Editing Language delay (section)

==Presentation and diagnosis==
A language delay is most commonly identified around 18 months of age with an enhanced well-baby visit.<ref name=":1"/> It presents itself in many forms and can be [[Comorbidity|comorbid]] or develop as a result of other [[Developmental disability|developmental delays.]] Language delays act and develop differently individually. Language delay is different than individual variation in language development, and is defined by children falling behind on the timeline for recognized milestones.<ref>{{cite journal | vauthors = Wooles N, Swann J, Hoskison E | title = Speech and language delay in children: a case to learn from | journal = The British Journal of General Practice | volume = 68 | issue = 666 | pages = 47–48 | date = January 2018 | pmid = 29284642 | pmc = 5737311 | doi = 10.3399/bjgp17X694373 }}</ref>

=== Screening ===
Regular appointments with a pediatrician in infancy can help identify signs of language delay. According to the [[American Academy of Pediatrics|American Academy of Pediatrics (AAP)]], formal screening for language delay is recommended at three ages: 9, 18, and 24–30 months. Screening is a two-part process: first, a general developmental screening using tools such as the Parents' Evaluation of Developmental Status or Ages and Stages Questionnaire (ASQ-3); and second, specific screening for autism spectrum disorder using tools like the Modified Checklist for Autism in Toddlers. Not all patients with language delay have autism spectrum disorder, so the AAP recommends both screens to assess for delays in developmental milestones.<ref name=":4">{{Cite journal|last=Feldman|first=Heidi M.|date=2019-08-01|title=How Young Children Learn Language and Speech|url=https://pedsinreview.aappublications.org/content/40/8/398|journal=Pediatrics in Review|language=en|volume=40|issue=8|pages=398–411|doi=10.1542/pir.2017-0325|issn=0191-9601|pmid=31371633|pmc=7236655}}</ref>

However, the [[United States Preventive Services Task Force|US Preventive Services Task Force]] (last updated in 2015) has determined that there is insufficient evidence to recommend screening for language delay in children under the age of 5. Other national panels, including the [[UK National Screening Committee]] and Canadian Task Force for Preventive Health Care, have also concluded that there is limited evidence on the benefits of screening all infants for language delay.<ref>{{Cite journal|last=Jullien|first=Sophie|date=2021-09-08|title=Screening for language and speech delay in children under five years|journal=BMC Pediatrics|volume=21|issue=Suppl 1|page=362|doi=10.1186/s12887-021-02817-7|issn=1471-2431|pmc=8424786|pmid=34496812 |doi-access=free }}</ref>

=== Early signs and symptoms ===
There are several red flags in early infancy and childhood that may indicate a need for evaluation by a pediatrician. For example, language delay can present as a lack of communicative gestures or sounds. Language delay in children is associated with increased difficulty with reading, writing, attention, and/or socialization.<ref name=":023">{{cite journal|vauthors=McLaughlin MR|date=May 2011|title=Speech and language delay in children|url=https://www.aafp.org/afp/2011/0515/p1183.html|journal=American Family Physician|volume=83|issue=10|pages=1183–8|pmid=21568252}}</ref>  In addition, an inability to engage in social exchanges is a sign of language delay at all ages.<ref name=":4" />

Communicative deficits at specific ages and milestones might indicate language delay, including:

* Not smiling at 3 months
* Not turning the head toward sounds at 4 months
* Not laughing or responding to sounds at 6 months
* Not babbling at 9 months
* Not pointing and using gestures at 12 months
* Not producing more than 5 words at 18 months
* Not producing more than 50 words at 24 months
* Losing language and/or social skills after 36 months<ref name=":4" /><ref>{{Cite book|title=The Wiley-Blackwell Handbook of Infant Development|vauthors=Palmer FB, Capute AJ|date=2011-08-02|isbn=9781444351842|veditors=Bremner JG, Wachs TD|volume=2: Applied and Policy Issues|page=266|chapter=The Early Development of Autism Spectrum Disorders|publisher=John Wiley & Sons |chapter-url=https://books.google.com/books?id=CQNUmIoG1ykC&q=%22Language+delay%22+infant+development&pg=PA266}}</ref><ref>{{Cite book|url=https://books.google.com/books?id=ucAZIJUtJY4C&q=%22Language+delay%22+infant+development|title=An Overview of the Development of Infants with Down Syndrome (0-5 Years)|vauthors=Buckley S, Sacks B|year=2001|publisher=DSE Enterprises |isbn=9781903806029}}</ref><ref>{{Cite book|last1=Crocetti|first1=Michael|title=Oski's Essential Pediatrics|last2=Barone|first2=Michael A.|last3=Oski|first3=Frank A.|year=2004|isbn=9780781737708|veditors=Crocetti M, Barone MA, Oski FA|page=120|chapter=The Streams of Development: The Keys to Developmental Assessment|publisher=Lippincott Williams & Wilkins |chapter-url=https://books.google.com/books?id=I3Kh1cNJxyUC&q=%22Language+delay%22+infant+development&pg=PA120}}</ref>

Later in life, important signs include:

* A lack of speech
* An inability to comprehend, process, or understand language presented to the child<ref name=":023" />

===Consequences of language delay===
Language delay is a [[risk factor]] for other types of developmental delay, including social, emotional, and cognitive delay. Language delay can impact behavior, reading and spelling ability, and overall IQ scores. Some children may outgrow deficits in reading and writing while others do not.<ref>{{cite journal|author1=US Preventive Services Task Force|date=February 2006|title=Screening for speech and language delay in preschool children: recommendation statement|journal=Pediatrics|volume=117|issue=2|pages=497–501|doi=10.1542/peds.2005-2766|pmid=16452370|s2cid=41338449}}</ref> Other conditions associated with language delay include [[Attention deficit hyperactivity disorder|attention-deficit/hyperactivity disorder]], [[Autism spectrum|autism spectrum disorder]], and [[social communication disorder]].<ref>{{Cite web|title=Late Language Emergence|url=https://www.asha.org/Practice-Portal/Clinical-Topics/Late-Language-Emergence/|access-date=2021-09-20|website=American Speech-Language-Hearing Association}}</ref>