Late talker or speech delay? What to watch

Late talker, speech delay, language delay: the words

These terms overlap, which is part of what makes the subject confusing.

• Late language emergence, or being a "late talker", is a delay in the start of language in a toddler with no other diagnosed disability or delay in thinking or movement. ¹
• A language delay is about words and meaning: understanding what others say (receptive language) and putting words together to express ideas (expressive language).
• A speech delay is about producing sounds clearly enough to be understood.

A child can have one without the other. A toddler who understands a great deal and follows directions but says few words is in a different place from one who also seems not to understand or respond to their name.

What the CDC checklists list for language

These are CDC's language and communication milestones from the revised 2022 checklists, quoted exactly. Each is something most children (75% or more) can do by that age. ²

Notice how much of this is not words at all: pointing, gestures, following directions, looking at a named object. Those are part of communication, and clinicians pay close attention to them.

How common is late talking, and how many catch up?

According to the American Speech-Language-Hearing Association (ASHA), studies estimate that between about 10% and 20% of 2-year-olds are late talkers. A commonly used research definition is an expressive vocabulary of fewer than 50 words and no two-word combinations at 24 months. ¹

ASHA also reports that roughly 50% to 70% of late talkers catch up with their peers by the late preschool and school years. ¹ That is reassuring, but it also means a sizeable share do not, and there is no reliable way to tell at 2 which group a child is in. ASHA notes that late bloomers can only be identified "after the fact". ¹ This is exactly why waiting is not the recommended plan. Getting an evaluation does not label your child; it tells you whether help would be useful while it is easiest to give.

ASHA lists factors linked with a higher chance of late talking, including a family history of late language and being born before 37 weeks. ¹ Twins are also more often late talkers in the studies ASHA summarises. ¹

Always check hearing

A child who cannot hear well cannot learn to talk on schedule. CDC's signs that are worth a hearing check include a baby who does not turn toward a sound after 6 months, a child who does not say single words such as "mama" or "dada" by 1 year, and a child who turns when they see you but not when you only call their name. ³ Passing a newborn hearing screen does not rule out hearing loss that starts later. CDC's advice: if you think your child might have a hearing problem, ask the doctor for a hearing screening as soon as possible. ³

What to do if you are wondering

1. Note what you see for a week. Which words, sounds and gestures your child uses, whether they point to show you things, whether they follow simple directions without gestures, and how they respond to their name.
2. Answer the CDC checklist for their age. childow's checklist for 2 years or 18 months records Yes, Not yet or Not sure, and turns "Not yet" into a question for the visit.
3. Ask the pediatrician for a hearing test and a developmental screening. AAP recommends developmental screening at 9, 18 and 30 months and autism screening at 18 and 24 months, and at any age when a parent has a concern. ⁵
4. Call early intervention yourself if your child is under 3. You do not need a doctor's referral. CDC suggests saying: "I have concerns about my child's development and I would like to have my child evaluated to find out if he/she is eligible for early intervention services." ⁴ Evaluations through the state program are free. Find your state's number on our early intervention page.
5. If your child is 3 or older, call your local public elementary school, even if your child does not go there, and ask for an evaluation for preschool special education services. ⁴

Things that help at home, whatever the outcome

Talking with your child through the day, naming what they look at, reading together and pausing to give them a turn are simple habits that support language for every child. NIDCD describes how speech and language skills develop in the first years and why the period before age 3 is so active. ⁶ None of this replaces an evaluation if you are concerned, but you do not have to wait for one to start.

Two-language homes

ASHA summarises the research plainly: learning more than one language does not appear to harm a child's ability to learn and use language, and when vocabularies in both languages are counted together, bilingual children learn words at the same rate as children learning one. Late talking is not caused by a second language, and dropping a home language is not recommended as a response to it. ¹ If you are concerned, tell the evaluator about every language your child hears, so that both can be assessed. If your child is having difficulty in each of their languages, an evaluation may be warranted, as for any other child. ¹