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Does my child need speech therapy?

The first three years of a child’s life are crucial to language development. Before your child begins to talk, they absorb language around them and pick up the meaning of words and phrases. Research has shown that babies begin to recognize their mother’s voice even before they are born.

By the time your child is six months old, they should begin to babble and play with sounds. By the time they are a year old they usually can say a few words. Between ages one and two, children go through a "language burst" where they begin rapidly acquiring and using more words on a weekly, or even daily basis. They also might begin combining words into short phrases. For example, "where daddy," "hi mama," "my ball." That burst should be followed by them having little conversations or sharing their very strong three-year-old opinions!

However, for a lot of children language doesn’t come so easily.  

Language milestones

By 18 months

  • uses at least five words
  • follows simple one-step directions for example, "come here" or "sit down"
  • knows what common items are: phone, baby, cup, ball, etc.
  • is interested in engaging with and getting attention from others

By two years old 

  • uses the sounds p, b, m, d, t, w, h in words
  • combines words more often and begins to put together short sentences, like "where's daddy?"
  • asks simple questions and makes comments
  • is learning and using new words consistently

By three years old

  • uses k, g, n, f
  • begins to use longer three to four word sentences
  • has a word for almost everything
  • is understood most of the time by familiar listeners
  • begins to interact with peers
  • asks questions, makes comments and begins to answer questions 

When should I be concerned?
Seek the advice of your doctor if your child struggles with these speech and language skills at these age milestones:

18 months old

  • doesn't use at least five words
  • is unable to follow simple directions
  • doesn't engage verbally with others

Two years old

  • hasn't begun to combine words, for example, "go home," "what's that," "hi mommy"
  • uses only a small number of sounds, such as d, b
  • isn't learning new words consistently
  • can't point to simple items in a book or follow simple directions

Three years old:

  • can't speak simple sentences such as, "those are daddy's," "I want my doll," "I need to go potty," "I don't want to nap," etc.
  • isn't interested in playing with other children or engaging in pretend play
  • isn't understood at least 80 percent of the time
  • doesn't understand basic language concepts such as pronouns (I, you, me) and prepositions (in, out, on, off)

What can I do to help my child's speech development?
Try to provide a language-rich environment at home. Ways to do this include talking about what you are doing, reading books, singing songs and talking while you play with your child. 

However, if your child has any of the above warning signs, contact your doctor and ask them to make a referral for a speech therapy evaluation. Speech language pathologists will be able to determine if your child’s speech development is typical or if he or she would benefit from speech therapy. If your child does require therapy, your therapist will provide ideas and suggestions for you to do with your child at home to boost their speech skills.


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