Keeping Your Kids Healthy

Delayed Speech or Language Development

Source: The Nemours Foundation

Your son is 2 years old and still isn't talking. He says a few words, but in comparison to his peers, you think he's way behind. You remember that his sister could put whole sentences together at the same age. Hoping he will catch up, you postpone seeking professional advice. Some kids are early walkers and some are early talkers, you tell yourself. Nothing to worry about...

This scenario is common among parents of children who are slow to speak. Unless they observe other areas of "slowness" in the early development of their child, parents may hesitate to seek advice. Some parents may excuse the lack of talking by reassuring themselves that "he'll outgrow it" or "she's just more interested in physical things."

Knowing what's "normal" and what's not in speech and language development can help you figure out if you should be concerned or if your child is right on schedule.

Understanding Normal Speech and Language Development

It's important to discuss early speech and language development, as well as other developmental concerns, with your child's doctor at every routine well-child visit. Although it may be difficult to tell whether your child is just immature in his or her ability to communicate or if your child has a problem that requires professional attention, the following developmental norms may provide clues:

Before 12 months

It's important for kids of this age to be observed for signs that they're using their voices to relate to their environment. Cooing and babbling are early stages of speech development. As babies get older (often around 9 months), they begin to string sounds together, incorporate the different tones of speech, and say words like "mama" and "dada" (without really understanding what those words mean). Before 12 months, children should also be attentive to sound. Babies who watch intently but don't react to sound may be showing signs of hearing loss.

By 12 to 15 months

Children this age should have a wide range of speech sounds in their babbling and at least one or more true words (not including "mama" and "dada"). Nouns usually come first, like "baby" and "ball." Your child should also be able to understand and follow single directions ("Please give me the toy," for example).

From 18 to 24 months

Children should have a vocabulary of about 20 words by 18 months and 50 or more partial words by the time they turn 2. By age 2, kids should be learning to combine two words, such as "baby crying" or "Daddy big." A 2-year-old should also be able to follow two-step commands (such as "Please pick up the toy and bring me your cup").

From 2 to 3 years

Parents often witness an "explosion" in their child's speech. Your child's vocabulary should increase (to too many words to count) and he or she should routinely combine three or more words into sentences. Your child's comprehension should also increase - by 3 years of age, he or she should begin to understand what it means to "put it on the table" or "put it under the bed." Your child should also begin to identify colors and comprehend descriptive concepts (big versus little, for example).