Feldman HM: Evaluation and management of language and speech disorders in preschool children. Pediatr Rev 2005:26(4):131-40.
This article defines language, looks at epidemiology of disorders, the normal language and speech development to 5 years of age, detection and causes of delay, and evaluation, management, and prognosis for delays. Normal language develops effortlessly from interest in human voices to producing melodic vowel sounds, adding consonants, and using verbal cues for practiced routines. The 2-year-old's vocabulary reaches 30 to 60 words and they learn three to four new words per day. When language is delayed, assessment needs to look for a cause: environmental, organic, hearing loss, global delays, autism, or other syndromes. Generally, language and speech delays that are treated early and appropriately will improve over time, but it is not a simple process. This delay is a chronic special healthcare issue and requires meaningful, long-term care involving the family and the child.
Depending on the reason for delay, interventions need to help the child communicate, make speech sounds if possible, use environmental and behavioral approaches, employ a range of techniques, and occasionally use medications. These children are at risk for developmental, academic, and psychiatric disorders if they cannot communicate.