What Causes Speech Delays? 8 Clear Reasons You Absolutely Need to Know

It’s 10pm—the kitchen is clean, your sweet toddler is finally asleep, and you’re Googling, what causes speech delays?

Your child’s not talking yet. Maybe they say a few words, but they haven’t been picking up new words in the way you’d expect. You’re starting to wonder if something’s wrong—or if you’re doing something wrong.

You deserve clear answers—and real ways to support your child in the meantime.

In this post, we’ll walk through:

• The most common causes of speech delays

• Myths about speech delays you should avoid

• Easy, powerful steps to support your child now

When your child’s not talking, all of the waiting and wondering can feel really unsettling. If this is how you’re feeling, know that you’re not alone- many of the parents I work with in early intervention feel this way.

That’s why I started creating music for speech therapy that weaves in the strategies we use everyday in early intervention. I created First Words Dance Party® as a way for parents to support language through speech therapy songs kids love, even while waiting for evaluations or answers.

You can download a free guide to discover 5 easy, parent-friendly steps to use music for speech therapy at home to spark connection and communication with your child. As a bonus, you’ll receive song boards with cards for every First Words Dance Party®  song, so your child can make choices and discover the power of their voice.

Now on to answer your question: what are the causes of speech delays?

What are childhood speech delays, exactly?

Before we talk about what causes speech delays, it helps to understand what a speech delay actually is.

A speech delay means a child is developing speech and language skills at a slower rate than their peers. It might show up in different ways in the infant and toddler years, like:

• limited or delayed babbling in infancy

• using limited consonant-vowel combinations within babbling (like ba, da, ma, wa, sa, etc.)

• saying fewer than 10 words by 18 months

• saying fewer than 50 words by 24 months

• Not combining words together by 24 months

You can check out The American Speech-Language-Hearing Association’s milestone checklists here to see what the milestones are for your child’s age in months.

Why learning to talk is so complex

Before we dive into what causes speech delays,  it’s very helpful to understand all the skills involved in learning to talk. Children can struggle with any or all of these aspects.

For a toddler to say even one word, their brain, body, and environment have to line up just right:

• They need to hear and understand the word

• Know when and why to use it

• Plan how to coordinate the different articulators, or body parts, necessary for speech (the lips, tongue, teeth, etc.)

• Coordinate their breath and voice

• Be engaged enough with others to communicate

That’s a hefty list! There are so many contributing factors toward speech delays.

What causes a speech delay? 8 common reasons

When a child is very young, it’s often hard to know the exact causes of speech delay. As a child continues to age and more is known about their strengths, struggles, and rate of progress, a specific cause usually becomes clearer over time.

Oftentimes, additional diagnostic information from medical specialties, like an autism evaluation, genetic testing, audiology evaluation, ENT (Ear, Nose, and Throat) consultation, etc. can also point toward a cause.

Here are 8 of the most common causes of speech delays.

1. Developmental Language Disorders (DLD) are one of the most common causes of speech delays.

This is a category of language-based learning differences that affect how a child understands and uses language. DLD is more common than most people realize—affecting roughly 1 in 14 children—but often goes undiagnosed in early childhood. 

With support, children with DLD can make steady progress over time. Different types of developmental language disorders can include: receptive language disorder, expressive language disorder, and mixed receptive-expressive language disorder. 

You may also hear the terms language impairment or simply language disorder. These all refer to the same thing.

2. Hearing loss and chronic ear infections are sometimes what causes speech delays.

Children need consistent access to sound in order to develop speech and language. Even mild or temporary hearing loss—like from frequent ear infections—can interfere with how they hear and process speech sounds. 

Because hearing loss is the most common birth defect, universal newborn hearing screening typically happens in the hospital after a baby is born. However, children can still develop hearing loss during the infant and toddler years.

This is usually due to chronic fluid and inflammation (otitis media) in the middle ear that interferes with hearing. Fluid may or may not become infected. When fluid does become infected, that’s when an ear infection occurs.

