- At 18 months
- Consistent words are present
- At 24 months
- Two-word combinations begin
- Referral
- Not required
Markers you can use yourself
Around 12 months: gestures have appeared — pointing, waving bye-bye. No gestures at all at this age is more concerning than no words yet.
Around 18 months: consistent words are coming out, not just sounds. A child who always chooses gesture and avoids using their voice to communicate should be looked at.
Around 24 months: two-word combinations are starting ("want milk", "daddy go"). A commonly used marker for a "late talker" is fewer than 50 words and no two-word combinations at this age.
More important than any of those numbers: a skill that was there and has been lost, at any age, always needs checking — as does a child who does not respond to their name or does not understand simple instructions.
What matters most happens at home
A therapy session is only one hour a week; the child spends all the rest of the time at home. So the largest part of our work is teaching parents to talk in a way that makes a child want to answer.
Some of what we teach most often: leave a pause after asking, longer than feels comfortable — many children need time to process and adults fill the silence too fast. Narrate what the child is doing rather than quizzing them. Cut down on closed questions. And put something they want in sight but out of reach, so there is a reason to communicate.
On screens: language grows out of back-and-forth exchanges — your child makes a sound, you answer, they go again. A screen does not answer and does not wait for them, so watching cannot take the place of talking together.
Frequently asked questions
We speak two languages at home. Does that cause delay?
No. Bilingual children reach language markers on a comparable timetable to monolingual ones, though vocabulary is split across the two languages so it looks smaller if you count only one. Dropping a language is not the solution and often cuts a child off from their own family. If there is a delay, the cause is elsewhere — and that is what we look for.
People say they will grow out of it. Is that true?
Some children do catch up on their own. The trouble is that from the outside there is no way to tell which ones will and which will not — and the ones who do not catch up lose the most valuable time. An assessment does not mean starting therapy; often the result is "no therapy needed, here is what to do at home". That is a more reassuring answer than waiting in the dark.
My child understands everything, just does not speak. Still worth coming?
That is good news — intact understanding is a favorable sign. It is still worth checking, because the question is not only "is this a problem" but "what would speed this up". Often the assessment is short and what you take home is a handful of concrete things to do, not a weekly therapy schedule.
Sources
The figures and recommendations on this page come from the sources below. The links go to third-party sites.
- Late Language Emergence: a literature review — NCBI
- HealthLink BC — Speech and Language Development: Red Flags
This page is educational and does not replace an examination by a doctor. If your child is unwell, or something does not feel right to you, have them seen first.