When should you worry about a toddler’s speech?

Look at communication, not only word count

Parents often search for a single number of words a child should say at a certain age. Word count can be useful, but it is only one part of communication. Notice how your child understands language, uses gestures, shares attention, tries to tell you things and combines sounds or words.

Children develop at different rates and may use more than one language. Learning two or more languages does not cause a speech or language disorder. A concern should be considered across all the languages a child hears and uses, not judged from English alone.

Reasons to ask for advice

A check does not commit your child to therapy. It can clarify whether development is within a broad expected range, whether hearing or another health issue should be checked, or whether a speech pathology assessment would help.

• Your child is not meeting the communication milestones for their age.
• They rarely use gestures, sounds or words to communicate wants and interests.
• They have difficulty following simple, familiar directions.
• People who know them well often cannot understand their speech.
• Stuttering, voice, chewing or swallowing is causing concern.
• They lose words, communication or other skills they previously had.

Where to start

You can raise the concern at a routine child health check or book an appointment with your GP or child and family health nurse. You can also contact a private speech pathologist directly. A hearing check may be recommended because hearing can affect speech and language development.

Bring two or three examples of what you have noticed and when it happens. Short videos from ordinary routines can be useful if the clinician says they are appropriate to share.

Do not use ‘wait and see’ as the only plan

Sometimes monitoring is reasonable, but it should have a review date and clear signs that would prompt earlier action. If you remain concerned after being reassured, it is reasonable to ask for another opinion.

Seek urgent medical help if your child has sudden loss of skills, breathing difficulty, choking, or another acute health problem. A routine directory search is not the right pathway for an emergency.