While a pediatrician can look in your child’s ear with an otoscope to see if there are signs of infection, the fluid that sits in the middle ear is actually on the other side of the eardrum.

In other words, the actual fluid itself isn’t something that can be seen in the doctor’s office. Only signs of an infection, like a red or pink swollen eardrum with effusion on it, can be seen in the doctor's office. 

If your child has had chronic ear infections, an audiology/ENT exam is a very wise idea. An audiology evaluation will indicate your child’s hearing thresholds, so that you can rule hearing loss in or out. Then, your child’s Ear, Nose, and Throat doctor will perform a physical exam and consult with you about next steps.

For more on otitis media and its role as a common cause of speech delays, check out this article from ASHA.

3. Autism spectrum disorder (ASD) is another one of the most common causes of speech delay.

Many autistic children develop speech and language differently. Some autistic children speak very well, but struggle with aspects of social language.

Some may use very few words. Others may echo phrases (called echolalia) or repeat lines from shows or songs. These scripts or gestalts are meaningful —but they don’t always follow the typical developmental path.

Other signs of autism might include:

• Difficulty getting your child to engage with you or imitate you

• Repetitive behaviors or intense interests in a limited number of toys or objects

• Sensory differences, like being in constant motion, being a highly picky eater, etc.

A speech delay can be an early sign of autism, but not all children with speech delays are autistic—and not all autistic children have speech delays. If you’re wondering how to tell the difference between a speech delay and autism, check out this article; it’ll help you make sense of how autism presents in a child as young as yours.

4. Cognitive delays or global developmental delay can be reasons for speech delay

When a child is experiencing delays across two or more areas of development, like play skills, problem-solving, movement, social or self-help skills—speech is often impacted. In these cases:

• Expressive language will likely emerge later than expected

• Children may also have trouble with their receptive language, or understanding of language

• Progress may be slower across multiple areas of development

Global developmental delay is often diagnosed in children under age 5 when more specific diagnoses aren’t yet clear. If you’re wondering how to tell the difference between a speech delay, developmental delay, and autism, check out this article. 

5. Motor speech disorders (like childhood apraxia of speech)

These disorders affect the brain’s ability to plan and coordinate the muscle movements needed for speech. Children with apraxia, for example:

• Often know what they want to say but struggle to get the words out

• May say the same word differently each time

• Often have speech that’s difficult to understand

Motor speech disorders are not the most common cause of delay, but they require specialized assessment and support from a speech-language pathologist.

6. Neurological differences or genetic conditions are causes of speech delay.

Some speech delays are linked to broader differences in how a child’s brain or body is wired. Some of these conditions can include:

• Cerebral palsy, which may affect muscle control for speech

• Genetic syndromes, like Down syndrome, Fragile X syndrome, and Jacobs syndrome, which often impact both articulation (pronunciation) and language development

In these cases, speech delays are often one part of a broader developmental picture—and early intervention can make a big difference.

7. Prematurity or low birth weight can be what causes delay in speech

Babies born prematurely—especially those with very low birth weight—may experience speech and language delays. These children often start out with a different developmental timeline and may reach milestones based on their adjusted age, not their birthdate.

For babies born earlier than 35 weeks gestation, their progress toward reaching milestones should be considered according to their adjusted age (based on due date, not birth date) during the first two years of life. 

According to the American Academy of Pediatrics, most children born prematurely close the gap between their adjusted and chronological age by around 24 months in areas like language, motor skills, and social development.

8. Limited Language Exposure or Interaction are sometimes what causes speech delays

Speech and language develops through interaction and exposure. When children don’t have consistent opportunities for back-and-forth communication, it can impact how quickly they develop speech. This might happen in homes with:

• Chronic stress, instability, or trauma

• Caregiver mental health challenges

This is never about “bad parenting.” I firmly believe that parents are doing the best they can with the support and resources they have under hard circumstances. That’s why it’s so important for early interventionists like myself to support and empower parents and caregivers in a coaching model.

