10-Minute Speech Practice That Doesn't Require Sitting Still

Last updated 2026-07-09

How many words should a 22-month-old actually be saying?

There's a real range, and the published benchmarks matter more than what you read on a parenting forum.

The American Academy of Pediatrics uses 50 words and the beginning of two-word combinations as the expected milestone at 24 months ^[1]. At 22 months you're two months out from that mark, so the working target is roughly 30-50 words and at least some attempts at stringing two words together, things like "more milk" or "daddy go." If your child is nowhere near that, that's not a minor lag.

The MacArthur-Bates Communicative Development Inventories, the most widely used parent-report tools in research, show that the 10th percentile for vocabulary at 22 months is around 20-25 words, and by 24 months children at the 10th percentile average about 28-30 words ^[2]. Below the 10th percentile is where clinicians start using the term "late talker" formally.

Here's what most parents don't realize: words only count if the child uses them spontaneously and consistently. A word your toddler said once last month, or only says when prompted, doesn't go on the count. Neither do sounds that just happen to resemble a word. Speech-language pathologists ask you to be strict about this when you build a word inventory.

So if you're counting and coming up with fewer than 20 reliable, spontaneous words at 22 months, or zero word combinations by the time you're reading this at 23 or 24 months, that's a real signal worth acting on today.

What does "late talker" actually mean, and is my child one?

"Late talker" is a clinical term, more than parenting shorthand. It describes a toddler who has age-appropriate play skills, social interest, understanding of language, and motor development, but whose expressive vocabulary sits well below the expected range for their age ^[3]. The key part of that definition is that comprehension and social skills are intact. Late talkers understand more than they say.

About 13-17% of 24-month-olds meet criteria for a language delay based on vocabulary size alone ^[3]. That number surprises most parents. Not all of these children have an underlying diagnosis. Research shows that roughly 70-80% of late talkers catch up by school age without formal intervention, but here's the part that number often leaves out: we cannot reliably predict in advance which child will catch up and which won't ^[4]. Waiting to find out is a gamble, and early intervention is low-risk.

A late talker is different from a child with a language disorder, with autism spectrum characteristics, or with childhood apraxia of speech. Those are distinct profiles that an evaluation can identify. If your 22-month-old isn't talking and also shows reduced eye contact, little interest in other people, repetitive behaviors, or very limited pointing and gesturing, those are additional red flags that go beyond a simple expressive delay and need prompt evaluation ^[5].

So "late talker" is a real category, not a diagnosis, and it doesn't tell you what's causing the delay. An evaluation does.

What are the red flags that go beyond a typical language delay?

Not all speech delays look the same. Some are purely expressive and resolve on their own. Others point to something that needs specific support. Here are the patterns speech-language pathologists and developmental pediatricians watch for in toddlers around 22-25 months.

The American Speech-Language-Hearing Association (ASHA) lists these as concerns at 24 months: fewer than 50 words, no two-word phrases, speech that strangers can't understand at all, and loss of previously acquired words ^[6]. That last one, regression, is the most urgent. If your child had words and lost them, call the pediatrician this week, not next month.

Beyond vocabulary count, watch for:

• No pointing to show you things (protodeclarative pointing) by 14-16 months
• Not following simple two-step directions without gestures
• Not imitating actions or sounds when given a chance
• Mostly communicating by pulling, not by eye contact or gesture
• Repeating phrases from TV without using them to communicate (this is echolalia and can be a sign that language processing works differently for this child)
• Strong preference for sameness, intense distress at transitions, or unusual sensory responses alongside the speech delay

None of these alone is a diagnosis. Together with a speech delay, they're a pattern worth evaluating. The AAP recommends developmental screening at 9, 18, and 24 months, with autism-specific screening at 18 and 24 months ^[1]. If your 22 or 23-month-old missed that 18-month screen, ask for it now.

When should I get an evaluation, and who should I call first?

If you're reading this because you're worried, that's already reason enough to make the call. Waiting until 24 months to see "if things improve" is almost never the right move when a child has fewer than 15-20 clear words at 22 months.

You have two main routes.

