Last updated 2026-07-09
Most toddlers have 50 or more words by their second birthday. If your 22-month-old says fewer than 10 to 15 clear words, or isn't yet combining any words by 24 months, that's worth acting on now rather than mentioning at the next well-child visit. It meets the clinical threshold for a language delay, and a speech-language pathology evaluation is the right next step.
How many words should a 22-month-old actually be saying?
There's a real range here, and it's worth trusting the published benchmarks over whatever you read on a parenting forum last night.
The American Academy of Pediatrics sets the expected milestone at 24 months: 50 words and the start of two-word combinations [1]. At 22 months your child is two months out from that mark, so a reasonable target is roughly 30-50 words along with at least a few attempts at stringing two words together, things like "more milk" or "daddy go." If your child is nowhere near that range, it isn't a minor lag you can shrug off.
The MacArthur-Bates Communicative Development Inventories, the parent-report tool researchers rely on most, put the 10th percentile for vocabulary at 22 months around 20-25 words, rising to about 28-30 words by 24 months [2]. Falling below that 10th percentile is generally where clinicians start using the term "late talker."
One thing most parents don't realize: a word only counts if your child says it on their own, and says it consistently. A word uttered once last month, or one that only shows up when you prompt for it, doesn't belong in the count. Neither does a sound that just happens to resemble a real word. Speech-language pathologists want you to be strict about this when you tally up what your child actually says.
So if you count and land on fewer than 20 reliable, spontaneous words at 22 months, or you're reading this at 23 or 24 months and still hearing no word combinations at all, that's worth acting on now rather than waiting to see what happens.
What does "late talker" actually mean, and is my child one?
"Late talker" is a clinical description, not just something worried parents say. It describes a toddler whose play, social interest, understanding of language, and motor skills are all developing normally, but whose expressive vocabulary lags well behind what's expected for their age [3]. The key point is that comprehension and social skills are fine. These kids understand far more than they can say.
Somewhere between 13 and 17% of 24-month-olds meet the criteria for a language delay based on vocabulary size alone [3], which surprises most parents when they hear it. Not all of these children turn out to have an underlying diagnosis, and research suggests roughly 70-80% of late talkers catch up by school age without formal help. What that statistic leaves out is that no one can reliably predict ahead of time which child will catch up and which won't [4]. Waiting around to find out which group your child falls into is a gamble. Getting help early, on the other hand, carries basically no downside.
A late talker is a different profile from a child with a language disorder, autism spectrum characteristics, or childhood apraxia of speech, and an evaluation can tell these apart. If your 22-month-old isn't talking much and also shows reduced eye contact, little interest in other people, repetitive behaviors, or very limited pointing and gesturing, those signs go beyond a simple expressive delay and deserve prompt evaluation [5].
So "late talker" describes a pattern, not a cause. On its own, it can't tell you what's behind the delay. Only an evaluation can do that.
A speech delay can look very different depending on what's underneath it. Some kids are just late talkers whose language catches up on its own. Others are showing signs of something that needs real support, and the trick is telling the two apart. Here's what speech-language pathologists and developmental pediatricians actually watch for in toddlers around 22 to 25 months.
The American Speech-Language-Hearing Association flags these as concerns at 24 months: fewer than 50 words, no two-word phrases, and speech that strangers can't understand at all [6]. There's also a fourth sign that matters more than the rest: losing words your child used to say. If your toddler had a word and it's gone now, that's worth a call to the pediatrician this week, not sometime next month.
Word count isn't the only thing to pay attention to, though. Also look at whether your child points to show you things (not just to reach for something) by 14-16 months, whether they can follow a simple two-step direction without you gesturing, and whether they'll imitate a sound or action when you invite them to. Some toddlers communicate mostly by grabbing your hand or pulling you toward what they want, rather than through eye contact or gesture, and that's worth noting too. Repeating lines from TV shows without using them to actually communicate is another pattern worth watching for: it's called echolalia, and it can mean language is being processed a bit differently for that child. And if the speech delay shows up alongside a strong need for sameness, real distress during transitions, or unusual reactions to sound, touch, or light, mention that combination to your doctor too.
