Speech Delay in Toddlers: Signs at 18 Months, 2 and 3, and What to Do Next

A speech delay means a toddler is saying fewer words, or putting words together later, than most children their age. One marker covers most worries at this age: by 2, most children say at least two words together, like “more milk”, according to the CDC.

The question that matters most is whether your child is talking late or communicating late. A toddler who understands you, points, gestures and plays with you but has few words is what clinicians call a late talker, and many catch up. A toddler who also understands little, rarely points or responds to their name, or has lost words they once said needs a look sooner.

You can ask for a free evaluation yourself. Under 3, every US state’s early intervention program evaluates children at no cost to parents, and a doctor’s referral is not needed. This page covers the signs at 18 months, 2 and 3, when to wait and when to ask, what causes a delay, what an evaluation involves, and how to help at home.

What is a speech delay?

A speech delay is when a child’s talking develops along the usual path, but later than for most children their age. “Speech delay” is how parents usually say it. Clinicians split it in two, using the definitions of the National Institute on Deafness and Other Communication Disorders (NIDCD): speech “is talking”, the muscle movements that make the sounds, and language “is a set of shared rules that allow people to express their ideas in a meaningful way”, meaning understanding and using words.

The terms you may hear at an evaluation:

Term	What it means	Source
Expressive language delay	Trouble using words: says fewer words, or combines them later	AAP
Receptive language delay	Trouble understanding words and gestures	AAP
Late talker	Fewer than 50 words and no two-word phrases at 24 months, with no other diagnosed condition	ASHA
Speech sound disorder	Trouble saying sounds, or speech that is hard to understand	ASHA

The American Speech-Language-Hearing Association (ASHA) calls being a late talker “late language emergence”, defined as “an expressive vocabulary of fewer than 50 words and no two-word combinations by 24 months of age”. This page says late talker from here on.

A speech sound disorder is a different question from a delay in words. It is about how sounds come out, not how many words a child has, and the patterns young children use are explained on the phonological processes page, with practice games on the minimal pairs page. A delay and a disorder can look alike at home, and an evaluation, not a checklist, tells them apart.

Signs of speech delay at 18 months, 2 years and 3 years

The signs of a speech delay in toddlers are missing the talking and understanding milestones that most children reach by 18 months, 2 years or 3 years. The CDC’s milestones, revised in 2022, list what “most children (75% or more) can do by a certain age”. The items below are the CDC’s own wording.

By 18 months, most children:

• Try to say three or more words besides “mama” or “dada”.
• Follow one-step directions without any gestures, like giving you a toy when you say “Give it to me”.

By 2 years, most children:

• Say at least two words together, like “More milk”.
• Point to things in a book when you ask, like “Where is the bear?”
• Point to at least two body parts when you ask.
• Use more gestures than just waving and pointing, like blowing a kiss or nodding yes.

By 3 years, most children:

• Talk with you in conversation using at least two back-and-forth exchanges.
• Ask “who”, “what”, “where” or “why” questions.
• Say their first name when asked.
• Talk well enough for others to understand, most of the time.

At any age, ask straight away if your child loses words or skills they had, or does not seem to hear you. The CDC lists lost skills as a reason to act early, and the American Academy of Pediatrics (AAP) tells parents to mention a child who “doesn’t seem to notice certain noises”, such as hearing a car horn but not their own name.

If your child is not doing one of these, that is a reason to ask, not a verdict. The CDC’s pages for 18 months, 2 years and 3 years say: “Don’t wait. If your child is not meeting one or more milestones, has lost skills he or she once had, or you have other concerns, act early.”

Interactive

Check the Signs for Your Toddler’s Age

Answer from what you have already seen. It ends with guidance in words on whether to ask for an evaluation, and who to call.

How old is your child?

Your child does not need to be there.You answer a few questions about what you have noticed, for their age only.

18 to 23 monthsThe 18-month signs2 years24 to 35 months3 years or older36 months and up

Younger than 18 months? The signs on this page start at 18 months. At any age, losing words or skills, or not seeming to hear you, is a reason to ask straight away.

This is guidance, not a diagnosis. Your answers are not saved and never leave this page.