Route 1 is your state's Early Intervention (EI) program. Every state in the US has 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 do not need a doctor's referral. Call your state EI program directly, and the evaluation is free. If your child qualifies, therapy services are free or low-cost on a sliding scale. This is one of the best deals in American healthcare. Call now, because there are often waiting lists, and the program ends at age 3.

Route 2 is a private speech-language pathologist (SLP). Your pediatrician can refer you, or you can self-refer. Private evaluations typically run $200-500 out of pocket depending on your area and whether insurance covers it, but many insurance plans are required to cover speech-language evaluations for children. In some regions the wait for a private SLP is shorter than EI, sometimes by a lot.

Doing both at once is smart. Call EI today and also ask your pediatrician for a referral to a private SLP. You can decline services if the evaluation comes back fine, but you can't get back the weeks you spent waiting.

For more on what to expect from the process, see our full guide to early intervention and speech therapy.

What causes a 22-month-old to not be talking?

Parents almost always want to know why. The honest answer is that the cause often isn't pinned down from a speech evaluation alone, and sometimes it's never identified precisely. What an evaluation does is describe the pattern of the delay and point toward the right support.

That said, here are the most common contributors:

Expressive language delay with no underlying diagnosis. The child understands language well, plays appropriately, and is socially connected, but words are slow to come. This is the "late talker" profile. The cause is usually multifactorial (genetics, slightly different processing speed, input factors) and often not fully knowable.

Hearing loss. This is the first thing a pediatrician should rule out, and it's often overlooked in toddlers who passed their newborn hearing screen. Children can develop conductive hearing loss from frequent ear infections. The AAP recommends a formal audiological evaluation whenever a speech delay is identified ^[1]. Don't skip this step.

Autism spectrum characteristics. Many children with autism are first identified because of a speech delay combined with social communication differences. Autism does not have a single speech profile. Some children are nonverbal or minimally verbal; others develop speech but use it differently ^[5].

Childhood apraxia of speech. A motor speech disorder where the child has difficulty planning and coordinating the movements for speech. It's less common than a general expressive delay but looks different: very inconsistent word attempts, limited consonant sounds, and sound sequences that come out differently each time ^[8].

Bilingual or multilingual home. Children learning two languages at once may have smaller vocabularies in each language individually, but their combined vocabulary across both languages is typically in the normal range. A monolingual vocabulary count undercounts a bilingual child's true knowledge. Always tell your SLP if your child hears more than one language.

Structural or medical factors. Enlarged tonsils and adenoids, palate differences, and certain neurological conditions can all affect speech. An SLP evaluation and a medical workup together cover the bases.

Is there a difference between a 22-month-old not talking and a 24 or 25-month-old not talking?

Yes, and the difference matters clinically.

At 22 months, a child with fewer than 20-25 words is below the 10th percentile but is still two months away from the major 24-month checkpoint. That's still a reason to call Early Intervention or an SLP now, because evaluation and intake take time. But it's also two months of potential growth.

At 24 months, the AAP milestone is 50 words and two-word combinations ^[1]. A 24-month-old toddler not talking, or talking with fewer than 30 words and no phrases, sits clearly outside the expected range by the standard clinical definition. A 24-month-old not talking is no longer a "wait and see" situation by any published guideline I'm aware of.

At 25 months, if a child still has fewer than 50 words and no phrases, that's a pattern that has now persisted across several months. The research on late talkers suggests the longer the delay, the less likely it resolves completely without support ^[4]. A 25-month-old not talking who hasn't had an evaluation should have one this week.

One more thing. The 24-month mark is also when the gap between a late talker and peers starts widening fast, because typically developing children at this age add new words at a rapid clip. Catching up gets harder, not easier, with time.

What can I do at home to help my toddler talk more?

Home strategies are not a substitute for an evaluation, but they genuinely help alongside one. The strategies with the strongest evidence are simple. They're about how you interact during ordinary daily moments.

Follow your child's lead. Get on the floor, watch what your child is interested in, and comment on it. If they're pushing a truck, say "truck go" or "push, push." Skip the "what's that?" quizzing. Commenting and narrating build input; testing builds pressure.

Add one word. This technique, sometimes called "expansion," means taking what your child communicates and adding one word to it. If they reach for a ball and say "ba," you say "ball" or "red ball" or "throw ball." Just one step up from where they are.

