My Child Isn’t Talking - What Do I Do?
Parents worry about everything from the size and color of their child’s poop – to if they’re getting too much screen time – to whether or not their child has a genetic diagnosis because they look (kinda) like a child they saw on TikTok. And in today’s world of misinformation and fear mongering, it’s easy to search for answers to our questions - but it’s a lot harder to find the right answers.
Two of the questions I’ve heard most from parents as a speech therapist are “should I be worried my child isn’t talking?” and “how can I help them talk?”. I can’t tell you how many parents I met whose non-speaking children were already four or five at their first speech therapy evaluation - so to try and get kids the help they need earlier - I’ve written this article.
This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a speech, language, hearing, or feeding problem or disease and those seeking personal medical advice should consult with a licensed speech-language pathologist and physician.
When Should I Worry About My Late Talker?
If you’re not already familiar with the speech and language milestones (checkout my article all about it) for early child development, here are some important markers:
Milestones for Speech and Language
7-12 Months: babbling (ba-ba-ba) starts, tries to imitate sounds and words, uses waving or reaching to communicate, says one or two words (ex: “babo” for bottle)
12-18 Months: says at least 5-10 words, understands simple commands (“give me the ball”), points to objects/pictures when named, starts to combine gestures with sounds
18 to 24 Months: has a vocabulary of 50 words, begins combining two words, understands simple questions (ex: where is mama?), imitates new words, uses words more than gestures to request
Before you start spiraling - take a deep breath, and know that these are averages. Why should that calm you down? Well, without going into an in-depth lesson on statistics (I’m a speech therapist, not a mathematician!) it’s important to know that these averages are a number representative of all the values in a data set NOT exact deadlines. That means that there are lots of children who started speaking earlier and later than these months.
Want to know a secret? While it would be soo much easier if all children followed the exact same pattern of babbling, saying a few words, and then building up their vocabulary - not every child develops language the same way. That’s right! I’ve seen children whose babbles slowly turned into words - but I’ve also seen lots of children who went straight from making zero sounds to suddenly saying their first word. Believe me when I say, progress looks different for every child. ‘
Why Isn’t My Child Talking?
There are many reasons why children are late talkers, and in some cases, the reason for a child’s language delay may never be determined. The most important thing to know is that you did not cause your child’s speech delay. Did you read that right? You did not cause your child’s speech delay. That’s right. Unless you have been providing your child with a level of neglect that warrants a CPS call, you should not blame yourself for your child’s speech delay.
So what causes a speech delay? Current research shows that a child may be predisposed to have a language delay if there is a family history of speech delays, if they have hearing loss (read our article on PE “ear” tubes), if they have birth complications (ex: premature, low birth weight), have a developmental disorder (ex: Autism, Cerebral Palsy), an intellectual disability, oral motor difficulties, or a neurological disorder. A child may have one or more of these factors contributing to their speech delay or none at all. As you continue to work with your speech-language pathologist and pediatrician, you should be able to get some answers.
How Can I Help My Child Talk?
Consult your Child’s Pediatrician
As I hinted at in the last section, your first line of defense when it comes to a speech delay is to schedule a time to talk to your child’s pediatrician about your concerns.
Tip: Don’t just tell your pediatrician that your child isn’t talking/making sounds. Pretend you’re a researcher observing your child and write down answers to the following questions. I’ve listed out some example answers to show what your thought process might be.
Does my child ever imitate silly faces/sounds I make?
Example Answer: My child doesn’t imitate blowing raspberries or rolling her eyes like I do, but she does imitate me when I stick out my tongue!
Does my child make eye contact?
Example Answer: My son is all about go-go-go. He’s constantly playing with his toys and running around so he doesn’t pay a ton of attention to what his dad and I are doing. However, he does turn to look at me when I call his name or ask him if he wants to do his favorite things like “do you want to go to the park?”, and he’s always making eye contact when we do pat-a-cake!
How does my child communicate that they’re hungry/tired?
