Between 5% and 12% of children ages 2 to 5 years are diagnosed with a speech or language delay. Fifty percent of these children experience delays that persist into adolescence, and face educational and occupational challenges later in life. The causes of speech and language delay vary. Some children are born with physical or physiologic conditions that impede speech and language development, whereas others have cognitive or developmental conditions, such as autism spectrum disorder. Risk factors include male sex, prematurity, low birth weight, late birth order, larger family size, and maternal intimate partner (ie, domestic) violence. Although there is no required screening or universally recommended screening tool for speech or language delay, reliable milestone indicators and parent and physician questionnaires can help identify children in need of diagnostic evaluation. If further screening is warranted or if parental concern exists beyond the well-child visit, local resources are available for evaluation and intervention. These include agencies and school districts, as well as speech and language pathology subspecialists.
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