Wait with expectation. After you say something or offer a choice, wait 5-10 seconds with an expectant look. Give your child time to attempt a response before you fill the silence. Most adults jump in too fast.

Reduce screen time. The AAP recommends limiting screen use to video chatting for children under 18 months, and high-quality programming with an adult co-viewing for 18-24 months ^[1]. Passive screen time doesn't build the back-and-forth interaction that language development depends on. This is one of the clearest levers you have.

Read together every day. Point to pictures, name things, pause to let your child respond. Board books with simple images beat dense text at this age. The goal is interaction, not reading aloud.

Narrate your day. "Now we're washing hands. Soap, water, rub rub." Children need to hear language in context constantly. You can't overdose a toddler on good language input.

If your child is older or has more significant needs, online speech therapy has become a genuinely solid option, especially for families in rural areas or with limited access to in-person services.

How does early intervention work, and does it actually help?

Early Intervention (EI) under IDEA Part C is a federal program that provides services to children birth through age 2 who have developmental delays or conditions likely to result in delays ^[7]. Every state runs its own version, so timelines and eligibility criteria vary somewhat, but the evaluation and the service coordination are always free.

Here's how it usually works. You call your state's EI intake line, they schedule a multidisciplinary evaluation (typically within 45 days of referral, though some states move faster), and if your child qualifies, the team writes an Individualized Family Service Plan (IFSP) that outlines what services your child will receive. Services can include speech-language therapy, developmental therapy, occupational therapy, and others, depending on what the evaluation finds.

Does it work? The research says yes, with some nuance. A review of early language interventions found that parent-implemented language interventions, the type commonly used in EI for toddlers, produced meaningful gains in expressive vocabulary compared to no intervention ^[9]. The effect sizes were moderate, not miraculous, and the quality of implementation matters a lot. The therapist teaches you strategies during sessions, and you carry those strategies through the week. That's the model that works.

The main practical problem with EI is that demand often outstrips capacity. In some states, wait times for an initial evaluation run 6-8 weeks or more, and services may not start for another month after that. Call early, be persistent, and pursue the private SLP route at the same time if you can.

Services end when your child turns 3. At that point, children who still need support transition to services through the public school system under IDEA Part B, a different process built around an IEP (Individualized Education Program).

For a detailed walkthrough of the EI process, see our guide to early intervention.

Could my child have autism, and how would I know?

A speech delay by itself is not a sign of autism. But autism is one of the conditions that can include a speech delay, and it's worth understanding what else to look for.

The core features of autism in toddlers involve social communication and interaction more than language. The screening tool used at 18 and 24 months, the M-CHAT-R/F (Modified Checklist for Autism in Toddlers, Revised with Follow-Up), looks at things like pointing to share interest, bringing objects to show parents, responding to their name, and interest in other children, alongside speech ^[5]. A toddler who is socially engaged, makes good eye contact, points often, and loves interacting with caregivers but just has fewer words than expected is far less likely to have autism than one who shows both a speech delay and reduced social connection.

The median age of autism diagnosis in the US is still around 4-5 years, which is too late for the best early support ^[5]. If you suspect autism is part of the picture, ask for a developmental pediatrician referral specifically, not only a speech evaluation. Some areas also have autism diagnostic clinics with shorter waits than hospital-based programs.

For families where autism is already identified or strongly suspected, see our guide to autism spectrum speech therapy for strategies that match how autistic children often process and develop language differently.

What happens during a speech-language evaluation for a toddler?

A lot of parents are nervous about this appointment, mostly because they don't know what to expect. It's worth demystifying.

A speech-language evaluation for a 22-25 month old typically takes 60-90 minutes. The SLP will observe your child in play, try to draw out spontaneous communication, and often give a standardized assessment like the PLS-5 (Preschool Language Scales, 5th Edition) or the Bayley Scales of Infant and Toddler Development. They'll also interview you about your child's history, what words they use, how they communicate wants and needs, and what their comprehension looks like.

The SLP looks at several things: receptive language (what the child understands), expressive language (what they say and how they say it), speech sound production, oral motor function, and social communication skills like eye contact, joint attention, and turn-taking.