None of these signs means much on its own. But stacked together with a speech delay, they form a pattern worth having evaluated. The AAP recommends developmental screening at 9, 18, and 24 months, plus autism-specific screening at 18 and 24 months [1]. If your child is 22 or 23 months old and missed the 18-month screening, it's reasonable to ask your pediatrician to do it now instead of waiting for the next visit.
When should I get an evaluation, and who should I call first?
If you're worried enough to be reading this, that's reason enough to make the call. Waiting until 24 months to see whether things improve is almost never the right move when a child has fewer than 15-20 clear words at 22 months.
You've got two routes to choose from, and it helps to know both.
The first is your state's Early Intervention (EI) program. Every state in the US runs a federally mandated program under IDEA Part C that provides free evaluations and services to children under age 3 who have developmental delays [7]. You don't need a doctor's referral, just call your state EI program directly, and the evaluation costs nothing. If your child qualifies, therapy is free or priced on a sliding scale. It's one of the better deals you'll find anywhere in American healthcare. Call soon rather than later: waiting lists are common, and the program stops at age 3.
The second route is a private speech-language pathologist. Your pediatrician can refer you, or you can go directly yourself. Private evaluations usually run $200-500 out of pocket depending on your area and your insurance, though many plans are required to cover speech-language evaluations for kids. In some places the wait for a private SLP is shorter than for EI, sometimes considerably so.
Honestly, doing both at once makes sense. Call EI today, and ask your pediatrician for a referral to a private SLP as well. If the evaluation comes back fine, you can always decline services, but there's no getting back the weeks lost to waiting.
For a clearer sense of what happens next, it's worth reading through how early intervention actually works and what a typical course of speech therapy looks like.
What causes a 22-month-old to not be talking?
Parents almost always want to know why, and honestly, a speech evaluation alone often can't pin down the cause. Sometimes it never gets identified precisely. What an evaluation can do is describe the pattern of the delay and point you toward the right support. Still, a few things come up again and again.
Some children have an expressive language delay with no underlying diagnosis: they understand language well, play appropriately, and connect socially, but the words themselves are slow to arrive. This is the classic "late talker" profile, and the cause tends to be a mix of things (genetics, processing speed, how much language input the child gets) that can't always be sorted out.
Hearing loss is the first thing a pediatrician should rule out, and it gets missed surprisingly often in toddlers who passed their newborn hearing screen, since frequent ear infections can cause conductive hearing loss later on. The AAP recommends a formal audiological evaluation any time a speech delay shows up [1], so don't skip that step.
Autism is another possibility. Many children with autism are first identified because a speech delay shows up alongside differences in social communication, but autism doesn't follow one speech pattern: some children are nonverbal or minimally verbal, while others talk but use language differently [5].
Childhood apraxia of speech is less common but worth knowing about. It's a motor speech disorder where the child struggles to plan and coordinate the movements needed for speech, and it looks different from a general delay: word attempts are inconsistent, consonant sounds are limited, and the same word can come out differently each time [8].
If your home is bilingual or multilingual, the math works differently. Children learning two languages at once often have smaller vocabularies in each language on its own, but their combined vocabulary across both is usually within the normal range, so a count done in only one language will undersell what the child actually knows. Make sure your SLP knows if your child hears more than one language at home.
Structural or medical factors matter too: enlarged tonsils and adenoids, differences in the palate, and some neurological conditions can all affect speech. Pairing an SLP evaluation with a medical workup covers both angles at once.
Is there a difference between a 22-month-old not talking and a 24 or 25-month-old not talking?
Yes, and the two-month gap matters more than most parents expect.
A 22-month-old with fewer than 20-25 words falls below the 10th percentile, but there are still two months before the major 24-month checkpoint arrives. It's still worth calling Early Intervention or a speech-language pathologist now, since evaluation and intake take time to get moving, and those two months are also a real window for growth to happen on its own.
