Thank you so much, endlessly."


"I just want to tell how fortunate I feel to have found your website and you!! I became a special instructor in EI almost a year ago and I started with hardly any applicable training. I felt so lost and confused as how to help the kids I work with learn how to use words and play. Honestly, I didn't even understand the importance of play, although I always played with my kids. But, once I started to watch your podcasts and get some of your manuals I felt a weight had been lifted off my shoulders and that I could finally teach these kids and their families something of value from a real therapist and based on research!. Thank you so much for seeing the need to help other EI service providers and providing a forum to share your knowledge and years of valuable experience. I'm sure you get a lot of these emails every week if not every day, but I wanted to make I could add to those notes of gratitude!! THANK YOU again!!"


"Just wanted to say a HUGE thank you for these emails and your books, I have them all and they have seriously saved and improved my sessions with my kiddos. Huge thank you."


"I was very frustrated with how speech therapy was going for my child. I would take him and drop him off and not hear much of anything from his therapist and teachers other than, "He had a good (or a bad!) day." Your materials were invaluable for us because I learned how to work with him on his speech. I learned how to teach him to talk and play. I learned how to pay attention to his cues and work with him to teach him to communicate. Without it, I have no doubt he still wouldn’t talk."


"Hi! I just wanted to say (from an SLT perspective) how incredibly useful I am finding absolutely all of your articles, blogs and resources - I only discovered your site last month and have just received all your books which I feel I am learning more than on my entire university training course!! But also the way in which you give specific, realistic, fun, encouraging ideas for working with parents is really just fantastic, I only wish I have your site sooner! Thanks so much from the UK! Kind regards."


"I just wanted to reach out to say thank you for making things a little easier to manage for me this year. I made the transition from school SLP to private therapist about a year ago. While the change was welcome, it was a lot, and I was just getting my footing in the clinic when I began teletherapy full time. Your website has been a huge lifeline in helping me work with late talkers and coach their parents in an accessible but effective way, even remotely. I look forward to getting your emails each week. I am floored by the amount of valuable, free information that your website provides, and I’m looking forward to investing in your workbooks soon. A sincere thank you for all you do!"


"You are an inspiration! I am truly grateful for the way you put into words and writing how to do what we do as SLPs. At this time in my 13 years of practicing, I find your encouragement keeps me going. As a single mom, I find it a stretch to buy materials these days and I am so thankful for the freebies you so generously share that help me teach my families. I don’t have much time to put together lists or quick references for parents!! Much gratitude!!"


"I just really appreciate your courses! I have two new clinicians that I’m working with and have recommended these courses to both of them. I’ve watched quite a few and have learned so much about serving this population. To be honest, before I started implementing your strategies I was a little frustrated with the lack of progress. My skills with engaging these little ones have improved so much! Thank you so much for making these CEUs so valuable!" C, SLP