At the end, you'll get a summary of findings and, if there's a delay, a recommendation for therapy frequency. Typical recommendations for a toddler with a moderate expressive delay are one or two sessions per week, often 30-45 minutes each, with a heavy emphasis on coaching you as the parent to use specific strategies throughout the day.

The evaluation report will note standard scores and percentile ranks. A standard score below 85 (more than one standard deviation below the mean) is typically counted as a delay. Below 78 (1.5 SD below the mean) is counted as a significant delay that strongly supports therapy eligibility.

What about apps and tools to help a toddler who isn't talking?

The app market for toddler speech is enormous and, honestly, mostly not evidence-based. Most "educational" apps for this age function as passive entertainment, and passive screen time doesn't build language. Be skeptical of anything that claims to teach speech by having your child watch content.

The tools that do have research behind them are parent-coaching tools and, for children with more significant communication needs, augmentative and alternative communication (AAC). AAC devices include speech-generating apps, picture exchange systems, and sturdy communication boards that give children a way to express themselves while speech develops. There's good evidence that AAC does not slow speech development and can actually support it by reducing communication frustration ^[6].

For families looking for AI-supported parent coaching alongside therapy, Little Words (littlewords.ai) offers a structured approach built around the same evidence-based strategies SLPs use with toddlers. It's not a replacement for an evaluation or for therapy, but it can help parents get more consistent practice between sessions. Start with their quiz at /start to see if it fits your child's current needs.

If your child's SLP recommends AAC and you want to understand the options, ASHA has a solid overview on their website ^[10].

What should I tell my pediatrician at the next visit?

Pediatricians are busy, and developmental screenings at well-child visits are often brief. You'll get more out of the appointment if you come prepared.

Write down your child's vocabulary before you go. Actual words, used spontaneously and consistently. If you can, video your child communicating at home. Toddlers often go quiet in the doctor's office, and a clip of how your child actually communicates day to day is genuinely useful clinical information.

Tell the pediatrician specifically:

• How many clear, spontaneous words your child has
• Whether they're combining any words at all
• How they communicate wants and needs (do they point, gesture, lead you by the hand, make eye contact?)
• Whether they respond to their name reliably
• Whether they've lost any skills they previously had

Then ask directly: "Can you refer us to a speech-language pathologist and to our state Early Intervention program? And should we do an audiology evaluation?"

Some pediatricians still tell parents to "wait and see" with a 22 or 23-month-old who has fewer than 20 words. That advice is inconsistent with current AAP and ASHA guidance. You can push back politely. You can also self-refer to EI without a doctor's referral, in all 50 states, because IDEA gives parents that right ^[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, that meets the threshold for a language delay evaluation. The AAP's milestone at 24 months is 50 words. Two months is not much runway if you're well below that now.

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

Speech delay means difficulty with the sounds and production of words. Language delay means difficulty with the content and meaning of communication, either understanding it (receptive) or expressing it (expressive). Many toddlers around 22-24 months have expressive language delays: they understand a lot but aren't talking much. A speech-language evaluation assesses both and tells them apart.

Can a toddler just be a late talker and catch up on their own?

Yes. Research suggests 70-80% of children identified as late talkers do catch up to peers by school age. But clinicians cannot reliably predict which children will catch up without support. Early intervention is low-risk and has documented benefit. Waiting to find out is a gamble with your child's language development, particularly if the delay is significant.

My toddler understands everything I say but won't talk. What does that mean?

Strong comprehension with limited expressive output is the classic late-talker profile. It's generally a better sign than delays in both comprehension and expression. It does not mean you should wait. An SLP can confirm that comprehension is genuinely on track and build a plan to close the expressive gap. Sometimes the issue is motor planning for speech, which needs specific intervention.

How do I contact Early Intervention for my state?

You can call your state's Early Intervention program directly without a doctor's referral. The federal IDEA Part C program requires each state to run an intake process. A searchable directory is available through the CDC and ASHA websites. Your pediatrician's office can also provide the number, but you don't need to wait for them to make 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 sits well outside the expected range. The AAP milestone is 50 words and two-word phrases at that age. Zero words warrants an urgent evaluation, not a wait-and-see approach. Call your state's Early Intervention program and your pediatrician today. Ask for an audiology evaluation to rule out hearing loss at the same time.

Does bilingualism cause speech delays?

