Speech and language disorders can affect your child’s comprehension and how they express themself. Certain conditions can affect their development in these areas.
Toddlers are busy little beings. They walk, talk, and explore the world around them with fascinating curiosity.
You may notice that your child’s development goes at its own unique pace. And that’s OK — at least most of the time. Still, if you’re worried that your 2-year-old isn’t talking as much as their peers, or that they’re still babbling versus saying actual words, it’s a valid concern.
Understanding what’s developmentally appropriate at this age can help you know if your tot is on track. Here’s more about the milestones, what to watch for, and how you can seek help for potential issues.
Related: Language milestones at 1 to 2 years
By age 2, milestones for speech and language include having a vocabulary of 50 or more words, even if they aren’t pronounced perfectly or understood by strangers. Your tot may also call their favorite foods by their correct names and make various animal sounds — moo, baa, cluck, oink — when prompted.
Two-word phrases also emerge (e.g., “want food”), as well as the use of pronouns like “mine,” by your child’s second birthday.
Between the age of 2 and 3, your child may know between 200 and 1,000 words. That’s a big jump in vocabulary! They may begin to understand and speak about spatial concepts, such as “on” or “in.” They also demonstrate a better understanding of pronouns and know words to describe people, places, and things, including “happy” or “sad” and “big” or “small.”
Other milestones include:
- using two- to three-word sentences (e.g., “I want more” or “I see that”)
- speaking more clearly so that caregivers can understand
- answering simple questions
- using more pronouns, such as “I,” “you,” or “me”
- adding appropriate inflection to questions (e.g., “my turn?”)
- beginning to use plural words by adding “s” to everyday words, like “toys” or “shoes”
- beginning to use past tense for verbs, like “walked” or “jumped”
It’s important to note that children of this age still may leave the ends off of words. They may also not speak in a way that’s totally understood by strangers. When they’re 2, you or other caregivers may only understand around 50 percent of the words your child says.
As your child gets closer to age 3, their speech may be understood fairly well by the people in your family or others who regularly care for them.
Related: Does my toddler have a speech delay?
You may have heard that speech delays are associated with autism. This is true, but delays can exist on their own as well. In general, children with isolated speech delays tend to meet their milestones in other areas of development — just not in speech or language.
For example, your child may have trouble speaking but does respond when their name is called or can use other ways to communicate, such as shaking their head yes or no, using sign language, or vocalizations. Your child may not have a large vocabulary, but they can follow age-appropriate directions or use age-appropriate social skills.
Children with autism spectrum disorder (ASD) may have speech delays, as well as difficulty with communicating in general. For example, you may notice your child doesn’t respond to their name or follow directions. Your tot may not point toward objects or use other gestures.
Other features of autism include:
- Additional communication issues. These include repeating certain words or phrases and losing words or phrases that were once in their vocabulary. You may also notice that when your child does speak, they do so in a robotic, sing-song, or other unusual tone of voice.
- Social challenges. In children with autism, these include things like limited eye contact and trouble reading cues, such as facial expressions or body language, among other challenges.
- Repetitive behaviors. Rocking or hand-flapping are other signs of autism. Your little one may be extremely focused on certain interests, play with their toys only in a specific way (e.g., lining up dolls or spinning crayons), or even seem interested in just one part of a specific toy, such as the buttons on a doll’s dress.
Being extremely troubled with breaking a normal routine is yet another
Resist the urge to self-diagnose your child, and bring up any concerns with your child’s pediatrician. Some of the behaviors above may be part of your toddler’s personality or development. Experts say that a doctor’s diagnosis of autism at age 2 can be “
Related: How early can autism be detected?
Outside of ASD, there are a number of reasons your child may experience a speech or language delay. Primary causes are those that can’t be attributed to some other condition affecting your child.
Speech and language are two different things. Speech is the way your child forms words and sounds, while language is how your child applies meaning to those words and communicates. Children can have trouble saying words, putting them together, or other issues with speech and language.
Some primary causes include:
- Developmental expressive language disorder (DELD). Children with this condition have trouble expressing themselves with speech, gestures, and writing (though trouble with writing won’t be noticeable with a toddler). The cause of this disorder is unknown.
- Receptive language disorder. On the flip side, children with receptive language disorder have trouble understanding and processing language they hear. These kids may hear the words around them but have trouble connecting the words to their meanings. As with expressive language disorder, the cause is generally unknown.
Other secondary conditions that may also cause delays in speech and language. This means the delay is caused by another condition that affects another part of your child’s body or brain. For example, the ears or soft palate of the mouth.
- cerebral palsy
- childhood apraxia of speech
- hearing loss before or after speech is developed
- intellectual disability
- selective mutism
Related: Speech disorders
In the United States, children are eligible for a free federal program called “early intervention” until age
In regards to language and speech, audiologists and speech-language pathologists help children with communication skills, including listening, talking, gesturing, and overall understanding.
You may also get in touch with your state’s early intervention program
After your first contact, your child will be evaluated by a professional to discover their individual set of needs. If your little one is eligible, they may undergo more tests or observations so your child’s team can write up an Individualized Family Service Plan.
As the name implies, each child’s plan will be catered to their needs and the corresponding potential treatments. As a caregiver, you help decide what’s part of your child’s plan.
Therapy activities for toddlers might involve:
- playing games
- reading books to interact through language
- practicing with sounds and syllables
Sessions may take place in your home or at a nearby school, day care center, or other public space.
You, as the parent, may also be able to help your child with speech therapy with proper training from a speech-language pathologist. Experts share that children exhibit a more varied response to learning from their parents, though, so be sure to work with professionals when coming up with your ultimate plan.
Discussing any concerns you may have with your child’s pediatrician is a good idea, too. They can help with the evaluation, as well as recommend and help coordinate any appropriate medical testing, such as a hearing test, and potential specialist referrals.
What about after age 3?
Is your child almost 3? Before their birthday, your early intervention team will help write a transition plan for the next stage of therapy/support. Some states continue to offer early intervention after this age — your team can give you more information on the specifics. For others, services may be available through their local school district.
Related: What is speech therapy?
Keep in mind that every child is different, and every treatment plan is individual. Your little one may respond quickly to therapy (if needed) or, on the other hand, they may take some time to get the hang of things.
That said, in instances of an isolated speech and/or language delay that isn’t associated with another condition, early treatment can be helpful. Experts at the American Academy of Family Physicians share that children in this category typically have normal speech by the time they enter kindergarten.
A more recent study showed that late talkers may have more emotional or behavioral issues at age 2 due to not being able to adequately express themselves. However, over time these children didn’t show a significant difference in these areas when compared with their peers.
For speech and language delays caused by secondary issues, your child’s progress will likely depend on the cause and continued treatment therapies. Don’t lose hope. Continue to reach out to your child’s pediatrician or early intervention specialist for guidance and support.
There’s a lot you can do at home to promote good speech and language skills in the early years. Try reading to your toddler daily. You can also sing songs and talk out loud as you go about the day’s tasks to get your little one hearing more words and sentences.
If you still have concerns about your child not reaching speech or language milestones, consult your pediatrician. You don’t need a referral for early intervention services, but your child’s doctor may be able to point you in the right direction for help. The key is to identify potential issues and get support as soon as you can.
And don’t worry if you’re unsure about whether your family needs services. Leave that part up to the professionals and continue to advocate for your child.