Speech and Language Delay in Early Childhood: Insights from A Clinical Study in Islamabad, Pakistan

Speech and language delay (SLD) in early childhood is a prevalent neurodevelopmental concern, often resulting in long-term academic, behavioral, and emotional difficulties if unaddressed. While risk factors have been well studied in high-income countries, data from low-resource settings like Pakistan remain limited. Objective: This study aimed to identify and quantify medical, familial, and environmental risk factors among children with isolated SLD in Islamabad. Methods: A cross-sectional study was conducted from August 2023 to February 2024 at the Pediatric Outpatient Department, KRL Hospital, Islamabad. A total of 145 children aged 2–5 years with isolated SLD were enrolled after clinical assessment and audiological screening. Data were collected via structured parent interviews on perinatal history, medical comorbidities, familial predispositions, and environmental exposures. Descriptive statistics were used to report frequencies. Results: Medical risk factors were present in 55.2% of children, with chronic ear infections (45%) and hearing loss (28.6%) being the most common. Birth asphyxia (19.3%) and seizure disorders (16.6%) were also noted. Familial factors were observed in 78.6% of cases, including consanguinity (67.5%) and family history of SLD (21.1%). Environmental exposures were highly prevalent (87.6%), particularly excessive screen time (>2 hours/day in 49.6%), pacifier use (40.9%), and thumb-sucking (27.6%). Conclusions: Children with SLD frequently present with modifiable risk factors across medical, familial, and environmental domains. Early identification of these risks, especially in settings with high consanguinity and limited screening infrastructure, can inform timely interventions and improve developmental outcomes.