By 24 months, the AAP milestone is 50 words and two-word combinations [1]. A toddler this age with fewer than 30 words and no phrases sits clearly outside the expected range by the standard clinical definition. No published guideline calls this a "wait and see" situation.
At 25 months, fewer than 50 words with no phrases means the pattern has held steady for several months running. Research on late talkers suggests that the longer a delay continues, the less likely it resolves on its own without support [4]. If a 25-month-old hasn't been evaluated yet, that should happen this week, not next month.
One more thing worth knowing: 24 months is roughly when the gap between a late talker and everyone else starts widening fast, because typically developing toddlers are adding new words quickly right around then. Catching up only gets harder from here, not easier.
What can I do at home to help my toddler talk more?
Home strategies won't replace an evaluation, but they make a real difference alongside one, and the ones with the strongest evidence are surprisingly simple. They come down to how you interact during ordinary moments in the day.
Start by following your child's lead. Get on the floor, notice what they're interested in, and comment on it. If they're pushing a truck, say "truck go" or "push, push." Skip the "what's that?" quizzing: naming and narrating what you see builds language input, while testing your child just builds pressure.
From there, try adding one word to whatever they give you. Speech therapists call this expansion: your child says "ba" while reaching for a ball, and you say "ball," or "red ball," or "throw ball." You're only stepping one rung up the ladder from where they already are, not handing them a whole new sentence.
Then slow down. After you say something or offer a choice, wait five to ten seconds with an expectant look on your face, and let your child attempt a response before you jump in and fill the silence yourself. Most parents, most adults really, rush this part.
Screen time is worth a hard look too. The AAP recommends limiting it to video chatting for children under 18 months, and to high-quality programming watched together with an adult for children 18 to 24 months [1]. Passive screen time doesn't give a child the back-and-forth exchange that language actually grows from, and cutting it back is one of the clearest levers a parent has.
Reading together every day helps too, as long as it stays interactive: point to pictures, name things, pause and let your child respond. A board book with a few simple images works better here than a page dense with text, because the point is the exchange between you, not getting through the story.
And just narrate your day out loud. "Now we're washing hands. Soap, water, rub rub." Toddlers need to hear language in context, over and over, and there's no such thing as giving a child too much good language input.
If your child is older or their needs seem more significant, it's worth knowing that online speech therapy has become a genuinely solid option, especially for families in rural areas or anywhere in-person services are hard to reach.
How does early intervention work, and does it actually help?
Early Intervention (EI) is a federal program under IDEA Part C that provides free services to children from birth through age 2 who have developmental delays, or conditions likely to lead to delays [7]. Each state runs its own version, so timelines and eligibility rules shift a bit from place to place, but the evaluation and service coordination don't cost you anything, no matter where you live.
You start by calling your state's EI intake line. They'll schedule a multidisciplinary evaluation, typically within 45 days of referral (some states move faster than others), and if your child qualifies, the team puts together an Individualized Family Service Plan, or IFSP, laying out what services your child will get. Depending on what the evaluation turns up, that might mean speech-language therapy, developmental therapy, occupational therapy, or some combination of these.
Does it actually help? The research says yes, with some caveats. A review of early language interventions found that parent-implemented approaches, the kind EI commonly uses with toddlers, led to real gains in expressive vocabulary compared to no intervention at all [9]. The effect sizes were moderate rather than dramatic, and how well the program gets carried out matters a great deal. The therapist teaches you strategies during your sessions together, and then you're the one using them the rest of the week. That's what actually makes it work.
The biggest practical snag is that demand tends to outpace what states can supply. In some places, you're looking at 6 to 8 weeks or more just for an initial evaluation, and then another month before services actually begin. Call as early as you can, stay persistent, and if it's an option for you, pursue a private SLP at the same time rather than waiting on EI alone.
Services stop at age 3. Kids who still need support at that point move into the public school system under IDEA Part B, which works differently and centers on an IEP (Individualized Education Program) instead of an IFSP.
