Tips and Resources5 MINUTE READ

When Should You Consider Speech Therapy for Your Child?

When it comes to a child's speech and language development, there’s one perennial question that all parents have asked themselves at some point: “what’s normal?” 

Children don’t come with a guidebook. And it can be hard to determine whether they’re reaching age-appropriate milestones, if professional help from a speech therapist is required, and when to get started. 

Communication issues, such as speech errors, slight stuttering, and lack of comprehension are common in nearly all developing children. In a child’s early years, their budding brains are rapidly developing as they learn to talk and better understand the world around them. 

So what separates a bump in the road from a more serious issue? Will these speech errors naturally resolve on their own or do they require intervention? What’s normal for other children their age? Let’s dive in.

What are Speech and Language Problems?

While speech and language problems often intersect, there is an important distinction between them. The first step in recognizing speech or language impairments is understanding the difference. 

Speech involves how children verbalize and articulate their communication. Children with speech difficulties may have trouble pronouncing certain sounds and letters (such as /s/ or /z/), forming these sounds into intelligible sentences, and expressing their thoughts and opinions. Speech delay, for example, is a common problem in young children that is defined as not hitting certain developmental milestones expected for their age. This can be caused by a number of factors, including oral-motor problems such as trouble coordinating tongue, lip, and mouth movements needed to articulate sounds properly. Stuttering is another example that affects millions of people, and is characterized by the disruption of speech due to the prolongation, repetition, or sudden stoppages of sounds.

Language disorders, on the other hand, affect how a person processes, interprets, and understands both verbal and non-verbal communication. Unlike speech problems, a child with a language disorder may pronounce words perfectly, however, in many cases they experience difficulty organizing them together into coherent sentences. They may struggle to learn and use new vocabulary or tell stories (expressive language disorder) or have trouble grasping what their conversational partner is trying to communicate, defining words, or comprehending written text (receptive language disorder). 

Typical Speech and Language Milestones

Every child follows their own developmental timeline. Some kiddos are simply late talkers and will soon be rattling off a million words a minute. Others may exhibit normal signs of speech and language progression and then suddenly hit a plateau or develop a stutter. 

Regardless, there are certain milestones that children should meet within an expected age range. 

3-12 Months:

Communication extends far beyond verbal utterances. We use non-verbal communication everyday, such as gestures and facial expressions, to express our thoughts and feelings. Even before toddlers say their first words, they should be smiling, making eye contact, responding to social cues, babbling, painting, waving, playing, gesturing, etc.  By the end of 12 months, children also begin to experiment with speech. They may try to imitate your sounds, say simple words like “mama,” and begin to make associations between objects and their names.  If you notice your child is not interacting with people at all, or is generally unresponsive, it’s recommended you seek the professional help from a speech therapist. 

12-18 Months: 

At this age, children generally begin saying their first intelligible words. While their vocabulary will still be limited, they should exhibit an increased capacity to use and understand verbal and nonverbal communication. They should also begin to understand and follow simple directions and recognize common names, items, and body parts.

24 Months:

By 2-years-old, children's speech and language should have rapidly progressed. They should not only have said their first words, but know as many as 50 words or more. Additionally, children should begin to string these words together into simple phrases and questions, such as “milk please,” or “bye-bye now?” 

This is also the age where independent and spontaneous vocalizations become noticeable. In other words, they’re not just imitating or repeating your words, but expressing themselves on their own volition. While children this age won’t be understood 100% of the time, as a rule of thumb they should generally be speaking well enough to be understood by you and immediate family members at least 50% of the time. 

Beyond 24 Months:

At this point, identifying whether your child has a speech or language impairment becomes quite apparent. Some red flags can include:

  • Your child continues to have limited vocabulary and isn’t saying many words

  • Inability to put words together and create simple phrases or sentences

  • Not being understood at least 75% % of the time

  • Low levels of interactions (ex: not pointing when asked or answering questions)

  • Not understanding simple instructions and directions

  • Continuing to mispronounce vowels or rarely using consonants


When Should Children Correctly Pronounce Sounds?

Similarly, there are many sounds and letters in the English language that children master overtime. It’s important to observe not only what your child is trying to say, but how they’re saying it. Mispronunciations of expected sounds by different ages can be another indication that your child would benefit from speech therapy. 

While all children develop at their own pace, below are certain sounds that most English-speaking children should be using correctly.

By 3 months:
  • Your child has started making cooing sounds

By 5 months:
  • Laughs and makes playful sounds

By 6 months:
  • Makes speech-like babbling sounds like puh, ba, mi, da

By 1 year:
  • Starts putting sounds together to say things like mimi, upup, bababa

By 3 years:
  • Can use the following sounds proficiently in words: /m/ /n/ /h/ /w/ /p/ /b/ /t/ /d/ /k/ /g/ and /f/


By 4 years:
  • Uses the following sounds in words: /y/ and /v/


By 6 Years:
  • Uses the following sounds in words: /l/ /sh/ /ch/ and /j/ sounds in words

By 8 Years:
  • Can correctly use all sounds, including those more difficult to pronounce, such as /r/ /s/ /z/ and /th/

Early Intervention Can Lead to Better Outcomes

Communication can affect all aspects of a child’s life: their ability to express themselves, understand others, how they perform in the classroom, their motivation and confidence, mental health and socialization, and so much more.

Therefore, it’s imperative that parents and caregivers carefully observe their child’s communication strengths and challenges. While the “watch and wait” approach may be appropriate for some children in certain situations, it also runs the risk of delaying necessary treatment. The longer a child uses improper speech and forms errant speech patterns, the longer they can take to correct and the greater impact they can have on their quality of life. 

Therefore, if you notice your child struggling to communicate, or if speech errors are affecting their day-to-day lives and interactions, it’s generally recommended that you seek a comprehensive evaluation from a certified speech-language pathologist. These communication experts will draw on their education and experience to make a clinical recommendation about “if and when” your child should begin therapy.

Again, there’s no simple formula for determining exactly when a child should initiate speech therapy. What’s important is that you remain vigilant in identifying any potential issues, speak regularly with your pediatrician, and if necessary, seek an evaluation from a speech therapist. Generally, the earlier you can intervene and start working on corrective strategies to fix or compensate for their communication challenges, the more progress your child will make.

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