Which statement describes language delays at age 4 or older?

• A. A child who speaks clearly and is easily understood.
• B. A child who cannot follow simple instructions.
• C. A child who uses gestures to communicate only.
• D. A child whose spoken language is hard to understand.

Answer: (D)

When a preschooler’s spoken language is hard to understand, that signals a language delay or disorder. By age four, children should be producing speech that most unfamiliar listeners can understand; difficulties with intelligibility indicate a problem with how language is developing, not just occasional mispronunciations or mistakes. This makes it the clearest indicator of a language delay among the options.

The other statements describe either typical development (speaking clearly and being easily understood) or aspects that don’t specifically point to a language delay: following simple instructions can be related to attention or hearing, and using gestures only shows nonverbal communication, which isn’t as direct a marker of a language delay as not being understood.