For the fuller picture of what this process looks like in practice, our guide to early intervention walks through it step by step.
Could my child have autism, and how would I know?
A speech delay by itself doesn't point to autism. But autism is one of the conditions where a speech delay can show up alongside other things, so it's worth knowing what else to watch for.
Autism in toddlers tends to show up mainly through social communication, not just language. The M-CHAT-R/F (Modified Checklist for Autism in Toddlers, Revised with Follow-Up), the screening tool used at 18 and 24 months, looks at whether a child points to share interest, brings objects to show parents, responds to their name, and shows interest in other children, along with how they're talking [5]. A toddler who makes good eye contact, points often, and clearly enjoys interacting with caregivers, but just has fewer words than expected, is much less likely to be autistic than one who has both a language delay and less social connection.
In the US, the median age of autism diagnosis is still around 4-5 years, later than you'd want if the goal is getting early support in place [5]. If you suspect autism might be part of the picture, ask specifically for a referral to a developmental pediatrician rather than just a speech evaluation. In some areas, autism diagnostic clinics actually have shorter waits than hospital-based programs, so it's worth calling around and comparing.
If autism has already been identified or is strongly suspected in your child, our guide to speech therapy approaches for autistic children covers strategies that fit how they often process and develop language differently.
What actually happens at a toddler speech evaluation
Most parents show up to this appointment nervous, mainly because they've never sat through one before. Knowing roughly what to expect takes some of the edge off.
For a 22-25 month old, the evaluation usually takes 60-90 minutes. The speech-language pathologist will get down on the floor and play with your child, trying to draw out natural communication, and will likely run a standardized assessment such as the PLS-5 (Preschool Language Scales, 5th Edition) or the Bayley Scales of Infant and Toddler Development. Along with that, they'll ask you plenty of questions: what words your child uses, how they let you know what they want, what they seem to understand even when they're not saying it out loud.
The SLP is watching several things at once: how well your child understands language, how well they talk, how they produce speech sounds, how their mouth and jaw work for speech, and the social side of communication, like eye contact and taking turns in an exchange.
By the end, you'll get a summary of what they found and, if there's a delay, a recommendation for how often therapy should happen. For a toddler with a moderate expressive delay, that's often one or two sessions a week, 30-45 minutes each, with a good chunk of that time spent coaching you on strategies to use during ordinary moments at home.
The written report will include standard scores and percentile ranks. A standard score under 85 (more than one standard deviation below the mean) generally counts as a delay. Under 78 (1.5 SD below the mean) is considered a significant delay, and that alone is usually enough to qualify for therapy.
Do apps and communication tools actually help a toddler who isn't talking yet?
The app market for toddler speech is huge, and most of it isn't backed by real evidence. Most "educational" apps aimed at this age are just passive entertainment dressed up as learning, and passive screen time doesn't build language. If something claims your child will learn to talk by watching a screen, be skeptical.
What does have research behind it is parent coaching, and for kids with more significant communication needs, augmentative and alternative communication (AAC). That covers things like AAC devices, speech-generating apps, picture exchange systems, and sturdy communication boards that give a child a way to express themselves while spoken language is still developing. There's good evidence that AAC doesn't slow speech down. In fact it can ease the frustration that comes with not being able to communicate [6].
If you want AI-supported coaching to use alongside therapy, Little Words (littlewords.ai) builds its approach around the same strategies SLPs already use with toddlers, and you can try their quiz at /start to see whether it fits where your child is right now. It won't replace an evaluation or actual therapy sessions, but it can help you keep practice more consistent between them.
If your child's SLP brings up AAC and you want to read more about what's out there, ASHA has a solid overview on their website [10].
What should I tell my pediatrician at the next visit?
Well-child visits move fast, and developmental screening usually gets only a few minutes of that time. You'll get more out of the appointment if you walk in prepared instead of waiting for someone to ask you the right questions.
