Difference Between Speech & Language
Speech and language are often confused,
but there is a distinction between the two:

> Speech is the verbal expression of language and includes articulation, which is the way words are formed.

> Language is much broader and refers to the entire system of expressing and receiving information in a way that's meaningful. It's understanding and being understood through communication - verbal, nonverbal, & written.
Although problems in speech and language differ, they frequently overlap. A child with a language problem may be able to pronounce words well but be unable to put more than two words together. Another child's speech may be difficult to understand, but he or she may use words and phrases to express ideas. And
another child may speak well but have
difficulty following directions.

Warning Signs of a Possible Problem
If you're concerned about your child's speech and language development, there are some things to watch for. An infant who isn't responding to sound or who isn't vocalising is of particular concern.

Between 12 and 24 months, reasons for concern
include a child who:
> isn't using gestures, such as pointing or
   waving bye-bye by 12 months
> prefers gestures over vocalisations to
   communicate by 18 months
> has trouble imitating sounds by 18 months

Seek an evaluation if a child over 2 years old:
> can only imitate speech or actions and doesn't produce words or    phrases spontaneously
> says only certain sounds or words repeatedly and can't use oral    language to communicate more than his or her immediate needs
> can't follow simple directions
> has an unusual tone of voice (such as raspy or nasal sounding)
> is more difficult to understand than expected for his or her age.
   Parents and regular baby-sitters should understand about half of    a child's speech at 2 years and about three quarters at 3 years. By    4 years old, a child should be mostly understood, even by people    who don't know the child.

Causes of Delayed Speech or Language
Many things can cause delays in speech and language development. Speech delays in an otherwise normally developing child are rarely caused by oral impairments, such as problems with the tongue or palate (the roof of the mouth). Being "tongue-tied" (when the frenulum - the fold beneath the tongue - is too tight) is almost never a cause of delayed speech.