Disclaimer: This article is for educational purposes only and is not a substitute for medical advice, diagnosis, or an individualized evaluation by a qualified healthcare professional or speech-language pathologist.

When You're Not Sure Whether to Worry or Wait

As a speech-language pathologist, I should feel confident (no room for doubt) in knowing when to worry or when to wait when it comes to my children's speech and language development, right? Maybe, but that's not the reality of being a parent. Even with my education and experience, there are moments when the worry that comes with being a parent takes over all rationale thoughts. 

Worrying about our children is a good thing! It's what helps keep them safe and helps parents take action when needed. 

Maybe you've noticed that other toddlers at daycare seem to be chatting nonstop while your child is mostly pointing and grunting. 

Maybe a grandparent told you, "Just wait. They'll talk when they're ready."

Maybe a friend reassured you that their child didn't talk until age 3 and turned out just fine.

Or perhaps you've heard, "They understand everything, so there's nothing to worry about."

As a speech-language pathologist and a parent of two toddlers, I understand how confusing these messages can feel. Most parents aren't looking for a reason to worry. They're looking for clarity and reassurance.

You do not have to choose between panicking and doing nothing. What I want to give you is in information that helps you feel better informed. An action plan on what to do next. 

A speech and language evaluation can help you better understand your child's communication skills, identify strengths, answer questions, and provide recommendations for next steps when needed.

It's also helpful to know that speech therapy is about much more than pronunciation. Speech-language pathologists evaluate many areas of communication, including speech sounds, expressive language, receptive language, gestures, play skills, social communication, and sometimes feeding-related concerns.

What Does a Speech-Language Pathologist Look At?

When evaluating toddlers, speech-language pathologists look at several different communication skills.

Speech

Speech refers to how a child produces sounds and how understandable those sounds are to others.

Expressive Language

Expressive language is how a child communicates wants, needs, thoughts, and ideas through words, signs, sounds, or other forms of communication.

Receptive Language

Receptive language is a child's ability to understand words, directions, questions, and everyday language.

Social Communication

This includes using communication to connect with other people, take turns, share interests, and participate in interactions.

Gestures and Nonverbal Communication

Pointing, waving, reaching, showing objects, facial expressions, and body language all help toddlers communicate before and alongside spoken words.

Play and Interaction Skills

Play is an important part of communication development. Through play, children learn new words, problem-solving skills, and social interactions.

Putting them all together:

A toddler may have difficulty in one area while doing quite well in another. For example, a child may understand many directions but use very few spoken words. Another child may talk often but struggle to understand language.

That is one reason a comprehensive evaluation can be so valuable and informative. A speech-language pathologist will complete a range of tests with your child and provide you with a picture of where your child is in each area.

7 Signs Your Toddler May Need Speech Therapy

1. Your Toddler Is Not Using Many Words

One of the most common reasons parents seek a speech evaluation is because they're concerned about limited spoken words.

You might notice that your toddler:

• Uses very few words compared to their peers
• Relies mostly on pointing or pulling adults
• Uses the same few words repeatedly
• Is not adding new words over time
• Becomes frustrated easily and often when attempting to communicate

It's important to remember that words do not have to be pronounced perfectly to count.

Examples of meaningful communication may include:

• Spoken words
• Consistent word approximations ("ba" for ball)
• Animal sounds used intentionally ("moo" for cow)
• Exclamations like "uh-oh"
• Consistent signs used to communicate 

Rather than focusing on one specific vocabulary number, speech-language pathologists look at the overall communication picture, including:

• Gestures
• Understanding
• Progress over time
• Attempts to communicate
• Early word combinations

If you're wondering what is typically expected around age 2, you may also find this post helpful on How Many Words Should a 2 Year Old Say?.

When to consider an evaluation

If your toddler is using very few words, is not adding new words consistently, or communicates mostly through crying or leading adults, it may be helpful to discuss your concerns with a pediatrician or speech-language pathologist. Your pediatrician should be able to provide you with any necessary referrals and hopefully have a resource on available speech-language pathologists near you.

2. Your Toddler Is Not Combining Words

As vocabulary grows, many toddlers begin combining words to communicate more complete ideas.

