Toddler of few words? Late-talkers can catch up

Anxious parents of toddlers who start talking late can relax, at least a little.

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Australian researchers found that late-talking children were no more at risk for behavioral and emotional problems when they grew up than toddlers who were more expressive.

As a result, the best course for parents may be to take a “wait-and-see” approach to late-talking toddlers who are acting out as a result of their frustration with communication difficulties, the researchers concluded.

“When late-talking children catch up to normal language milestones — which the majority of children do — the behavioral and emotional problems are no longer apparent,” said lead author Andrew J.O. Whitehouse, an associate professor at the Telethon Institute for Child Health Research at the University of Western Australia in Perth. The study followed almost 1,400 children who were born between 1989 and 1991, from ages 2 to 17.

While parents of late-talking toddlers may feel reassured by the study, they should not ignore the language delays too long, child development experts warned. Between ages 3 to 5 is the best time to intervene with developmental problems and while most kids seem to catch up on their own, some do not.

"What [the researchers] are saying — that you don’t have to worry about this — is worrisome to me," said Maxine K. Orringer, a speech-language pathologist and coordinator of the department of audiology and speech pathology at the Children’s Hospital of Pittsburgh. "I don’t think parents need to be frightened by delays, but the earlier we can get in and identify the problem and resolve it, the better. The brain is just more malleable when children are young."

For the new study, parents were asked about their children’s language skills six times — starting at age 2 and ending at 17. The parents also filled out questionnaires designed to ferret out behavioral and emotional problems.

“Two years of age is really the earliest reliable opportunity we have to assess whether a child’s language is developing normally,” Whitehouse said. “At around 2 years of age, children are likely to have an expressive vocabulary of about 50 words and are able to string together two and three words in a phrase. Between 7 and 18 percent of toddlers don’t meet this benchmark.”

TODAY Moms: Was your child a late-talker?

Whitehouse and his colleagues compared 142 late-talking children who had no other developmental delay to 1,245 others who were on track with language skills. The researchers found that late-talking children tended to exhibit behavioral and emotional issues when they were younger, but these problems diminished as the children grew to be more proficient speakers.

Experts lauded the researchers for studying such a large group of children over such a long period of time. “In many ways, it’s a very impressive study,” said pediatric psychologist Jerilynn Radcliffe of the Perelman School of Medicine at the University of Pennsylvania and the Children’s Hospital of Philadelphia.

Still, Radcliffe noted flaws in the research — most importantly, that the study excluded children who were diagnosed by age 17 with a developmental or intellectual disability. "These are the ones you want to know about," she said.

Another problem is that the study does not address how many late-talkers got help as they were growing up, making it unclear whether some kind of intervention helped improve their behavior and language skills.

"I have done a lot of evaluations of preschool children with language delays and followed them over time to see how they turned out," Radcliffe said. "Some were fine; some had just speech and language delays; and some had full-fledged developmental delay, a broad-based intellectual disability."

Pediatrician Dr. Carlos Lerner, an assistant professor at the UCLA Medical Center and medical director of the UCLA Children’s Health Center, said parents of children with delayed speech should feel encouraged by the study, but cautioned, "I wouldn’t be as dismissive of those delays."

Parents can help improve their children's speech by restricting TV and spending more time talking and reading to their kids, Lerner said.

"Some of the interventions we advocate we want to encourage for a variety of other reasons,” he said. “These are low-cost interventions."

For Orringer, intervention for toddlers is often mostly about educating the parents on how to help their kids.

“Some parents instinctively know what to do for their children, but don’t know how far they can push without creating a behavioral problem," Orringer said.