Dear doctor;

My son is three years old now but can’t talk. Should I begin to worry considering that my neighbor’s daughter who is yet to make even two years is already talking several words? All my son does is understand commands but to talk, he only emits gibberish.

Collin.

Dear Collin, You have not specified whether your child understands spoken words or not, has never spoken or speaks only monosyllables or utters only words. Have his other development milestones like sitting, neck holding, walking, dentition, etc been normal? Does he have ear pain or any discharge or any other problem?

Each child has his or her own mile stones  for development, hence patience is required. A child may not be able to articulate well, if there is congenital abnormalities of the teeth, tongue or palate. This can be in form of mal setting of the teeth, a tongue tie, cleft lip or palate. Therefore he may hesitate to speak. Chronic infections of the ear since being a baby may impair his hearing ability. If he is not able to hear sounds, he may not pick up speaking.

Regarding more serious causes, injury to the brain due to infections, birth trauma or some physical trauma later, may impair speech area of the brain thus impairing speech. Similarly, if there is damage to the comprehension area of the brain, his understanding is impaired, thus he does not pick up language.

If the child has a normal birth, no serious infantile sickness occurred, is normal in all other aspects, then I think there is nothing much to worry. Get him examined by a good dentist and ENT specialist. If there is any problem, it can be treated. If everything is normal, then he would need help of a speech therapist. On your part, try to talk to him more with something which might be of interest to him. Motivate him to respond by signs or syllables. Gradually, he will start to speak, as his confidence improves, his vocabulary will also improve.