Examples include:

• More milk
• Mommy help
• Daddy go
• Big truck
• My turn
• Want snack
• Baby sleep

These combinations communicate a clear message and show language growth.

It's helpful to distinguish between:

• Independent combinations: Words your child puts together on their own
• Memorized phrases: Repeated chunks learned as a routine
• Immediate repetition: Echoing what someone just said

All communication attempts provide useful information, but spontaneous combinations often tell us more about expressive language development.

When to consider an evaluation

If your toddler has a growing vocabulary but is not beginning to combine words as expected for their age and developmental profile, a professional evaluation may provide helpful guidance.

3. Your Toddler Has Difficulty Understanding Language

A child's ability to understand language is called receptive language.

Parents may notice challenges such as:

• Difficulty following familiar one-step directions
• Trouble finding familiar objects when asked
• Difficulty pointing to familiar pictures or body parts
• Limited understanding of routine phrases
• Difficulty answering simple questions
• Trouble learning new words during daily activities

For example, your child may not consistently respond when you say:

• "Get your shoes."
• "Bring me the ball."
• "Where's Daddy?"
• "Time for bath."

Hearing also plays an important role in language development.

If you have concerns about hearing, discuss them with your child's healthcare provider and consider an evaluation by an audiologist if recommended. Additionally, your pediatrician's office should have a tool to screen your child's hearing right in their office.

*My grandfather was born deaf in one ear, so both of my children have had their hearing screened at every routine appointment since birth! It's fairly easy and not painful for the child.

A child who understands language well but uses few words may have a different communication profile from a child who has difficulty both understanding and expressing language.

When to consider an evaluation

If understanding language seems difficult in everyday situations, seeking professional guidance will be helpful.

4. Your Toddler Uses Few Gestures or Rarely Tries to Communicate

Communication begins long before spoken words. Babies may start waving "hi/bye" between months 8-12. This counts as communication!

Many toddlers communicate through gestures such as:

• Pointing to request something
• Pointing to share something interesting
• Waving
• Reaching
• Nodding yes
• Shaking their head no
• Showing objects
• Bringing toys to caregivers
• Looking between a person and an object
• Using facial expressions to share feelings

You might also notice whether your child attempts to get another person's attention.

For example:

• Bringing you a toy to show you
• Looking at you after seeing something exciting
• Attempting to share a discovery

One behavior by itself is rarely enough to draw conclusions. A reduced amount of eye contact alone, for example, does not diagnose any specific condition.

The overall pattern of communication is much more informative. At an evaluation, a speech-language pathologist will look at which skills your child can/cannot do along with the other types of communication skills.

When to consider an evaluation

If your toddler rarely uses gestures, has limited nonverbal communication, or seldom attempts to engage others, it may be worth discussing with a professional.

5. Your Toddler Becomes Frequently Frustrated When Communicating

Communication difficulties can sometimes lead to frustration.

You may notice:

• Crying when you cannot understand what they want
• Pulling you toward desired items
• Giving up when misunderstood
• Becoming upset during choices
• Hitting or throwing during communication breakdowns
• Relying heavily on adults to guess needs

As parents, it's hard to watch.

At the same time, frustration can have many causes. It should not automatically be assumed that a speech delay is responsible.

Behavior is often communication, but understanding the reason behind the behavior requires looking at the bigger picture.

Helpful strategies you can try

• Acknowledge the message: "You're telling me you need something."
• Offer two choices.
• Model one simple word or gesture.
• Use pictures or visual supports when helpful.
• Avoid repeatedly saying, "Say it."
• Pause and give your child time to respond.

My youngest just turned 2 about a week ago. I keep telling my husband that I think her brain is going through a lot of cognitive changes as we're having new night wakings (ah!) and she's starting to use new words and put more words together at a rapid pace. It's definitely a fun and exciting time (especially as an SLP mom!). However, there are still multiple times a day that she is trying to communicate something to us and we're not sure what she's saying or asking for. She gets quite frustrated and upset when we can't figure it out instantaneously - and I don't blame her! My go-to in this situation is to ask her to show me and I try to guide her to point to or give me what's she's talking about. It doesn't always work but it's helping us make progress!

