Early Age Speech Development in Indian Children: What Research Says

Language and Speech Development
Early Age Speech Development in Indian Children: Research Findings

Developmental problems in the early years are often precursors of problems in later life. Early intervention can facilitate favourable outcomes among children with multiple risks. The high prevalence of speech difficulties in young children underscores the need to target speech delay in the early years, to reduce the likelihood of adverse outcomes and thus optimize chances of improvement.

Speech and language development is one of the most useful pointers of a child’s overall development and intellectual functioning. Parents are most likely to raise speech and language delay concerns in their encounters with primary care clinicians.

Prevalence rates for speech delay have been reported across wide age ranges and samples. For children aged less than 5 years, studies have reported prevalence rates ranging from 2.3% to 19%. [1] Evidence also indicates that untreated speech and language delay in preschool children can persist in 40-60% of the children and these children are at high risk for social, behavioural, emotional, and cognitive problems in the later years of their life. [2]

Most of the studies on language development have been conducted in the developed countries and only a handful of studies from India have examined the prevalence and correlates of language delay in young children.

In a study conducted of neurologic associations and factors related to speech and language delay, researchers examined the medical records of 670 patients, with a mean age of 6.1 years (SD = 4.72), attending the pediatric neurology clinic of a tertiary care hospital over a period of 1 year. Prevalence of speech and language delay was found to be 16.27% and the male to female ratio was 2.76:1. Speech delay was found to be associated with medical disorders such as seizure disorder, ADHD, autism, neonatal resuscitation, and epileptiform EEG with or without clinical seizure activity. [3]

In another study, researchers evaluated 79 parent-child dyads who were seeking well-child pediatric services in the outpatient department of a tertiary care teaching hospital. Children in the age range of 2-5 years with no history of motor or sensory impairment, chronic illness, or perinatal problems were recruited to study the relationship between parents’ concerns and the child’s developmental status. Parental concerns were elicited using a standardized questionnaire, Parents Evaluation of Developmental Status. Expressive language concerns were significantly more likely to be raised by parents of children with delayed development (23%) compared to parents of children with normal development (14%). The researchers concluded that parents’ concerns about expressive and receptive language and gross and fine motor development were moderately sensitive predictors of developmental delay in children between 2 and 5 years. [4]

In another community-level study, researchers assessed 123 pre-school children aged two and a half to five years for developmental status, twenty-one (17%) children showed delayed expressive language functioning. Children with delayed language showed significantly lower scores on tasks that tested attention, memory, reasoning, academics, perception, and concepts. The researchers concluded that language impairment in young children is associated with a broad spectrum of developmental impairments and there is a need for multi-disciplinary developmental surveillance. [5]

Several risk factors such as poverty, male sex, family history of speech and language delay, perinatal risk factors, family discord, family size, social stress, maternal depression, and poor parental education have been found to be associated with greater risk for language delay in children.

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Researchers have also established a linear relationship between cumulative biological and environmental risk factors and the language development of children. These Risk factors are Preterm Birth, Low Birth Weight, History of Birth Asphyxia, History of Neonatal Jaundice, Low Income Group Family, Large Family Size, Minimal Father’s & mother’s Education, Low level of occupation of Head of the Household, Absence of Father, and Higher Birth Order etc.

A significant general downward linear trend in the language quotient (LQ) was found as the number of risk factors increased. Each risk factor reduced the LQ of the children by 2.63 points. [6]

Researchers have also argued that the adverse effects of early exposure to risk factors for children living in disadvantaged and impoverished homes render children less likely to succeed in school, compromises their academic achievement and impacts their potential to succeed in adult life.

Given the significance of early language skills for cognitive development, schooling, and academic achievement of children, it is important to identify early both the prevalence of language delay and the socio-economic risk factors associated with it. Moreover, early screening and detection of children with language delays are important as it can identify children who require intensive stimulation services, which in turn leads to improved language performance.

Prevalence of speech delay and its correlates in the community is virtually unknown in India. Most of the studies have been conducted on clinical samples of children, and these cannot be used to shed light on the correlates of early speech delay in young children.

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Conclusion

Most research highlights the prevalence of language delay in Indian children less than 3 years of age from the community setting and highlights that a sizeable minority have a language delay. These research results are also in line with results from studies conducted in the West, which also report prevalence rates for speech and language delay in the range of 2-8%.

Further, many research has also highlighted that untreated speech-language delay in young children is associated with diminished reading skills, behavioural problems, social skills deficits, and psychosocial adjustment problems. In turn, these difficulties may lead to overall poor academic achievement and lower IQs. Furthermore, some longitudinal data research on early speech delay also suggests that these children continue to show poor academic skills even as adolescents.

Since speech delay has long-term cognitive and behavioural sequelae, the high prevalence of speech difficulties in young children found in the present community sample underscores the need to target speech delay in early years, to reduce the likelihood of adverse outcomes and optimize chances of improvement. Most speech problems in children can be identified at an early stage in the preschool period when interventions are most effective.

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