Hello, Many things can cause delays in speech and language development. Speech delays in an otherwise normally developing child can sometimes be caused by oral impairments, like problems with the tongue or palate. A short frenulum (the fold beneath the tongue) can limit tongue movement for speech production. Many kids with speech delays have oral-motor problems, meaning there's inefficient communication in the areas of the brain responsible for speech production. The child encounters difficulty using and coordinating the lips, tongue, and jaw to produce speech sounds. Speech may be the only problem or may be accompanied by other oral-motor problems such as feeding difficulties. A speech delay may also be a part of (instead of indicate) a more "global" (or general) developmental delay. Hearing problems are also commonly related to delayed speech, which is why a child's hearing should be tested by an audiologist whenever there's a speech concern. A child who has trouble hearing may have trouble articulating as well as understanding, imitating, and using language.Ear infections, especially chronic infections, can affect hearing ability. Simple ear infections that have been adequately treated, though, should have no effect on speech. And, as long as there is normal hearing in at least one ear, speech and language will develop normally. If you or your doctor suspect that your child has a problem, early evaluation by a speech-language pathologist is crucial. Of course, if there turns out to be no problem after all, an evaluation can ease your fears.