When to consider an evaluation

If communication frustrations happen frequently or seem to be increasing, a speech-language evaluation may help identify ways to support communication more effectively.

6. People Have Difficulty Understanding Your Toddler

Toddlers are still learning speech sounds.

It is completely expected that young children will mispronounce words.

However, some parents notice:

• Even familiar caregivers struggle to understand their child
• Parents frequently cannot figure out what is being said
• The child uses only a few consonant sounds
• Many words sound identical
• Communication breakdowns occur regularly
• Speech clarity is not gradually improving

Speech clarity develops over time and can vary significantly from child to child.

Rather than relying on one percentage or rule, professionals evaluate speech in the context of age, development, language skills, and communication effectiveness.

When to consider an evaluation

If speech is consistently difficult to understand or your child becomes upset because others cannot understand them, professional guidance may be appropriate.

7. Your Toddler Has Lost Words or Communication Skills

Parents sometimes report that a child was previously using a word, gesture, or communication skill that later disappeared.

Examples may include:

• A frequently used word is no longer used
• Previously used gestures stop occurring
• The child interacts less than before
• The child responds differently to familiar language
• Communication attempts decrease noticeably

Any loss of previously acquired communication skills should be discussed with your child's healthcare provider. Definitely trust your gut in this area, you know your child best and don't hesitate if you feel something is off.

Try writing down:

• What changed
• Approximately when it changed
• Skills involved
• Any other developmental changes you noticed

Avoid guessing at the cause. Specific observations can help healthcare professionals better understand the situation.

If you're curious about how communication skills typically develop across infancy and early childhood, the American Speech-Language-Hearing Association provides a helpful overview of developmental milestones.

At the end of this post, download my free printable checklist to keep handy!

Should I Wait and See?

Many parents hear advice to "wait and see."

Sometimes monitoring development with a clear plan is appropriate.

The key difference is whether you are:

Watching development actively

• Tracking progress
• Following up with professionals
• Monitoring specific skills

Or

Waiting indefinitely

• Hoping concerns disappear
• Not tracking changes
• Delaying questions because you're worried about overreacting

You do not need to prove that something is wrong before asking a question.

An evaluation does not automatically mean your child needs therapy.

Possible outcomes may include:

• Reassurance
• Monitoring recommendations
• Home strategies
• Hearing recommendations
• Follow-up appointments
• Referral to other services if needed

If you're trying to understand the difference between a late talker and a broader speech-language concern, read my post on Speech Delay vs. Late Talker.

What Happens During a Toddler Speech Evaluation?

Many parents worry that an evaluation will feel stressful for their child.

In reality, toddler evaluations are often play-based.

Depending on the provider and setting, an evaluation may include:

• Parent interview
• Developmental and medical history
• Discussion about words, gestures, play, and understanding
• Observation of interactions
• Play-based activities
• Assessment of communication attempts
• Discussion of hearing concerns
• Standardized assessments when appropriate
• Recommendations and next steps

Most toddlers are not expected to sit perfectly, answer questions on command, or perform like they are taking a test.

Providers often learn most by observing how a child naturally communicates during play and interaction.

Who Should I Contact If I Am Concerned?

Options may vary depending on where you live, but common starting points include:

• Your child's pediatrician or healthcare provider
• A licensed speech-language pathologist
• Your local early intervention program for children under 3
• School district or preschool evaluation services when age-appropriate
• An audiologist if hearing concerns are present

Before reaching out, consider writing down:

• Words your child uses
• Gestures they use
• Word combinations
• Directions they understand
• Communication frustrations
• Questions you have
• Any loss of previously learned skills

Having specific examples can make conversations more productive.

What Can I Do at Home While I Seek Guidance?

You do not need to turn your home into a therapy clinic.

Small changes during everyday routines can make a difference.

1. Follow Your Child's Interests

If your toddler loves cars, talk about cars.

• "Car go."
• "Fast car."
• "Blue car."

2. Use Short, Simple Language

Match your language to your child's level.

Instead of: "Would you like to participate in putting the puzzle together?"

Try: "Puzzle time!"

3. Repeat Important Words During Routines

During snack:

• "Banana."
• "More banana?"
• "Yummy banana."

4. Expand What Your Child Says

If your child says:

"Car."

