Does my toddler have a speech and language delay?

Ah…….it’s been almost a month since my last blog post…I really think I had and maybe still have writer’s block…with the holidays quickly approaching….and trying to manage and Christmas…which to me is like planning a major event every year…and of course as much as I love Christmas…having it….and celebrating with my family…it often is hard to manage and balance it all….with that in mind…I think that between Hurricane Sandy…and the approaching holidays…my brain just could not blog….

However…after doing another evaluation the other day…followed by a recommendation from a pediatrician whom often refers to early intervention….I thought that I really needed to write a blog post…specific to children between the ages of 12-18 months.  Often times in this age range…parents bring their little one for their well visit and the pediatrician of course asks about the child’s overall development…and the question then is asked: how many words does she have?…..and when the parent replies: none…or one…or maybe just two….the pediatrician often states:….well…around 15 months your little one should have at least 10 to 15 words.  And for children closer to the 18 month mark…the pediatrician is expecting closer to 20-25 words in your little one’s vocabulary……and although there are some little ones with a vocabulary of 20-25 words at the age of 18 months….what is more important to me is your little one’s receptive language development (her understanding of language)…overlooking the receptive component in speech and language development does not look at the child’s overall communicative competence.

For me as a speech and language pathologist…between the one and two-year mark when I am evaluating children…I am more concerned with her receptive language development….this is your little one’s understanding of language….and if I see a little one that is having a difficult time in her understanding of language..then I am more concerned than with regard to how many words she has.  Pediatricians often miss that piece of language development (in my experience).  As speech and language pathologists…when we evaluate children under three years of age…..and more specific to children between the ages of one and two years of age…and even more specific between 12-18 months…what I want to know is the following (all specific to receptive language development):


Does she understand COME HERE…with your hand extended as you say the words come here.

Does she respond to her name when her name is called?

Does your little one look at objects or people the caregiver points to and names: When the mommy points to an object or family member and say: Look at daddy.  Does your little one then look to daddy?  Did she understand that simple direction given both your language and also your non-verbal cue (pointing to daddy).

Does your little one respond to the word: NO….does she stop and pause what she was doing..showing you that she understands what you are saying….she may go back and do it again…but she is showing you that she UNDERSTANDS.

Does she understand a specific word or phrase without a gestural cue…such as: give me a kiss.

Does she play appropriately with her toys?

Does she use two objects during play together?

Does she use self-directed play….does she pretend to comb her hair…does she pretend to feed herself….maybe she does this with the mommy…combing mommy’s hair.

Is she beginning to follow a routine, familiar directive with cues…if you say to your little one: give me the keys (if she was holding your keys)…and your hand is extended…giving her the visual cue….does she follow this directive.  If she was holding a ball…and you asked her to throw the ball as you modeled throwing the ball…does she follow this directive?

So….it is really important…when testing a little one under 24 months of age…more specific to the 12-18 month mark…it is important that I look to see if theses skills are mastered…does your little one understand the world around her…is she related and connected….does she respond to her she recognizing family members and is she starting to understand simple routine directions…with cues…and then without cues as you get closer to 24 months of age.

If this is the case: your 15 month old is babbling and producing a variety of consonant sounds and vowels…maybe making some attempts to say a word with meaning…maybe she has one word in her vocabulary….or your 18 month old has maybe 2 words in her vocabulary…and is babbling and producing a variety of consonants and vowels…..and as stated above…she presents with all of the receptive language skills….well in my experiences…your little one will talk..she will acquire language typically…..she will learn that words work to get her what she wants…she will learn language on an incidental level.

I plan to post more receptive language skills…that are mastered closer to the 24 month level and beyond.  For me…receptive language is like the foundation on a house…you need the foundation to build the house…it is the same thing for language development.  If you have not yet acquired the receptive language skills..then it will be more challenging to acquire words…if you are not sure what the words mean…and how to use them on a functional level. 

Hope this was helpful!

About Kim

My name is Kim Marino and I have been practicing as a licensed speech and language pathologist since 1993. I work on Long Island providing diagnostic evaluations and services to children from birth to age 21. My experience is vast and am proud to say that I work with children that may present with articulation and phonological concerns, oral motor feeding concerns, Down Syndrome feeding, cognitive rehabilitation, auditory processing delays, receptive language delays, cleft palate feeding and sound development and expressive language delays. Most importantly, I am the mother of four amazing children and am happily married to my childhood sweetheart. I feel blessed to have my four children and so lucky to share this journey in life with my husband. I always had it somewhere in my head that I wanted to develop a blog or a website of some sort so that I could provide families with an additional that parents could help their little ones become a better communicator. And as I was developing this blog....I realized that I also needed to share the stories about my life and my children....and the funny things along the way that help to keep me smiling. Whether you are a working mother or not...finding balance between home, children and life can be a challenge....I hope that my blog helps to bring a smile to your face..and also some tools to help you help your little or big one. I hope you enjoy! Kim
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6 Responses to Does my toddler have a speech and language delay?

  1. Maddie says:

    Kim, I see that this post is several years old, but I was wondering if you could shed a little light on my 18 month old’s language delay. He points incessantly, has great eye contact, doesn’t respond to his name, though I feel like he did around 12 months. He will follow non verbal direction like if I point or show him throwing a ball, but words alone elicit no response. He also make no consonant sounds, but laughs a lot and grunts and makes almost singing sounds. Anything I can do to encourage him? Thanks much.

    • Kim says:

      hi there Maddie! sorry I did not see your comment. The set of flashcards I just made is a great starting point to work on sound production. You can just go through the cards and label the pictures for him. He soon will be able to identify the sound that goes with the picture. Keep in touch. Happy to help!

  2. Ayesha says:

    Hi Kim, I came across this post when frantically googling language delays in toddlers. I too am trying to figure out if my 27 month old daughter has a language delay or is on the Autism Spectrum. I read your list of receptive language signs and there are some she will follow (for instance she understands no, does self-directed play, will bring her shoes when asked etc), but does not understand if I say ‘where is dad’ or ‘give me the cup’. She has no other ASD symptoms except perhaps completely ignoring strangers who speak with her. I would really love an opinion, also thank you for this great site, the information in it is presented very clearly.

  3. keri S. says:

    Kim, thanks for your wonderful site! My 20 month old son has me so worried and I would love your input. We are working on pointing, which he does rarely on his own, and also on helping him find his words. He says many words, but randomly.With our help he is starting to say bite,up, juice, tickle at the correct times and hopefully with the knowledge I get from your site we will see more success! What I would love to know is what are the differences between speech delay and ASD? I get so worried thinking every little thing is a red flag for ASD that I have a hard time enjoying playtime with him 🙁 His only ASD like symptoms are a tiny bit of spinning/ arm flapping, not responding well to his name and most everything else is speech related. I know you do not want to give me a diagnosis but I would from the bottom of my heart love any insight you may have!!!

    • Kim says:

      HI Keri…I am glad my site has been so helpful….let’s do this so I can get more specific information…my email: Please email a list of the words he is able to use on a functional level in order to make his needs known. NOt words he just imitates. How well does he do with following of directions? REad my last post in reference to receptive language development and let me know if he has mastered the skills I listed. Where do you live…and do you have access to any early intervetion programs. Best, Kim

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