Does My Toddler Need Speech-Language Therapy?

Uncertainty about whether or not your toddler’s speech and language skills are developing normally can be confusing at best. Maybe you have been wondering if you should seek speech-language therapy for your toddler. While no article can replace a comprehensive evaluation by a speech-language pathologist, we have included a chart with some speech and language developmental milestones to help shed more light on what your toddler should be able to do and say from 1-4 years of age. Stay tuned for an interview on the topic with one of our excellent and experienced speech-language pathologists, Anna Waters Ed.D. CCC-SLP followed by a few tips to encourage speech and language development in your toddler. 

This chart provides some early speech and language milestones and is intended only as a loose guide

Interview with Anna Waters, CCC-SLP on toddler speech and language development

How many words should my toddler know and say?

There is a loose rule of thumb between ages 2-3 to build up to about a 500 word vocabulary. That is not just real words, it could also be signs or made-up words. They might say “boodoo” for all dogs, and that is still a word. It does not have to be strictly real words or strictly words they can say, it can be a variety.

My toddler’s teacher says she can’t understand my child but I can understand them fine, is this common?

It depends on the age of the toddler. The ability to be understood by unfamiliar adults really increases rapidly from 1-4 years of age.  At 18 months, you want an unfamiliar adult to understand your child about 50% of the time even if you still understand them all the time. By age 2, you want them to be understood about 70% of the time by unfamiliar adults. Before the start of kindergarten they should be understood by unfamiliar adults almost all the time.

I have heard some children are just late talkers, is it okay to wait until my child is older to consider speech-language therapy?

Of course! It is always a parent’s choice whether they think speech-language therapy is an appropriate intervention or not. However, there are a couple of caveats to that. If a child starts speaking at age 1, saying “go momma” or “gimme more”, and then for an unexplained reason they stop communicating and using true words. That is, they appear to lose the skills they previously had. Losing speech and language skills that have already been acquired is concerning and you may want to seek out an evaluation and talk to your pediatrician at the very least. Another caveat is if they are going to start preschool and not talking yet. It can be overwhelming for a person to join a social group if they are not talking yet. You really want children by age 3 to start talking to both other children and adults.

If I bring my nonverbal toddler to speech-language therapy will you be able to help him or her talk in sentences?

Well, I don’t have a crystal ball but most speech-language therapists are trained to start at the nonverbal stage. Really, even children who are nonverbal are communicating quite a bit. Some of the things you might see a speech-language therapist do is put things in transparent containers to work on functional words such as “open” or the sign language sign for “open”.  Additionally, they might put desirable things around the room or up high and work on children’s ability to point to things and ask for things with gestures. Speech-language therapists are trained to elicit early developing first words, even something as simple as “this one” from kids.

My three year-old knows a lot of words but does not form sentences. 

Should I be concerned?

If you are concerned as a parent then there is probably a concern. With all of these questions if a parent feels that something is not right, they are probably correct. Even if their pediatrician says not to worry, if they are still worried they should seek out a speech-language therapist for a standardized assessment of their child’s speech and language skills. Standardized assessment scores reflect the child’s observable speech and language abilities in comparison to peers and should be given to the family and pediatrician to determine if further steps should be taken. Most three year-olds can combine words together to communicate meaningfully. They might not be forming complex phrases, but they are saying things like, “no more” or “mommy go” at the very least.

What take home message would you like parents to remember about their toddler’s language?

To reiterate that if a parent has a concern then it is likely a real concern. If they seek out help no one is going to think they are just being overprotective or overreacting. If a parent thinks something is wrong then a speech-language therapist will listen to them. Also, to trust their own judgment if they are having interactions with their child or seeing their child with other toddlers and their child does not sound right. If they are dropping beginning sounds or are not saying enough words  it is worth getting checked out because early intervention is really beneficial to kids. Getting these things started and sometimes even taken care of before they start kindergarten is important.

Do you have any suggestions for parents or caregivers to help their toddler communicate more effectively?

As busy parents and caregivers it can be easy to fall into communication habits that might make it difficult for your child to listen and be heard. Imagine you are in the middle of doing dishes and your child has something to tell you. The whir of the dishwasher and focus on the task at hand creates a situation where your child has to compete with, not only environmental sounds, but also your attention. Try to limit situations where your child must struggle to be heard. Instead, try finding a better time to talk, encouraging the family to take turns when speaking, and waiting your child out if they are having trouble getting their message across. Easier said than done!