No. Bilingual children may have smaller vocabularies in each individual language, but their total vocabulary across both languages is typically within the normal range. An SLP evaluating a bilingual toddler should assess vocabulary in both languages and use bilingual norms. If a monolingual-normed test is used alone, bilingual children are frequently misidentified as delayed.

What is childhood apraxia of speech, and could my toddler have it?

Childhood apraxia of speech (CAS) is a motor speech disorder where the brain has difficulty planning and sequencing the movements for speech. Signs include very inconsistent word attempts, limited consonant sounds, groping movements of the mouth, and difficulty imitating speech even when the child seems to want to. It needs specific therapy techniques, different from those used for a general expressive delay. An SLP can evaluate for it.

Is it okay to use sign language with a toddler who isn't talking?

Yes, and there's good reason to do it. Sign language gives a toddler a way to communicate while speech develops, which reduces frustration and often speeds verbal output rather than delaying it. An SLP may teach you a core set of functional signs to use. Research on AAC broadly, including sign, 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 close to the age-3 cutoff for IDEA Part C Early Intervention services. Apply now. Even a few months of EI-funded therapy can make a difference. If your child turns 3 before services start, they may be eligible 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, the expected range is roughly 30-50 words, with some children at the lower end of typical showing fewer. The 50-word milestone is set at 24 months by the AAP. A 23-month-old with fewer than 20 reliable words and no word combinations is in the range where an evaluation is recommended, not optional.

Does screen time cause speech delays in toddlers?

Screen time doesn't cause delays the way a disease causes symptoms, but high amounts of passive screen time displace the back-and-forth interaction that language development depends on. The AAP recommends no solo screen time before 18 months and co-viewed, high-quality programming only for 18-24 month olds. For a toddler already showing a delay, reducing screen time is one of the most actionable steps parents can take.

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 18 and 24-month well-child visits. It screens for autism-related social communication patterns. If your child is 22-24 months and hasn't had this screening, ask for it at your next pediatrician visit. A positive screen triggers a follow-up interview and possibly a diagnostic evaluation, not an automatic diagnosis.

Sources

1. American Academy of Pediatrics, Developmental Milestones: AAP milestone at 24 months is 50 words and two-word combinations; recommends limiting screen time and autism screening at 18 and 24 months
2. MacArthur-Bates Communicative Development Inventories (MB-CDI), norming data: 10th percentile for vocabulary at 22-24 months is approximately 20-30 words based on CDI normative samples
3. Rescorla L, Journal of Speech, Language, and Hearing Research, 2011 — Late talkers at 24 months: Approximately 13-17% of 24-month-olds meet criteria for language delay; late talkers defined by expressive delay with intact comprehension and social skills
4. Dale PS et al., Journal of Speech, Language, and Hearing Research — Late talker outcomes: Roughly 70-80% of late talkers catch up by school age, but individual prediction of who will catch up is unreliable
5. CDC Autism and Developmental Disabilities Monitoring Network: Median age of autism diagnosis in the US remains around 4-5 years; M-CHAT-R/F recommended at 18 and 24 months; reduced social communication is a key early sign
6. American Speech-Language-Hearing Association (ASHA), Late Language Emergence: ASHA lists fewer than 50 words, no two-word phrases, and word loss as 24-month red flags; AAC does not impede speech development
7. U.S. Department of Education, IDEA Part C Early Intervention: IDEA Part C mandates free evaluations and services for children under age 3 with developmental delays; parents can self-refer without a physician referral
8. ASHA, Childhood Apraxia of Speech: Childhood apraxia of speech involves inconsistent speech errors, limited consonant inventory, and difficulty sequencing movements for speech; requires specific motor-based intervention
9. Roberts MY, Kaiser AP, American Journal of Speech-Language Pathology — Early intervention for language delays: Parent-implemented language interventions produce meaningful expressive vocabulary gains compared to no intervention in toddlers with language delays
10. ASHA, Augmentative and Alternative Communication: AAC includes speech-generating devices, picture exchange, and communication boards; evidence does not support concern that AAC slows speech development
11. AAP, Media and Young Minds — Council on Communications and Media: AAP recommends no solo screen time before 18 months and co-viewed high-quality programming only for 18-24 month olds