Myths about what causes speech delays in children

When you’re worried about your child’s speech, it’s easy to fall down internet rabbit holes that leave you feeling confused—or worse, blamed. Let’s clear up a few common misconceptions so you can focus on what actually matters.

Myth 1: Screen Time 

Excessive screen time can limit opportunities for back-and-forth interaction, which is crucial for language growth. It can also lead to issues with attention and emotional regulation—but it doesn’t cause a speech delay on its own. 

What matters most is balance and engagement: children learn best when language is shared with real people in real time. It can be hard to strike a balance nowadays.

This Media Use Plan is an awesome resource you can use to decide what priorities you want to set for your family- because your media priorities might look different from your friend’s or sister’s.

Myth 2: Parenting. When you’re wondering what causes speech delay, know that it isn’t you.

Parents often shoulder unnecessary guilt here. While responsive interaction is essential for language development, a lack of constant narration doesn’t cause a delay. 

Yes, reading, play, and talking with your child build a solid foundation of natural modeling and opportunities for speech and language- but you can be doing these things all perfectly and your child could still have a speech delay.

You are not the cause of your child's speech delay. And you're doing your best.

Myth 3: Bilingualism or Multilingualism is not what causes speech delays

I work with many parents who fear that they are confusing their child by speaking in a home language as well as English- but fear not. You are giving your child a gift by exposing them to two languages. 

Raising your child in a bilingual (or multilingual) home does not cause speech delays.

Children learning more than one language might start talking a bit later or mix languages at first—but that’s part of the process, not a problem. They’re building two language systems at once, and they’ll sort them out with time.

If a child has a true speech delay, it will show up in all languages they’re learning—not just one.

Myth 4: They’re too shy or introverted. Speech delay causes do not include personality traits.

Some babies are naturally quieter, slower to warm, or more observant. While those are examples of temperament and personality, they are not reasons for speech delays. 

A shy or slow to warm toddler might be quieter in general, but they will still demonstrate skills expected for their age.They’ll just be most likely to use those skills in the environments in which they are most comfortable.

Myth 5: They’re Being Stubborn or Lazy.

Of all of the myths about what causes speech delays, this is the one I dislike the most.

Children don’t choose to refuse to talk. When they don’t talk, it is because there is something about speech that is hard for them, and they can’t…yet. 

But when they can talk, they will. Because when kids can, they do!

Framing a speech delay as a choice misses the real issue. It turns it into a judgement on the child, rather than an opportunity to understand them and teach to their strengths and challenges.

What to do if you’re concerned about a speech delay 

If you’ve made it this far, you probably see some of your child’s story reflected in what we’ve covered. That can feel both validating and overwhelming. The good news is: there are meaningful steps you can take—and starting early matters.

1. Trust your gut

You know your child best. If something feels “off” or you’ve been worrying for a while, it’s good to act upon it. You don’t need to wait for a certain age or a pediatrician to bring it up before seeking answers.

2. Rule out hearing loss as a cause of speech delay with a simple audiology visit

Hearing is the foundation for speech. Unlike other potential speech delay causes, hearing loss can be ruled in or out pretty clearly.

Even if your child passed their newborn screen, things can change. A pediatric audiologist can run a quick, child-friendly test to rule out hearing loss or fluid issues that might be affecting speech. 

3. Talk to your pediatrician or primary care provider 

Share your observations clearly—include examples of how they typically respond (or don’t respond) when you play, read, or enjoy a snack together and any regressions you’ve noticed. Ask for a referral for speech therapy or your local early intervention program if your child is under 3.

4. Make a referral to your local early intervention program (for ages 0–3)

In the U.S., early intervention services are free or low-cost, and you don’t need a doctor’s referral to get started. If your child qualifies, a team can help support speech, language, and overall development in your home environment.