Before you go, write down your child's actual vocabulary: real words they use on their own, consistently, not just sounds they've made once. If you can, film your child talking or communicating at home. Toddlers tend to clam up in an exam room, and a short video of how your child really communicates day to day tells the pediatrician more than a quiet fifteen minutes in an office ever could.
Come ready to say how many clear, spontaneous words your child uses, whether they're putting any words together yet, and how they let you know what they want, whether that's pointing, gesturing, pulling you by the hand toward something, or eye contact. Mention whether they turn or respond when you call their name, and be direct if they've lost any skill they used to have.
Then ask outright: "Can you refer us to a speech-language pathologist and to our state Early Intervention program? And should we get an audiology evaluation done?"
Some pediatricians still say "wait and see" for a 22 or 23-month-old with fewer than 20 words. That advice doesn't match current AAP and ASHA guidance, and you're allowed to push back on it. It also helps to know you can refer your child to Early Intervention yourself, without waiting on a doctor's referral, in all 50 states, since IDEA gives parents that right directly [7].
Frequently asked questions
My 22-month-old says a few words but not many. Is that a delay?
Clinically, the 10th percentile for vocabulary at 22 months is around 20-25 words. If your child has fewer than that, and especially fewer than 10-15 clear, spontaneous words, it's worth getting a language delay evaluation. The AAP puts the milestone at 50 words by 24 months, and two months isn't much time to close a big gap if you're well below that now.
What's the difference between a speech delay and a language delay?
Speech delay is about the sounds and physical mechanics of talking. Language delay is about the content behind communication, understanding it or expressing it. A lot of toddlers around 22-24 months have expressive language delays: they follow along fine but just aren't producing much speech yet. A speech-language evaluation looks at both sides and figures out which one applies.
Can a toddler just be a late talker and catch up on their own?
Often, yes. Research suggests 70-80% of children identified as late talkers catch up to peers by school age. The problem is that no one can reliably predict ahead of time which children will be the ones who need help versus the ones who catch up naturally. Since early intervention carries little downside and has documented benefit, waiting it out is a gamble, especially if the delay looks significant.
My toddler understands everything I say but won't talk. What does that mean?
Strong comprehension paired with limited talking is the classic late-talker profile, and it's generally a better sign than delays in both understanding and expression. Still, that's not a reason to sit on your hands. An SLP can confirm comprehension is really on track and build a plan to close the expressive gap. Sometimes what looks like stubbornness is actually motor planning trouble, which needs its own kind of therapy.
How do I contact Early Intervention for my state?
You can call your state's Early Intervention program directly; no doctor's referral needed. The federal IDEA Part C program requires every state to run an intake process, and you can find yours through a searchable directory on the CDC and ASHA websites. Your pediatrician's office can give you the number too, but there's no reason to wait on them before making the call.
Should I be worried if my 24-month-old isn't talking at all?
Yes. A toddler with no words at 24 months is well outside the expected range, given that the AAP milestone is 50 words and two-word phrases by that age. Zero words calls for an urgent evaluation, not a wait-and-see approach. Call your state's Early Intervention program and your pediatrician today, and ask for an audiology evaluation at the same time to rule out hearing loss.
Does bilingualism cause speech delays?
No. Bilingual children may have smaller vocabularies in each individual language, but their combined vocabulary across both usually falls within the normal range. An SLP evaluating a bilingual toddler should check both languages and use bilingual norms. A monolingual-normed test alone often gets bilingual kids mislabeled as delayed when they aren't.
What is childhood apraxia of speech, and could my toddler have it?
Childhood apraxia of speech (CAS) is a motor speech disorder: the brain has trouble planning and sequencing the movements needed for speech. Signs include very inconsistent attempts at words, a limited range of consonant sounds, groping movements of the mouth, and difficulty imitating speech even when the child clearly wants to. It needs a different therapy approach than a general expressive delay, so it's worth having an SLP evaluate for it specifically.
Is it okay to use sign language with a toddler who isn't talking?
