A late talker is a toddler experiencing late language emergence (LLE), which can also be an early or secondary sign of an autism spectrum disorder, or other neurodevelopmental disorders such as fetal alcohol spectrum disorder, attention deficit hyperactivity disorder, intellectual disability, learning disability, hyperlexia, social communication disorder, or specific language impairment. Lack of language development, comprehension skills, and challenges with literacy skills are potential risks as late talkers age. Outlook for late talkers with or without intervention is generally favorable. Toddlers have a high probability of catching up to typical toddlers if early language interventions are put in place.
Language development
Expected language emergence Toddlers aged 1–2 years begin to use and comprehend different types of words. Initially, the most prominent types are nouns, and eventually they move on to other word types such as verbs and adjectives. Once toddlers have said their first word, they begin to acquire new words at a rate of roughly one per week. Words are related to things in the toddler's environment, such as body parts, toys, clothes, etc. They often use one word to mean many different things; for example, they may call all types of transport "car". Around the 15-month mark, toddlers know six words on average, and begin to notice and wonder about things that are a little outside of their environments. Once they reach 18 months, they refer to themselves by their name and eventually start using the pronoun I. During this stage, they also repeat parts of sentences they hear. As they get close to 2 years, toddlers start putting two words together. They begin to learn the use of "no" and ask adults to tell them the name of people and new objects. On average, a 2-year-old knows 50 words and then begins to learn new words at a rate around one per day. From 2 to 3 years of age, their vocabularies grow rapidly. At 30 months old, they are expected to know around 200 words and by 3 are able to participate in very simple conversations.
Late talker's language emergence Late language emergence (LLE) occurs when toddlers do not produce or comprehend language at the expected rate for their age. About 13% of two-year-olds experience a delay in language emergence. Late talkers differ from toddlers with developmental language disorder (DLD) and disabilities in the sense that their only characteristic is that they experience limited expressive vocabulary for their age, as opposed to a lack of receptive language or cognitive abilities. LLE can be an indicator of other kinds of disorders or disabilities. If late talkers are not catching up to typical talkers by the age of 4, they could have specific language impairment. Expressive language screening between the ages of 18 and 35 months help determine if LLE is "secondary to autism spectrum disorder, intellectual disability, hearing impairment, receptive language delay, or demographic risk". When compared to typical talkers, 24-month-old late talkers do not seem to struggle with verbs and their formation, which are an important part of one's grammatical development. They struggle with nouns more than a typical talker and have difficulty combining words. Late talkers perform lower than typical talkers in cognitive functioning and receptive language skills.
Characteristics Toddlers are at risk of being a late talker if:
They produced abnormal babbling from 9 to 21 months of age. By 15 months, they are not producing six or more words. By 18 months, they do not appear to comprehend more words than they can produce. At 18 months old, they are using less than 20 words and lack knowledge of different word types. At 24 months old, they are using less than 50 words and are not combining words from different word classes. After producing their first word, they demonstrate a lack of "complex syllable structures, lower percentage of consonants correct, and smaller consonant and vowel inventories". They show a lack of comprehension and insist on communicating using gestures. Between 2 and 3 years of age, they are using short sentences with very simple grammar.
Diagnosis LLE could be a sign of other types of language disorders or intellectual disabilities, so a risk exists of misdiagnosing a child as just being a late talker. This symptom may be secondary to problems with their vocal tract or hearing, autism, neglect, or abuse. For toddlers to be diagnosed as late talkers, they need to see a doctor and a speech pathologist. A doctor will conduct a full medical examination and a speech pathologist will do a full screening and comprehensive assessment. The Language Development Survey (LDS) is a prevalent screening method used on toddlers aged 18–35 months of age. This tests whether a child's expressive vocabulary and syntax are developing in a standard way. The LDS consists of a parent or caregiver of the child to report on the child's language development in regards to word combination. This screening takes a total of 10 minutes. It also takes risk factors into consideration, such as the child's demographic and history. This test, combined with other forms of assessment, determine whether children are late talkers, or if their language delay is associated with another type of language disorder or intellectual disability.
Types of assessment
Assessments are carried out to determine the speech and language ability of a child. A speech pathologist works with the parent or caregiver of the child to decide on the most appropriate assessment.
Ethnographic interviewing Ethnographic interviewing, a style of assessment, consists of one-on-one interviews between the assessor and assessed. It requires the assessor to ask the child open-ended questions to find information about the child's environment.
Language sampling Language sampling is used to obtain random samples of a child's language during play, conversation, or narration. Language sampling must be used with standardized assessments to compare and diagnose a child as a late talker.
Dynamic assessment Dynamic assessment involves testing, teaching, and retesting a child. Firstly, the child's knowledge is tested. Then, the child is taught a word. Finally, the child is retested to see if he has learnt the target language. This type of assessment is useful in determining whether a child is a late talker or if his language delay is a factor of another kind of disorder.
Standardised assessments
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