Different states run their early intervention programs differently; it can be through the county, the school district, or a different local education agency. This list from the CDC gives the contact information for each state, so you can get a referral started at little or no cost.

5. Create a language-rich environment at home

While you wait for appointments or services to start, small daily moments can make a huge difference when you know what strategies to use for your late talker. This article is full of easy ways to create a language-rich environment that gives your child plenty of opportunities for communication.

6. Use music as a powerful support to empower you AND your child

Music is a deeply effective way to support speech and language. Research shows that music and language share overlapping areas in the brain. The rhythm, repetition, and melody of songs help children process and remember language, while also building engagement and shared joy. 

These aspects are what make music such a golden strategy for autism spectrum disorder, motor speech disorders, cognitive delays, and any other cause of speech delay.

That’s exactly why I created First Words Dance Party®, fun, catchy, original songs written specifically to support early communication for children with speech delays. Each lyric is crafted with speech and language strategies behind it, giving parents a simple, engaging way to encourage language. 

Speech Therapy Songs for Speech Delays

These songs were born out of my work in early intervention—they’re designed to be both fun and functional. Regardless of the reason for your child's speech delay, the different strategies woven into these songs will help you and your child.

You’ll hear phrases like “help me,” “shoes on,” “my turn,” and “open please”—the kinds of words that carry over seamlessly into real life. And they’re fun and easy on the ears, so you’ll enjoy listening and singing along.

Here are a few examples:

• The Cookie Song: This kid favorite targets the core words yes and no, along with the words eat, want, what, doggie, and of course, cookie! This one is perfect for kids who aren’t yet gesturing or saying yes and no.

• Ready, Set, Go: This one uses a powerful strategy, called an anticipatory set, to promote engagement. It targets the opposite pair stop and go, along with the words push, pull, bubbles, uh-oh, oh no, more, and I. 

• It’s a Dance Party: Another kid favorite, this one teaches the names of body parts- llke eyes, nose, ears, hands, and feet. It also targets the words up and down, with plenty of functional examples in the lyrics (like clean up, pick me up, get down, slide down, etc.)

You can stream First Words Dance Party on Spotify, YouTube Music, Apple Music, and anywhere else you get your music.

If you’ve ever felt the weight of trying to support your child’s speech progress at home—wondering “Where do I even start?” or feeling like the things you have tried just haven’t been successful—you’re absolutely not alone. Trying to navigate speech therapy home activities that feel meaningful and manageable (rather than another exhausting to‑do) can leave you drained, second‑guessing, and wishing for something simpler.

That’s where the Homeschool Speech Therapy Handbook comes in. Designed specifically for parents (not trained therapists) who want real‑life tools, this guide breaks down exactly what to do, why it works, and how to bring speech‑therapy practice into everyday moments—snack time, bath time, play time—without turning your home into a clinic.

Framed within a song-by-song breakdown of the Speak up and Dance album, you’ll discover how to apply the strategies within each song to real life for easy speech therapy practice at home. You’ll move from feeling overwhelmed and unsure to feeling confident and connected—watching your child engage, communicate, and grow in ways that feel easy and natural.

Final thoughts for parents wondering, “What are the causes of speech delays?”

When you’re wondering, Am I doing enough?...Am I doing something wrong?, know that you are not the cause of your child’s speech delay.

I’ve walked alongside so many parents in that same space. The waiting. The not-knowing. The mix of love, fear, and fierce determination to help their child find their voice. Your concerns are real, and your willingness to ask hard questions is already a powerful first step.

The truth is, speech delays have many possible causes—but there are also many ways to support your child. With early action, connection-based strategies, and the right information, real progress happens- and it starts with the everyday moments you share together.

Ready to trade the tears and frustration for smiles, giggles, and communication growth? Don’t forget to grab your free 5 Easy Steps to Kickstart Communication with Music for Speech Therapy at Home.

It’s time for your child to discover the power of their voice. Imagine the feeling when your child sings a new word they’ve never said before or points to a picture of their favorite song to make a choice. Those small moments build into something bigger.