The CDC’s talking and understanding milestones for every age from 2 months to 4 years are on the talking milestones by age page, with a printable checklist to bring to a checkup.

My 2-year-old is not talking yet: when to wait and when to act

How many words a 2-year-old says depends on which source you read, because the sources measure different things. The AAP says that by 2 most toddlers “say about 50 to 100 words” and use two-word phrases. The CDC lists “Says about 50 words” at 30 months, because since 2022 its milestones are what at least 75% of children do by an age, a method set out by Zubler and colleagues in Pediatrics, which moved many milestones later. ASHA’s late-talker cut-off, fewer than 50 words at 24 months, is a research definition. If your child hears more than one language, the AAP and ASHA say to count words in all of them.

Late talking is common, and many late talkers catch up. “One out of 5 children will learn to talk or use words later than other children their age”, according to the AAP. ASHA reports that about 50–70% of late talkers “catch up to peers and demonstrate normal language development by late preschool and school age”.

Nobody can tell in advance which late talkers will catch up. ASHA says the difference between a late bloomer and a child with a lasting delay “can be made only after the fact”. The best clues are what your child understands, how many words they say, and how they communicate without words: ASHA names receptive language, meaning understanding, among “the best predictors”.

Ask for an evaluation now, rather than waiting, if any of these is true of your 2-year-old:

• They are missing any of the CDC’s 2-year signs above.
• They also understand little, or use few gestures such as pointing and nodding.
• They have lost words they used to say.
• You are worried, for any reason.

The joint advice of the AAP and ASHA on HealthyChildren.org is direct: “DON’T ‘wait and see’ if the child outgrows the problem”, because “The best outcomes occur when a child is seen by a professional early”. ASHA notes that for a late talker with no other concerns, a clinician may recommend regular monitoring. That is a plan the evaluator makes with you after looking, not a reason to put off asking.

What causes a speech delay?

Often no single cause of a speech delay is found. By ASHA’s definition, a late talker is a child whose words are slow to come with no other diagnosed condition to explain it. An evaluation still checks for the known causes, starting with hearing.

• Hearing. “A hearing test is often included in the evaluation because a hearing problem can affect speech and language development”, according to the NIDCD. ASHA’s page for families lists hearing loss “from ear infections or other causes” among the causes of speech difficulties, so mention frequent ear infections.
• Family history. ASHA reports late talking in about 23% of children with a family history of it, against 12% without.
• Being a boy. “Males are 3 times more likely than females” to be late talkers, according to ASHA.
• Wider developmental conditions. The AAP lists hearing loss, delays in other areas of development, and autism spectrum disorder among the conditions a language delay can point to.

Three beliefs about speech delay come up often, and the evidence treats each differently.

• “Learning two languages causes a delay”: false. ASHA’s family page on more than one language says: “Using multiple languages does not confuse children or cause speech or language delays.” The AAP and ASHA add that learning more than one language “does not cause or worsen” a delay.
• “It is because of something I did”: not supported. None of the sources on this page names parenting as a cause of a speech delay.
• “Boys just talk later”: partly true. Boys are more often late talkers, so a slow start in a boy is common. That is a reason to watch closely, not a reason to wait: a boy missing the signs for his age needs the same evaluation as a girl would.

Is it a speech delay or autism?

A speech delay on its own is not a sign of autism. Many toddlers talk late for reasons that have nothing to do with autism, and autism is identified from a much wider set of signs than the number of words a child says. ASHA’s Practice Portal on autism says screening looks at “eye gaze, orienting to one’s name, pointing to or showing objects of interest, pretend play, imitation, nonverbal communication, and language development”, and that “speech difficulties are not the same as language and social communication problems”.

If you notice some of those signs as well as few words, tell your pediatrician. The AAP recommends screening all children for autism at the 18- and 24-month well-child visits, so you can raise it then or at any visit in between. What doctors look at to tell the two apart, and why a child can have both, is set out on the speech delay or autism page.

How to get a speech evaluation: pediatrician, hearing test and free early intervention

There are two ways to get a toddler’s speech evaluated, and you can use either or both: your pediatrician, and your state’s early intervention program. Your pediatrician may order a hearing test and refer you to a speech-language pathologist, according to the AAP. You do not need the pediatrician’s referral to go to early intervention.

