Speech and language development disorders

Photo of a mother and child with a book

Speech development disorders are often noticeable when the child is still an infant. Children with these types of disorders can be given speech therapy and special support to deal with day-to-day life. The problems then often improve.

About 8% of all children have a speech development disorder. This kind of developmental disorder is roughly twice as common in boys as it is in girls. Some of the children who have a disorder also develop reading and writing difficulties.

Problems with speaking often become noticeable at the age of two to three years. But at that age it’s not yet possible to tell whether a child actually has a speech development disorder or whether they’re just developing a little slowly. There can be huge differences within this age group. At two years, children who are late talkers have a smaller spoken vocabulary than most of their peers, but around half of them catch up by the time they turn three. The rest develop a speech development disorder.

What forms do speech development disorders take?

A child who has a speech development disorder has trouble expressing themselves verbally or understanding others. Speech development disorders can be grouped into:

  • Problems expressing things in spoken language (expressive language disorder): The child takes a lot longer than others to learn to talk or has a small vocabulary. Words are left out or the wrong words for things are used. They might make significant grammar mistakes (mixing up the parts of a sentence, for instance) or find it difficult to express things properly. Many of these children also have problems making specific sounds.
  • Problems understanding spoken language (receptive language disorder): The child has trouble understanding what others say to them. This can result in them not following simple instructions or not reacting in the right way.

The expressive and receptive language skills of children who have a speech development disorder are significantly lower than what would be expected of a child of that age.

What are the potential consequences?

Over time, these speech problems can improve or disappear completely, especially if they involve pronunciation. Speech issues that persist into adulthood can have a long-term impact. This is particularly true of problems with understanding speech.

Lots of children have low self-esteem and anxiety due to their problems with spoken language. They might also be teased or suffer from stress.

Speech development disorders can increase the risk of reading and writing disorders. In addition, children who have trouble understanding information in spoken form find learning in general more difficult. As well as causing problems in language-related subjects, difficulties can occur in other subjects too. For instance, it’s impossible to answer a math question if you can’t actually understand the question. Learning difficulties can result in the child leaving school with a poor qualification and being restricted when it comes to job choices.

How are speech development disorders diagnosed?

In Germany, the child development check-ups carried out by pediatricians or family doctors can point to a possible disorder. The doctor starts by asking the parents about the child's speech development. This is followed by general speech tests and then additional language tests as needed to check things like pronunciation and how the child uses and understands words and sentences.

But an abnormal result on its own is not enough to provide a reliable . This is because the child might just be learning speech at a lower pace than their peers or they might not have cooperated properly in the speech tests due to nervousness. Children from immigrant families also tend to do worse in speech tests that aren’t conducted in their own mother tongue.

Additional tests are needed to tell whether the child has a speech development disorder. These examinations are mostly performed by specialists for speech and voice disorders or hearing disorders in children and sometimes by speech therapists.

As well as assessing the child’s speech development, the doctors assess their mental and emotional development. They also test the child’s hearing because speech problems can sometimes be caused by hearing problems that have gone undetected.

Usually, it’s not possible to diagnose a speech development disorder reliably until the child has turned three.

What forms of treatment and support are available?

The following forms of support are available for children with speech development disorders:

  • Speech training – at home or at kindergarten, for instance: Good ways to help the child’s language development include regular conversation, and singing with and reading aloud to the child. A lot of kindergartens also offer special speech training programs.
  • Speech therapy: This usually involves the child doing age-specific exercises once to twice a week to practice aspects such as pronunciation, breathing, using their voice, expanding vocabulary, sentence formation and grammar. There are also language perception exercises to practice things like hearing the difference between certain sounds. The child is meant to be encouraged so that they become more confident in their own abilities.

In addition, it’s important that parents seek advice on the best way to deal with the child’s impairments and offer support. The child might also need psychological help or psychological therapy to cope with problems in day care or at school. This type of support is especially useful if the child also has behavioral or mental health problems.

Berufsverband Deutscher Psychologinnen und Psychologen (BDP), Bundesarbeitsgemeinschaft Selbsthilfe von Menschen mit Behinderung und chronischer Erkrankung und ihren Angehörigen (BAG-Selbsthilfe), Deutsche Gesellschaft für Kinder- und Jugendmedizin (DGKJ). Diagnostik von Sprachentwicklungsstörungen (SES), unter Berücksichtigung umschriebener Sprachentwicklungsstörungen (USES). (Interdisziplinäre S2k-Leitlinie, in Überarbeitung) AWMF-Registernr.: 049-006. 2022.

Deutsche Gesellschaft für Phoniatrie und Pädaudiologie (DGPP). Therapie von Sprachentwicklungsstörungen (S3-Leitlinie). 2022.

Schlack HG, Esser G. Umschriebene Entwicklungsstörungen. In: Schlack HG, Kries R (Ed). Sozialpädiatrie. Berlin: Springer 2009. P. 157-187.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on August 30, 2023

Next planned update: 2026


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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