You don’t have to have the answers now; you just need to take the next right step. I hope this has given you the encouragement and knowledge to go from “What causes speech delays?” to “I have a plan to help my child with their speech delay.”

FAQs: What are the causes of speech delay?

What is a speech delay?

A speech delay means a child is developing speech skills in the typical order but at a slower pace than expected for their age. This might look like using fewer words than expected for their age or using shorter, less complex phrases. 

What causes speech delays in toddlers?

Toddlers are so young that the exact cause is often not immediately clear. Over time, certain medical conditions and diagnoses can be ruled in or out, like hearing loss/chronic ear infections, genetic syndromes or neurological differences, and autism spectrum disorder. 

In addition to these, other common causes of speech delays include: developmental language disorders, cognitive delays/global developmental delays, limited language exposure, and motor speech disorders. Some causes, like prematurity, low birth weight, and birth trauma are known early on in a child’s life.

At what age is speech considered delayed?

Speech and language milestones are specific to a child’s age in months. These are based on years of research, In general:

• By 12 months, children are babbling many different consonant vowel chains (babababa, mamamama). A child’s first word (a word in addition to mama and/or dada) usually appears right around their first birthday.

• By 18 months, children are using between 10-50 words and imitating new words consistently. While this is a big range, a speech delay is often first identified between the ages of 15-18 months. This is typically a time of rapid speech and language growth, so when a toddler is not consistently adding new words during this time, their speech can be considered to be delayed.

• By 24 months, children use over 50 words and combine them into all kinds of different combinations. They use words to name objects, foods, and people, but they also use action words (like eat and ride), descriptive words (like hot and cold), and other words like mine or my to put together all kinds of two-word phrases.

Should an 18-month-old be talking?

Yes! While 18 month olds don’t typically use phrases yet, they use single words to ask for things and to interact with others. It’s a time of rapid growth.

While 18 month olds typically say between 10-50 words, the time between 18-24 months consists of exponential growth. Some variation is absolutely normal (that’s why it’s such a wide range of 10-50 words). If your child isn’t using at least ten words at 18 months or steadily adding new ones, it’s a good idea to pursue early intervention.

How can I get my 18-month-old to talk?

The best way to encourage language with this age is through responsive interaction: 

• get down at your child’s level for play, books, etc. so you can try to be face to face whenever possible 

• talk about what they’re doing with simple 1-3 word phrases, 

• don’t stress about teaching colors or shapes right now; instead model functional words like open, close, up, down, in, out, eat, drink, more, all done, etc. These words will be much more beneficial for them to understand and say across their day.

• pause to give them a turn to respond after you model a word. You can do this when reading a familiar book, singing a song, playing with a favorite toy, etc.

Can too much screen time cause speech delay?

Too much passive screen time can limit opportunities for real interaction, which is essential for speech development—but screen time itself doesn’t cause speech delays.

What matters most is how much opportunity your child has for back-and-forth communication during their day. Interactive time with caregivers is key, and screentime is a one-sided, passive activity. Children learn language most effectively when they are actively engaged with the objects and people in their environment.

How long do speech delays last?

It depends on the cause and the support a child receives. Some children catch up within a few months to a year, while others may need speech therapy over a longer period.

We just don’t have a good way of knowing which kids will truly just be late talkers, and which kids will need the early support from skilled professionals to make progress. That’s why early identification and intervention give children the best chance to make strong, lasting progress.

What is the most common cause of speech delay?

There isn’t one single cause, but three of the most frequent are developmental language disorder (DLD), autism spectrum disorder, and hearing issues, such as chronic ear infections. All are highly treatable with early intervention and support from skilled professionals.

That’s why it so important to pursue an evaluation earlier rather than later, so you don’t lose valuable time that could make all the difference for your child.

With some children, we never determine exactly what causes speech delays- but we do know that early support makes a world of difference.