Early intervention evaluates children under 3 for free, and parents can refer their own child. Early intervention is the public program for children from birth “through the third birthday”, set up under Part C of the Individuals with Disabilities Education Act. The Center for Parent Information and Resources (CPIR) says “evaluations and assessments are provided at no cost to parents”, and that parents “may contact your local program directly and ask to have your child evaluated”. The CDC adds that “A doctor’s referral is not necessary” and that programs “provide services for free or at reduced cost for any child who is eligible”. The CDC also keeps a state-by-state directory with every program’s contact.

The CDC suggests these words for the call: “I have concerns about my child’s development and I would like to have my child evaluated to find out if he/she is eligible for early intervention services.”

From age 3, the evaluation goes through your local school district instead. The CDC suggests calling your local public elementary school’s special education director and saying: “I have concerns about my child’s development and I would like to have my child evaluated through the school system for preschool special education services.”

Before the appointment, write down:

• the words your child says, and in which languages;
• whether they put two words together, with an example;
• what they understand, such as following a simple direction;
• how they communicate without words: pointing, nodding, leading you by the hand;
• any ear infections, and anyone in the family who talked late;
• any words or skills they used to have and have stopped using.

An evaluation for a toddler mostly looks like play. The speech-language pathologist or early intervention team asks about your child’s development, watches how your child plays, understands and communicates, and often includes a hearing test. The early intervention evaluation is free whatever your insurance. For a private speech-language pathologist, ASHA ProFind lists certified clinicians by area.

How to help a late talker at home

Help a late talker at home by giving them more chances to hear words and to use them: say back what they meant, talk face to face, read and sing together, and offer choices. This is the everyday version of what ASHA calls “indirect language stimulation”, which its Practice Portal describes as part of the usual plan for a late talker, including “imitating or expanding the child’s actions or words” and “giving the child adequate time to initiate communication”. The five steps below come from the CDC’s tips on its milestone pages.

1. 1

   Say it back, a little longer

   When your child says a word or two, say back what they meant with 1 or 2 words added. If they say "or nana", say "You want more banana." Do not ask them to repeat it.

2. 2

   Get down to their level and talk

   Face your child at eye level and talk about what you are both doing or looking at, in short, simple sentences, so they can watch your face as well as hear your words.

3. 3

   Read 1 or 2 books a day together

   Read 1 or 2 books a day, at bedtime or any quiet time. Talk about the pictures in simple words, and let your child point to things when you ask, such as "Where is the bear?"

4. 4

   Sing together

   Sing short songs with actions, such as Head, Shoulders, Knees, and Toes, which teaches the names of body parts while you both move.

5. 5

   Offer a choice, then wait

   Hold up 2 things and ask, "Milk or water?" Then wait a few seconds before you help. A pause gives your child time to start talking or pointing on their own.

The CDC’s 18-month tips put the talking one directly: “Teach your child more words by adding to the words she says.” Do these in short moments through the day, at meals, in the bath and at bedtime, rather than as a lesson. If your child sees a speech-language pathologist, follow their plan first and use these around it. For activities between therapy sessions, the speech therapy at home page has a 10-minute routine and games for any sound.

Screens work best with you beside them, because toddlers learn words from people talking with them. The CDC advises no screen time before 2 except video calls with family, and from 2, children’s programs watched with an adult present.

Do late talkers catch up?

A small vocabulary at 2 does not mean a child will always struggle: about 50–70% of late talkers catch up by late preschool or school age, according to ASHA’s Practice Portal on late language emergence. Prevalence estimates for 2-year-olds run between 10% and 20%, so a late talker is one of many.

Catching up in talking does not always mean catching up in everything. ASHA reports that children with a history of late talking, taken as a group, showed “poorer performance on reading and spelling measures at ages 8 and 9 years” than children who talked on time. Early talking and early reading draw on the same language, the words a child knows and how well they hear the sounds in them.

So a child who was a late talker is worth watching when letters and sounds start, at 4 and 5. If reading is slow to start, ask early rather than waiting for school to raise it. The reading check-in by age page lists what is typical at each stage of early reading.