What to do when your toddler doesn’t talk

*Boys tend to develop a little later than girls.

*Children who are communicating with non-verbal sounds and actions and who clearly understand you are usually fine.

*More than half of cases of language delay in children under-3 resolve of their own accord.

*Children with much older siblings are often later to talk – because there’s someone to talk for them!

While the general message is not to worry, speech difficulties are on the increase. Verbal communication problems are now the most common developmental disorder in children and affect 14% to 20% of pre-schoolers. The National Literacy Trust – which runs a Talk to Your Baby campaign – says that most nursery and school heads think language competency in 3-year-olds has declined in recent years.

They put the increase largely down to three things:

*Children watching television unsupervised for longer hours.

*Modern buggies, which usually face the child away from the parent, so there’s no eye contact and little opportunity for conversation.

*Busy parents pre-empting their children’s needs or answers - for instance asking rhetorical questions like, "You want juice rather than milk, don’t you?" which requires only a one-word answer from the child.

These and related behavioural causes account for about 60% of cases of language delay, but in the remaining 40% the reason can be more profound. However, only one in 10 children suffer delayed speech because of a significant physical or developmental problem.

These can include:

*Acquired hearing loss (as a result of infection, disease or injury).

*A learning difficulty such as dyslexia, autism.

*Childhood apraxia of speech (a nervous system disorder).

*Some form of neural impairment.

In these cases, early detection and intervention is crucial so that your child can avoid further social and emotional problems.

Getting help if you’re worried about your toddler's speech development

There’s plenty the health service can do to help if you notify them of your concerns.

First of all, speak to your health visitor - but if your child is under 2 years, don’t be surprised if you’re told that language delay is normal.

If your child’s problem is thought to merit further investigation, you’ll be referred for clinical help. There will probably be a waiting list and if your child’s condition resolves you can always take yourself off it.

If he goes forward for treatment, the healthcare team will probably include a GP, speech and language therapist, audiologist, psychologist, occupational therapist and social worker.

Tests will probably be carried out to ascertain the severity of the situation, as well as the underlying cause. Your child should be treated individually, helping him to find strategies for understanding language and communicating, even if that doesn’t include the spoken word. Whether or not his problem can be treated successfully depends on the severity and nature of the condition. But the sooner you have the problem diagnosed, the better.

Helping your child learn to talk

Whether or not your child’s speech delay is down to environmental or physical causes, there’s a lot you can do at home or when out and about to stimulate his development:

*Spend as much time as possible talking, reading and singing with your child. As well as increasing his vocabulary, this will increase his confidence, which is a crucial part of communication.

*Keep TV time to a minimum. Even so-called ‘educational’ programmes deprive your child of interactive verbal play and make the communication all one-way.

*If your child has tantrums caused by frustration over his limited communicative abilities, be sympathetic – and talk to him about what he’s wanting or trying to say.

*Sing songs – to yourself and to your child, who will soon join in. Singing is an excellent stimulus to talking, especially if it involves rhymes, repetitions and actions.

*Applaud your child’s attempts to talk, however fumbling, in order to develop his verbal confidence.

*Give a running commentary on what you’re doing, even if it’s just washing up.

*Read books – take one in your bag whenever you go out, for quiet moments in the café, waiting at the school gates or on the bus.

*Make sounds when playing, like “choo choo” when playing with a train.

For more info

*Visit I CAN - it provides a combination of specialist therapy and education for children with communication disabilities.

*Visit Afasic (Association for All Speech Impaired Children) or call the helpline on 0845 355 5577.

Mums' stories

Jules Murray, 32, realised that her 4-year-old, Grace, had a speech problem when she was 2.

"At 18 months, Grace started trying to talk, using phrases instead of words, which just sounded like nonsense. It’s heartbreaking to see Grace torn apart by not being able to speak. Outsiders think she’s naughty, but she’s just desperate to communicate and breaks down when she can’t.

"I self-referred Grace for speech therapy at two-and-a-half. We’re still waiting for a concrete diagnosis and with periods of up to six months between appointments, it can be incredibly frustrating to cope with."

Natalie Reid, 35, is mum to Morgan, 13, Isabella, 10, and Mabel, 2.

"When Isabella was 2, she grunted, pointed and only said, 'Mum'. People asked if I read and talked to her enough, making me feel it was my fault. When she started nursery, I was worried. I had visions of her wetting herself because the staff wouldn’t know she needed the loo!

"After a month at nursery, things began to change dramatically. Isabella started using more individual words, and by the time she was 3 she moved on to sentences. At 4, she was at the same stage as her peers. The problem had completely rectified itself. So even though Mabel isn’t speaking yet, I’m not worried at all."