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Expressive language delay ("late talking") in young children

Laura Sices, MD, MS
Marilyn Augustyn, MD
Section Editor
Carolyn Bridgemohan, MD
Deputy Editor
Mary M Torchia, MD


An overview of expressive language delay ("late talking") in young children is presented below. The etiology, evaluation, and treatment of speech and language disorders in children are discussed separately. (See "Etiology of speech and language disorders in children" and "Evaluation and treatment of speech and language disorders in children".)


The development of communication and language skills is one of the most important tasks of early childhood. It is the key to early learning and social skills.

Primary care providers will see many infants and preschool-age children whose early expressive language development and communication skills do not appear to be progressing as expected ("late talkers"). Receptive language delays often coexist with expressive delays but may not be suspected by the clinician or parents until the child is older. (See 'Prevalence' below and 'Cautions' below.)

Some children with expressive language delay "catch up" during the preschool years ("late bloomers"), whereas others have persistent delay (see 'Natural history' below). Early evaluation can help to correctly identify late-talking children who will benefit from intervention and/or additional evaluation. The developmental, psychosocial, and family histories are particularly important. Most children with language delays have no associated medical or physical findings, but the absence of such findings should not delay referral for functional evaluation of suspected delay. (See 'Primary care evaluation' below.)

There is no universally accepted definition of "delay" in developmental conditions, and different definitions may be used for research and treatment purposes (see 'Definitions' below). Specific program eligibility requirements should not discourage clinicians from identifying children with delays, although they may affect how information about such conditions is communicated to families. Even if the child does not qualify for services, awareness of a delay can lead to closer monitoring and provision of information to parents about ways to promote early language skills (see 'Prevention' below). All families of late-talking children benefit from guidance and close monitoring of their child's early communication development. The provision of appropriate supportive services and accommodations can help children with language delay achieve their full developmental and academic potential. (See 'Management' below and 'Prognosis' below.)

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Literature review current through: Nov 2017. | This topic last updated: Mar 24, 2017.
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