Is My Child’s Language Development Normal?

by Beth Brown, M.S., CCC

Children vary greatly in the amount and type of language they develop during the first three years of life.  Many children have 50-100 words by 2 years of age and are combining two words together, but other children are slower at acquiring verbal language.  They point and gesture and wait for an adult to anticipate their wants and needs.  Some children have many single words but their speech is unclear to most people except for very familiar listeners.  When should you be concerned?  Here are some “red flags” that you may want to discuss with your pediatrician:

At 18 month of age:

  • does not use at least 8-10 words, or is not talking at all
  • does not wave and/or say “hi” and “bye-bye”
  • does not use words to communicate, but continues to rely on gestures, pointing and leading an adult to a desired object
  • does not respond to very simple request, directions and questions such as “No,” “Don’t,” “Come here,” “do you want more?”
  • does not follow several simple verbal directions such as “Give me the _,” or “Show me your nose.”

At 24 months of age:

  • does not put words together to form simple phrases (“more milk”)
  • does not follow simple directions involving familiar objects such as “Get the ball and put it on the table”
  • cannot look at books for at least a few minutes at a time or does not point to pictures of familiar objects in the book as you name them
  • is not easily understood at least 50% of the time by adults and peers.


Another area of concern is in the area of stuttering.  Many toddlers go through a period of normal nonfluency. This is usually temporary and different than true stuttering. Often times the child is processing quicker than he is able to verbally communicate. Parents are encouraged to be patient and wait through this period.  They should not tell the child to do anything differently and make them think that talking is “work”.

 Other areas of communication that might indicate a problem are:

  • a child who appears to be having more difficulty with communication than most of his/her peers
  • a preschool child whose spoken vocabulary is not growing steadily from month to month
  • a child who does not seem to understand unless you use lots of gestures or show him/her what you mean
  • a child who displays signs of frustration or reluctance to talk
  • a child who uses mostly vowel sounds
  • sentence structure is noticeably faulty at the age of 4
  • voice is monotone, too loud, or of a poor quality
  • vocal pitch is too high or too low for their age and sex
  • sounds like they are talking through their nose or has a cold

If you have concerns about your child’s speech and language, discuss these concerns with your pediatrician.  He or she may refer you to a speech and language pathologist for further evaluation and treatment.

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 Beth Brown is a Licensed and Certified Speech Language Pathologist from Rady Children’s Hospital San Diego.  She has over twenty years of experience providing speech and language services to children in San Diego.  She has extensive experience in language and speech development and provides evaluations and therapy at Rady Children’s Hospital Solana Beach location.  She can be contacted by calling (858) 793-9591.

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