Example Answer: I always know when my daughter is hungry - she’s a snacker. Everytime she wants something to eat she goes into the kitchen and stands next to the fridge. I normally know that she’s tired when she starts throwing a tantrum, but she doesn’t communicate in any other ways.
How does my child communicate when they want something?
Example Answer: My son will normally point to what he wants or reach for it. Sometimes if I’m in the other room he will pull me by the hand to what he wants.
Does my child do any gestures (waving hi/bye, pointing)?
Example Answer: She isn’t pointing yet, but she does wave hello when someone comes into our apartment and she always waves at Bluey when he comes on the t.v.
Has my child met their other milestones on time?
Example Answer: My son was quick to roll over for the first time, but he was a pretty late walker. I think he didn’t start walking until he was closer to two.
These questions should help you get thinking about what your child’s non-verbal communication skills are - which should truly help you and your pediatrician decide if further action is necessary.
Speech Therapy Evaluation
If your pediatrician agrees with your concern over your child’s speech delay, they will likely write a referral for a speech therapy evaluation. This evaluation will likely span from 40-90 minutes and include an observation component as well as questions for you (the caregiver). Don’t worry about answering every question perfectly - we know parents haven’t been preparing for a quiz on their child with questions like “how well do they follow one-step directions?” - you’ve been too busy being a parent!
Your pediatrician may refer you to a private clinic, home health company, or early childhood intervention. If your child is under the age of three, it may be worth looking into early childhood intervention /early intervention.
If your pediatrician waves off your concern and recommends let’s “wait and see” you can always choose to pursue an evaluation through early intervention as most states do not require a physician referral for your child to get evaluated. Pediatricians are amazing at what they do, but sometimes they don’t get a full picture of a child’s abilities and behaviors in seeing children only a few times a year - if your parental gut instinct is telling you something isn’t normal - follow it. Consider an early intervention evaluation or advocate for your child by sharing the additional information you’ve gathered from the questions above with your child’s pediatrician as well as your growing concern.
A pediatrician may not be concerned if your child’s only issue is being a late talker, but if you’ve noticed your child also isn’t using any gestures, doesn’t make eye contact, doesn’t seem to communicate that they’re hungry/thirsty/tired, or is delayed in other areas - this may be of more concern.
What is Early Childhood Intervention/Early Intervention?
You may be wondering - what the heck is early childhood intervention/early intervention? While the name may differ slightly from state-to-state, the programs are virtually the same.
Early intervention refers to the programs available in all 50-states of the United States (authorized through the Individuals with Disability Education Act) that provide services to children from birth to age three. You can find the program available in your area by Googling “Early Intervention in [your zip code and state]”.
Here is a list of some of the services that may be available through your local early intervention:
Speech and Language Services
Occupational Therapy
Physical Therapy
Audiology and Hearing Services
Medical/Nursing Services
Nutrition Services
Counseling and Training for Families
Psychological Services
Here are some reasons I love early intervention for families:
Free Evaluation: that’s right! Whether or not your family is ensured/your child qualifies for services your child’s initial evaluation will be free of cost to you.
NOTE: if you have insurance your insurance will be billed but any remaining co-pay/balance will be taken care of.
Subsidized by the Government: most programs have a sliding scale for treatment (pay what you can) which makes services much more affordable than other options.
Therapy Takes Place in the Home: while there are some exceptions to this rule, the majority of early intervention programs are home-based - meaning your child’s therapist will provide services in your home instead of a clinic. This is super helpful for parents as getting out of the house can sometimes feel like a headache-inducing production.
Parent-Coaching Model: Instead of the “traditional” speech therapy model where you would drop off your kiddo for their session and wait in the lobby: early intervention includes parents as part of the session. In fact, the goal of early intervention is to teach you strategies to use with your child when a therapist is not present - so that you’re able to carryover speech therapy into your daily lives.
Seamless Transition to the Schools: while services for a child in early intervention do end at age three, your child’s case manager will help you to coordinate an evaluation with your local school district before services end. This is so helpful to parents as getting your child evaluated in the schools can sometimes be a confusing process.
