Signs Your Child May Need Speech Therapy

Every child develops speech and language at their own pace, and a wide range of that pace is entirely typical. This article sets out general milestones, some gentle signs that it may be worth a closer look, and what a speech pathology assessment actually involves, so you can feel informed rather than anxious.

A general guide to speech and language milestones

By around 18 months, most children understand simple words for everyday objects and people, and follow one-step directions like "give me the ball." By 2 years, many children are using and understanding at least 50 words, and starting to put two words together, such as "more water" or "go outside." Through the third year, word combinations become more frequent, and early sounds such as p, b, m, h, w and d are usually clear, though speech may not yet be easy for unfamiliar listeners to follow. By around 4, most people can understand the majority of what a child says, and by 4 to 5, most consonants are produced correctly and speech is generally understandable in conversation.

These are general guides, not strict deadlines. Children vary, and a child who is a little behind on one milestone is not necessarily behind overall.

Signs that support could help

It can be worth speaking with a speech pathologist, GP or paediatrician if, by around 12 months, your child is not yet trying to communicate with you using sounds, gestures or words, or if by around 2 years they are not yet saying about 50 words or starting to put two words together. Other things worth a conversation include speech that remains hard to understand well past age 3, difficulty following simple directions, or your child seeming frustrated because others cannot understand them.

The loss of words or skills your child previously had, at any age, is also worth a prompt conversation with your GP or paediatrician, rather than a wait-and-see approach.

None of this is about ticking every box perfectly. If something feels off to you as a parent, that instinct is worth following up, even if your child is meeting some milestones and not others.

Late talkers often catch up, and support still helps

Some children are described as "late talkers," usually meaning that around age 2 they have a smaller vocabulary or are not yet combining words, without another explanation for the delay. Research suggests this affects a meaningful minority of toddlers, and many of these children go on to catch up to their peers over the following one to two years. But not all do, and it is not possible to predict in advance which children will catch up on their own and which will benefit from support. Because of this, an assessment is a useful way to understand where your child sits, rather than something to be reserved only for children who are clearly and significantly behind.

Boys are more commonly identified as late talkers than girls, and a family history of being a late talker is also more common among children with slower early language. None of this points to anything a parent has done differently; broad family and environmental factors are not what drives whether a toddler is a late talker.

A quick word on hearing

Because hearing and speech are so closely linked, a hearing check is a sensible early step whenever there is a speech or language concern, alongside seeing a speech pathologist, GP or paediatrician. Even mild or intermittent hearing loss, such as from recurrent ear infections, can affect how clearly a young child hears the speech sounds around them and, in turn, how they learn to produce those sounds themselves.

What a speech pathology assessment involves

An assessment helps a speech pathologist understand your child's current communication skills, identify their strengths, and work out whether therapy would help and what it might focus on. At Hunter Children's Clinics, speech pathology is provided by Claire Cooper, and an episode of care usually begins with a parent-only intake for children under 12, giving her time to gather a full history before working directly with your child. You do not need a GP referral to access our speech pathology service, although referrals and reports can be helpful for certain funding. You can read more about our speech pathology service, and see current fees on our fees and referrals page.

Talking to your child about seeing a speech pathologist

Young children generally do not need much preparation before an assessment. It can help to describe the visit in simple, positive terms, such as meeting someone who plays and talks with children and helps them use more words. Keeping the tone light and avoiding language that suggests something is wrong tends to help children feel comfortable. Bringing a favourite toy or book along can also make the session feel more familiar.

If you are unsure

You do not need to be certain something is wrong before seeking an opinion. An assessment can simply confirm that your child's communication is developing well, which is valuable information in itself, or it can identify support that helps your child move forward with more confidence. If you have concerns about your child's speech or language, our admin team can talk you through the options when you call.

Related reading: stuttering in children, speech, language and early literacy, and what to expect from a parent-only intake session.

This article is general information only and is not a substitute for individual medical advice. If you have concerns about your child, please speak with your GP or paediatrician.