You might say:

• "Blue car."
• "Car go."
• "Fast car."

5. Offer Choices

Show two items.

"Crackers or banana?"

This encourages communication without pressure.

6. Pause and Allow Time to Respond

Ask a question, then wait.

Many toddlers need extra processing time.

7. Pair Words With Gestures

Wave while saying "bye."

Point while labeling objects.

8. Read Simple, Repetitive Books

Books with repeated words make participation easier.

9. Sing Songs With Predictable Pauses

Pause before a familiar word and allow your child a chance to participate.

10. Avoid Pressuring Your Child to Imitate

Try not to repeatedly ask a child to "say it" or telling the child to "use your words."

Model language naturally and keep communication fun.

For additional ideas, consider exploring future My Speech Hive resources like my post on Daily Routines To Help Your Toddler Talk More. 

Trust Your Instincts Without Blaming Yourself

Many parents worry they somehow caused a speech or language delay.

You did not cause a communication difficulty by occasionally anticipating your child's needs.

You are not failing your child by asking questions.

Seeking guidance is a caring and responsible step.

Parents often notice subtle changes because they know their child best.

That does not mean every concern signals a problem, but it does mean your observations matter.

You can support your child's communication growth without making every interaction feel like therapy.

Frequently Asked Questions

Can a toddler need speech therapy even if they understand everything?

Yes. Some toddlers have stronger receptive language than expressive language. They may understand directions, routines, and conversations but have difficulty using words to communicate their own ideas.

A speech-language pathologist can evaluate both their understanding and expression skills to determine whether support may be beneficial.

Should I wait until age 3 to contact a speech-language pathologist?

No. Parents do not need to wait until age 3 to ask questions about communication development.

Early concerns can be discussed with a pediatrician, speech-language pathologist, or local early intervention program.

In fact, if a child needs speech therapy, then the earlier the better to get started.

Does a speech evaluation automatically mean my child will need therapy?

Definitely not!

An evaluation simply gathers information. Outcomes may include reassurance, monitoring recommendations, home strategies, referrals, or therapy recommendations depending on the child's needs. 

If things change for your child as they get older, then you have a starting point to refer back to on what their previous skills were. 

What is the difference between a speech delay and a language delay?

Speech refers to how sounds are produced and how clearly a child is understood.

Language refers to understanding and using words, ideas, gestures, and communication.

A child can have difficulty with speech, language, or both.

Can a late talker catch up without speech therapy?

Some late talkers make significant progress without ongoing therapy.

However, it can be difficult to predict which children will catch up independently and which may benefit from additional support.

A professional evaluation can help families make informed decisions.

Do signs, gestures, and animal sounds count as communication?

Absolutely!

Communication includes much more than spoken words.

Pointing, signing, waving, meaningful animal sounds, exclamations, and showing objects all provide important information about a child's communication development.

Should my toddler have a hearing test?

If there are concerns about hearing, language development, responsiveness to sounds, or frequent ear-related issues, discuss hearing evaluation options with your healthcare provider.

Hearing is an important part of communication development.

What if my pediatrician says to wait, but I am still concerned?

Parents can respectfully share specific observations and ask for guidance about which milestones to monitor.

Consider asking:

• What skills should I track?
• When should we follow up?
• Would a speech or hearing evaluation be appropriate?

Seeking additional evaluation when concerns remain is a reasonable option. You can still ask for a referral even if your pediatrician suggests to wait.

Conclusion

One sign alone does not diagnose a speech or language disorder.

Instead, look at the overall picture:

• Words
• Word combinations
• Understanding
• Gestures
• Social communication
• Speech clarity
• Progress over time

If you have concerns, remember that asking questions is not overreacting.

Consider tracking your toddler's communication skills, discussing concerns with an appropriate professional, and exploring practical language-building strategies during everyday routines.

You may also find it helpful to read other My Speech Hive resources, including Speech Delay vs. Late Talker, How Many Words Should a 2 Year Old Say?, 2 Year Old Speech Checklist, and Communication Styles & Toddler Speech Development.

Sometimes peace of mind comes from getting more information. Sometimes it comes from getting support. Either way, you do not have to figure it out alone.