Association Between Family Structure and Speech and Language Delay in Children

Marwa; Muhammad Sikander Ghayas Khan

doi:10.61919/v5dg8m71

Authors

Marwa Speech and Language Pathologist, Corner Stone, Lahore, Pakistan Author
Muhammad Sikander Ghayas Khan Professor, Department of Rehabilitation Sciences, FAHS, The University of Lahore, Lahore, Pakistan. Author

DOI:

https://doi.org/10.61919/v5dg8m71

Keywords:

Speech delay; Language delay; Family structure; Caregiver interaction; Screen exposure; Children.

Abstract

Background: Speech and language development in early childhood is strongly influenced by environmental and familial factors, particularly caregiver interaction, socioeconomic context, and household composition. Family structure may shape the quantity and quality of linguistic exposure through caregiver availability, supervision patterns, and communication practices. However, limited evidence exists from urban Pakistani clinical settings examining how family structure and related environmental factors coexist among children presenting with speech delay. Objective: To determine the association between family structure and speech and language delay among children attending tertiary care hospitals in Lahore, Pakistan, and to explore related caregiving and environmental characteristics. Methods: A cross-sectional observational study was conducted from July to December 2025 at Sehat Medical Complex and the University of Lahore Teaching Hospital. Sixty-eight children aged 3–9 years with clinically confirmed speech delay were recruited using purposive sampling. Data were collected through a structured questionnaire assessing family structure, parental education, household income, caregiver type, daily parent–child interaction time, storytelling frequency, and screen exposure. Descriptive statistics were generated using SPSS version 25. Results: Moderate speech delay was most prevalent (50.0%), followed by severe (26.5%) and mild (23.5%). Joint families constituted 52.9% of cases, nuclear families 38.2%, and single-parent households 8.8%. Male children represented 60.3% of participants. Low household income was reported in 79.4% of families. Limited daily interaction (≤2 hours) was observed in 77.9% of cases, while 83.8% engaged only occasionally or rarely in storytelling activities. Screen exposure ≥1 hour daily was reported in 77.9% of children. Conclusion: Children with speech delay in this clinical sample commonly resided in joint or non-nuclear family systems and experienced limited structured verbal interaction alongside considerable screen exposure. Household composition appears to interact with caregiving practices and socioeconomic factors, underscoring the importance of family-centered early intervention strategies.

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