Warning signs of a speech delay in toddlers

Children learn language at different rates, but most follow a general timeline. It's common for toddlers to run into roadblocks on the way to nonstop talking, but it can be hard to know what's a bump in the road versus signs of a true speech delay or disorder.

If your child falls behind most of their peers in terms of speech skills, they may be diagnosed with a speech delay. This is actually fairly common among young kids – about 1 in 5 kids experiences a speech delay.

Experts estimateOpens a new window 13.5 percent of 18- to 23-month-old toddlers are "late talkers." Even more older toddlers (30- to 36-months) are late talkers – 16 to 17.5 percent.

So what should you do if you think your child is behind? Talk to your pediatrician about getting a referral for an early intervention program or a speech-language pathologist. It's important to recognize and treat delays as early as possible so your child can develop critical language and cognitive skills.

If you're concerned about a speech delay, here are some signs to look for between the ages of 1 and 4.

Signs of a speech delay

The American Academy of Pediatrics (AAP)Opens a new window and other experts recommend talking to your child's doctor if they show any of these signs:

By 12 months:

• Doesn't say "mama" or "dada"
• Doesn't use gestures such as waving, shaking their head, or pointing
• Doesn't understand and respond to words such as "no," "bye-bye," and their name
• Isn't pointing out things of interest such as a bird or airplane overhead
• Doesn't say at least one word
• Doesn't babble as if talking

By 18 months:

• Doesn't point to at least one body part when asked
• Isn't somehow communicating to you when they need help with something or pointing to what they want
• Doesn't bring you things when you ask for them

By 24 months:

• Can't follow simple, one-step directions
• Doesn't know at least 50 words
• Doesn't pretend with their toys (like brushing their doll's hair or making car noises with a toy car)
• Can't speak two-word sentences
• Can only imitate the actions or words of others, rather than generate their own speech

By 30 months:

• Doesn't use any simple sentences of two to four words
• Can't use any pronouns
• Doesn't ask simple questions
• Can't be understood by anyone in their family

By age 3:

• Isn't putting together short phrases
• Can't tell a simple story
• Has little interest in being read to or looking at books
• Doesn't know the function of common household objects (like a toothbrush or fork)

By age 4:

• Hasn't mastered most single consonants
• Can't answer "why" questions
• Doesn't understand the concept of "same" and "different"
• Doesn't understand spatial terms like "on," "next to," or "under"

As a general rule, trust your instincts. If something seems wrong to you, ask your child's pediatrician about it. After all, you know your child best.

What causes a speech delay or disorder?

It's not always clear what causes a speech delay. Sometimes kids just need extra time and help building their skills. A delay means your child is still going through the typical language development process, just more slowly than their peers.

Plenty of things, including being born prematurely, can affect when your child starts hitting speech milestones. Preemies usually catch up with other children on milestones around the age of 2.

Speech delays can also be caused by conditions like hearing loss (which may be caused by repeated ear infections), cerebral palsy, and developmental disabilities like autism.

If your child isn't going through the typical milestones of language development and isn't catching up at their own rate, they may have a speech disorder rather than a delay. This means they may need intervention and the help of a speech-language pathologist.

If your child has a speech delay or disorder, it doesn't mean you did anything wrong. But it does mean you can help your child improve in simple ways, like reading, talking, and playing with them even more than you already have been.