Signs of Speech Delay in Toddlers – When to Worry
What’s the number one factor that unites mothers across cultural, social, and economic boundaries? It’s worry. Most of us obsess about our kids. In this article, we’re going to discuss signs of speech delay in toddlers and when to worry.
But first things first…
In the first few months of motherhood, it’s all about our babies’ regulatory needs, basically if they are sleeping, eating, and even pooping properly. Once we’re over that hump, we begin to wonder about their motor skills- rolling over, sitting up, crawling, and walking. We eagerly anticipate our baby’s mobility. Usually our wishes are granted, and our baby takes his first few wobbly steps on average between the ages of 10 to 13 months.
Then comes the second year. If the first year’s obsession is waiting for our baby to walk, then the second year’s obsession is waiting for our baby to talk. For some lucky mothers this happens early. A baby begins to coo around 8 weeks, babbles by 6 months, and then he starts to try to imitate common words before his first piece of birthday cake is served. For others it means waiting a little while longer, after the novelty of walking has worn off around 14 to 16 months.
Still others are waiting when that second birthday rolls around. Usually by then, even the freakishly calm mother is wondering, “Is something wrong? Should I be worried?”
We consult our families and friends. Invariably we hear any combination of the following,
“Calm down. It’s no big deal.”
“Uncle Jim (or the neighbor’s son, or my personal favorite, Einstein) didn’t talk until he was 3.”
Strangel,y this well-meaning advice is not comforting for most of us worrying mother types because we suspect that something is wrong. More importantly, we don’t want to feel guilty later if we did nothing about it.
Most of us also talk to the pediatrician, and sadly our concerns could even be dismissed by our most trusted and revered medical professional. You might be called “overanxious.” (By the way, in all of my education, I have never seen overanxious mother listed as an official reason babies don’t learn to talk on time.) When one mother took her non-verbal 3 year-old son in to be evaluated at a leading children’s hospital, the doctor advised, “Have another baby, and then he’ll talk.”
Although many pediatricians are wonderful about listening to a parent’s concerns or identifying a potential developmental problem themselves during a visit, some doctors simply have not been trained to judiciously screen for communication delays, particularly before a child turns 2. Many urge parents to wait and see. For some children this could be an acceptable approach. In some cases maturity kicks in and a toddler simply outgrows an earlier issue that caused his parents great alarm. However, from my experience, a child hardly goes from being silent one day to speaking in full sentences the next, no matter what your great aunt so-and-so, the friendly lady at Wal-Mart, or even your pediatrician told you.
Language development simply does not happen overnight for most children. Even though you’ve probably been told not to compare your child to someone else’s or even your own older children, and no two children develop alike, there are patterns of communication skills that babies acquire within certain age ranges. If earlier skills are not mastered within a time frame, communication problems are more likely to develop.
Many pediatricians themselves become worried about their own children at an age when their colleagues might otherwise fail to issue a referral. As a busy pediatric speech-language pathologist specializing in early intervention, that is seeing children with language delays ages birth to three, I typically have several clients on my caseload who are children of physicians. Currently I am seeing four children with mothers who are pediatricians, one who is the daughter of a neurologist, and one whose father runs a family practice. All six of these children began the referral process to be evaluated in our state’s early intervention program before turning two, and four of them by 18 months.
Interestingly, two of these mothers, pediatricians themselves, also began their initial conversations with me with a variation of this same question, “Should I be worried?” With all their medical training, they still weren’t sure enough about developmental communicative milestones to truly know if their own kids were at risk. This is shocking because most parents value their doctor’s knowledge above their own instincts. Often times, parents have expressed deep regret to me that they did not trust their own gut feelings earlier and insist that something be done, even against the advice of their pediatricians.
My advice to all parents has come to be, if you are worried that there’s a problem, there probably is.
Occasionally there are parents, and even spouses, who have to be convinced that something is wrong, but more often than not, mothers suspect this long before other people begin to mention it. Even if you are initially pacified by everyone’s advice, but later feel that something really could be wrong, trust your instincts. Pursue additional information until you are satisfied that everything is moving along nicely in your child’s development, or until you find guidelines that confirm your suspicions that he or she is falling behind.
You can find charts that list developmental milestones in communication for babies and toddlers from many sources including parenting books, magazines, and websites. There is one listed on this site as well. Sometimes parents focus on what a baby is (or is not) saying rather than considering all of the other prerequisite skills that must occur before those first words are spoken. Talking is only a part of the communication process. A baby must understand words, have a desire to be with people, and be able to initiate and respond to interaction before words become meaningful. For example, a baby has to recognize who Mama is and want to call her to come get him out of the crib before his babbles of mama mama begin to truly express meaning.
The following guidelines can serve as a red flag for parents who are wondering, “Is this a sign of speech delay in my toddler? Should I be worried?”
1. Difficulty making and maintaining eye contact with an adult by 6 months
2. No big smiles or other warm, joyful expressions during interaction with another person by 6 months
3. No back-and-forth sharing of sounds, smiles, or other facial expressions by 9 months.
4. No babbling by 12 months
5. No back-and-forth gestures, such as pointing, showing, reaching, or waving by 12 months
6. No consistent responding to their names by 12 months
7. No words by 16 months
8. No following simple and familiar directions by 18 months
9. No two-word meaningful phrases without imitating or repeating and says at least 50 words by 24 months
10. No back-and-forth conversational turn-taking by 30 months
11. Any loss of speech or babbling or social skills (like eye contact) at any age
The presence of any of these concerns warrants an immediate discussion with your pediatrician and insistence for a referral to an early intervention program and/or speech-language pathologist for a complete evaluation of your child’s communication skills.
Let me also add that babies who are doing well with social and language development exceed these milestones by leaps and bounds.These are very, very low thresholds for communicative skills. If your child is not meeting these basic guidelines, please don’t dismiss your feelings.There is in all likelihood a true developmental delay or disorder present.Seek professional help from your pediatrician, your local school system, or an early intervention agency.
If your child has accomplished these fundamental skills, but you’re still not sure that he’s where he should be, please know that there are many, many things you can do at home to improve your child’s ability to talk.This entire website is dedicated to educating parents with successful techniques to improve your child’s communication skills. When you learn and implement these new strategies at home, you will make a huge difference in your child’s ability to communicate. Remember, involved and loving parents are a baby’s first and best teachers. You can do this, and this website is here to help.
I recommend this speech therapy manual for late talkers to all my new families…
For my best help working with a young toddler when you first begin to worry is Teach Me To Play WITH You. It’s filled with easy, fun routines to do with your baby to help him begin to talk. When you see signs of speech delay in your toddler, you don’t have to worry! Take action and get going today.
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Laura thank you so much. Btw, you have transformed my therapy- I have become such a competent and strong therapist after watching probably like 350 of your videos and podcasts over the past few years. And I am a seasoned therapist with almost 25 years experience. (Yes prob 350 episodes ha!) But there was still a lot I learned from you. I have such a thorough understanding of birth to 3 development and how to properly incorporate appropriate therapeutic goals, techniques and strategies now, thanks to you. Kelly
Hi Laura,I want to thank you so much for the resources you provide, my daughter has delayed speech and though she qualifies for CDS. Honestly the most progress she has made in her speech/language development has been after I implemented your 5 top strategies for delayed talkers! She is now almost 2.5 and her vocabulary is well over 75 (I haven’t counted recently, could be over 100) words when at 2 she barely had four words. Honestly the last few months have been a transformation for her.
Ann