Yes, and there's good reason to. Signing gives a toddler a way to communicate while speech is still catching up, which cuts down on frustration and tends to speed up verbal output rather than hold it back. An SLP might teach you a small set of functional signs to start with. Research on AAC broadly, sign included, consistently shows no negative effect on speech development.
At 25 months my toddler still isn't talking much. Is it too late for early intervention?
It's not too late, but you're getting close to the age-3 cutoff for IDEA Part C Early Intervention services, so apply now. Even a few months of EI-funded therapy can make a real difference. If your child turns 3 before services start, they may qualify for school-based speech services under IDEA Part B through your local school district, which requires an IEP evaluation.
How many words should a 23-month-old say?
At 23 months, expect somewhere around 30-50 words, with kids at the lower end of typical showing fewer than that. The AAP sets the 50-word milestone at 24 months. A 23-month-old with fewer than 20 reliable words and no word combinations falls into the range where an evaluation is recommended, not optional.
Does screen time cause speech delays in toddlers?
Not in the sense of causing symptoms the way an illness does, but heavy passive screen time crowds out the back-and-forth interaction that language development runs on. The AAP recommends no solo screen time before 18 months, and only co-viewed, high-quality programming for 18-24 month olds. If your toddler is already showing a delay, cutting screen time is one of the most concrete steps you can take right now.
What is the M-CHAT and should my toddler be screened with it?
The M-CHAT-R/F (Modified Checklist for Autism in Toddlers, Revised with Follow-Up) is a parent-report screening tool used at the 18 and 24-month well-child visits, and it screens for autism-related social communication patterns. If your child is 22-24 months and hasn't been screened yet, ask for it at your next pediatrician visit. A positive screen leads to a follow-up interview and possibly a diagnostic evaluation, not an automatic diagnosis.
The American Academy of Pediatrics puts the milestone at 50 words and two-word combinations by 24 months, and recommends limiting screen time along with autism screening at 18 and 24 months, per the American Academy of Pediatrics, Developmental Milestones. Vocabulary norms from the MacArthur-Bates Communicative Development Inventories (MB-CDI), norming data put the 10th percentile for 22 to 24 month olds at roughly 20-30 words.
Rescorla's 2011 work in the Rescorla L, Journal of Speech, Language, and Hearing Research, 2011, Late talkers at 24 months found about 13-17% of 24-month-olds meet criteria for language delay, with late talkers defined by an expressive delay alongside intact comprehension and social skills. The natural next question is what happens to these kids later, and Dale PS et al., Journal of Speech, Language, and Hearing Research, Late talker outcomes found that roughly 70-80% catch up by school age, though there's no reliable way to predict which individual child will be one of them.
On the autism side, the CDC Autism and Developmental Disabilities Monitoring Network notes the median diagnosis age in the US still sits around 4-5 years, and recommends M-CHAT-R/F screening at 18 and 24 months, with reduced social communication flagged as a key early sign. For language specifically, American Speech-Language-Hearing Association (ASHA), Late Language Emergence lists fewer than 50 words, no two-word phrases, and any loss of previously acquired words as red flags at 24 months, and notes that AAC does not hold back speech development.
Families don't need a doctor's referral to start an evaluation: under U.S. Department of Education, IDEA Part C Early Intervention, children under 3 with developmental delays are entitled to free evaluations and services, and parents can self-refer. When speech errors are inconsistent and a child struggles to sequence the movements needed for speech, ASHA, Childhood Apraxia of Speech describes this pattern, along with a limited consonant inventory, as childhood apraxia of speech, which needs its own motor-based treatment approach.
On what actually helps, Roberts MY, Kaiser AP, American Journal of Speech-Language Pathology, Early intervention for language delays found that parent-implemented interventions lead to meaningful gains in expressive vocabulary compared to toddlers who get no intervention. For parents worried that tools like picture boards or speech-generating devices might set their child back, ASHA, Augmentative and Alternative Communication is clear that the evidence doesn't support that concern. And on screens, AAP, Media and Young Minds, Council on Communications and Media recommends no solo screen time before 18 months, and co-viewed, high-quality programming only between 18 and 24 months.