Help with Speech Delay

"Children are not excluded or singled out, but all children and their families are able to get speech and language training," Cowan says.


It is part of a "natural environments" approach – allowing children with special needs to receive services while interacting with their typically developing peers in community settings – that Cowan has been championing for a decade. A services provider for the Golden Gate Regional Center, she also works with Bayshore Preschool in Daly City, Head Start in South San Francisco and Starlight Preschool in San Francisco. In addition, Cowan offers free speech screenings at preschools and other community locations, using a "screening RV."


Cowan spoke to Bay Area Parent about how parents can respond to concerns about their children’s developing speech. For more information, visit


Signs of Speech Delay

Around the 18-month mark, if a child is not saying at least 10 to 15 words and is not responding to his name or other sounds consistently. If they’re not gesturing enough – pointing or putting up their hands when they want to be held – or not making eye contact, looking at a parent or teacher in the eye, those can be other red flags.


Children with speech and language delays have fewer words than they should at their age, have difficulty understanding directions or don’t understand questions well or answer appropriately. An adult or another child might have difficulty understanding them. Some of these kids have delayed social skills, tend to play alone or play with the same objects repetitively.

Where can parents go for speech delay help?

What I hear most is that parents mention it to their pediatrician, but pediatricians vary in their expectations for milestones. For children under 3, I suggest contacting (your local) Regional Center directly and requesting an evaluation. It’s free. (Santa Clara County is served by the San Andreas Regional Center. For a list of centers, visit

After age 3, you want to contact your local school district. But it can be a long process to refer yourself. If a school district says your child doesn’t qualify (for services), you can seek another opinion if your gut says otherwise. They follow very specialized guidelines that say speech has to affect the child academically. You can also seek a private speech therapist or check with your medical insurance or pediatrician.


If there’s doubt in parents’ minds at all, it’s vital to get any services the child needs prior to the start of kindergarten. … I think the most frustrating case is a child who really understands a lot but talking-wise may be at a 12- to 15-month level. You can imagine the frustration they have. Children with speech and language delays may hit and throw tantrums, and it can escalate if the speech is not addressed.&pagebreaking&What are the causes of speed delay?

It’s really unknown. There can be hereditary components. Hearing loss can cause speech delays, and some of the stronger diagnoses like autism. Multiple ear infections can be the cause of a speech delay as well.


If you can’t find a specialized preschool or program, what should you do?

I highly recommend socializing with other children and participating in a preschool environment. I believe highly in co-op situations where a parent can participate with their child. Get your speech therapist to communicate with the teacher about what is going on to get this child up to speed.


Janine DeFao is an associate editor at Bay Area Parent.