Here are some reasons early intervention may not be right for your family:
You Prefer the Clinic Environment: as mentioned above, your child’s therapy services will most likely take place at your home (don’t worry if it’s messy - we don’t judge). However, if you don’t feel comfortable having therapists come to your home or just prefer a clinic, early intervention may not be right for you.
You Don’t Want to be Directly Involved in the Therapy: while it is always recommended as best practice to be as involved in your child’s early intervention therapy as possible (and carryover strategies at home) - if being “coached” and present during your child’s therapy isn’t possible due to your work-schedule or it sounds like nails on a chalk-board to you, early intervention may not be the right fit for your family.
NOTE: sometimes a child is in full-time daycare and parents can’t slip away from work - we get it - and we also wish our workplaces were more parent friendly! Your child can likely still receive services in their daycare without you present (just make sure to sign off on any required documents to do so from your early intervention team and daycare).
You Want as Much Therapy as Possible: part of early intervention’s magic is that it is subsidized by the government and uses the parent-coaching model. However, this does create limitations as well. Many programs don’t have the bandwidth to see a child more than 1 - 4 times a month and the early intervention model relies on carry-over of strategies more than direct treatment methods for success. So if you’re looking for a frequency of 2-3 times a week, pursuing private speech therapy in addition to or in lieu of early intervention may be right for your family.
What Won’t Help Your Child Talk?
While we all wish there was a magic toy/t.v. show, or strategy that would miraculously get our child talking, there is no such thing. However, there are lots of flashy products/strategies being marketed towards parents to cure late talkers that I want to take a moment to debunk. The most important thing to know when it comes to learning language is that the only way to learn language and communication is through real life human interactions. So before buying a toy/turning on a YouTube channel advertising to “teach your kid to speak” consider - is this going to provide my child with real life human interactions?
Research has shown that just putting a child in front of a video of people communicating/teaching language is not an effective method - so save your money! While it’s true there are toys I recommend for facilitating language, it’s all about how you use a toy, not what the toy is. Trust me, you can make a box of cereal the most fun toy in the world if you just learn how. So if there are any toys/apps being marketed towards you to “get your kid talking!” especially ones that don’t require any human involvement - don’t fall for it.
Will My Child Have Language Problems Forever?
This is a common fear of the parents I work with, and unfortunately, there is no definitive answer I can provide you with. What I can tell you is that speech delays are common - 1 in 5 children learn to talk later than expected. And I can also tell you I was a late talker! Yes, I was one of those toddlers who was evaluated for a speech and language delay. I can also tell you that if your child is delayed in more than one area of development (ex: difficulty feeding, late walker, not interested in other children/toys) they are more likely to require ongoing support after the age of three.
If you think your child may continue needing support after the age of three, know that no matter what their diagnosis/current functioning is - there is always room for growth. I always tell parents that while I can’t tell them exactly what their child “will be able to do” I also never tell them what they’re child “will never be able to do”. Modern treatment and medicine is constantly advancing and while a child’s first words/communication may not look how we expect, we never want to limit their potential.
Final Thoughts
If you’re worried about your child’s speech and language development, you’re not alone. Many parents have the same concerns, and the good news is that there are steps you can take to support your child’s communication skills. Understanding typical milestones, observing how your child communicates, and seeking guidance from professionals are all important steps in getting the right help.
Remember, every child develops at their own pace, and being a late talker doesn’t necessarily mean a long-term problem. However, early intervention can make a huge difference, and if your gut is telling you something isn’t right, trust yourself and advocate for your child. Whether through early intervention services, private speech therapy, or simply implementing strategies at home, there are many ways to support your child’s language development.
Most importantly, give yourself grace. You did not cause your child’s speech delay, and you are already doing the right thing by looking for answers and seeking support. With the right resources, patience, and encouragement, your child can continue to grow and develop their communication skills in a way that works for them.
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