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

Last updated 2026-07-09

What should a 26-month-old be saying?

By 24 months, the American Academy of Pediatrics expects most toddlers to have at least 50 words and to be putting two words together, things like "more milk" or "daddy go." ^[1] By 26 to 28 months, that two-word combination should be happening regularly, and many kids are working toward three-word phrases. The number of words matters less than the trajectory: a child who had 10 words at 18 months and has 40 at 26 months is moving in the right direction, even if they're not at 50 yet.

What the research consistently flags as a red flag is the absence of word combinations by 24 months. ^[2] If your 26 or 27 month old is still using single words only, that's the clearest sign to act on. If your child has no words at all at this age, that is an urgent referral, not a wait-and-see situation.

The American Speech-Language-Hearing Association (ASHA) puts it plainly: two-word phrases are expected by age 2, and parents who have concerns should seek evaluation rather than waiting for the child to "catch up" on their own. ^[3] The catch-up myth is one of the most damaging things a well-meaning pediatrician can say, because the window for early intervention closes at age 3.

Some toddlers also have inconsistent speech: they said a word last month and now they've stopped using it. That regression, especially combined with other changes in social behavior, is worth mentioning to a specialist, more than noting in a baby book.

Is my 26-month-old a late talker or is something else going on?

"Late talker" is a real clinical category, more than a reassuring label. It refers to a child who is late to develop expressive language but whose comprehension, play skills, and social engagement look typical. Research using the MacArthur-Bates Communicative Development Inventories suggests roughly 13 to 15 percent of toddlers qualify as late talkers at age 2. ^[4] A meaningful portion of those children, somewhere between 50 and 70 percent in various studies, do catch up by school age without formal therapy. But that still leaves a large group who don't, and there's no reliable way at age 26 months to know which group your child is in.

The things that make a late talker more likely to catch up on their own include strong comprehension (they understand what you say even if they can't respond), good nonverbal communication (pointing, showing, making eye contact to share interest), and some functional play that isn't rigid or repetitive.

The things that suggest something more than a simple expressive delay include limited pointing or showing by 12 to 14 months (this is a flag parents often recognize in hindsight), repetitive speech or echolalia where the child repeats phrases but doesn't generate new ones, very restricted play patterns, or a loss of words that were previously present. Those patterns can point toward autism spectrum differences, childhood apraxia of speech, or other language disorders that genuinely benefit from earlier, more intensive support.

Nobody can diagnose your child from a checklist, including this article. But you can use what you know about your child to decide how urgently to pursue evaluation. If something feels off beyond the talking, trust that instinct.

What are the actual milestones for 24 to 30 months?

Here's what the CDC and ASHA describe as typical across this window. These are population-level medians, not pass/fail cutoffs, but they give you a concrete reference point.

The jump between 24 and 30 months is enormous. This is the fastest vocabulary growth period in human development, and children can add several new words per day at peak acquisition. ^[5] That's exactly why delays in this window matter so much: the child is losing time during a stretch when the brain is especially primed to connect words to meaning.

One honest caveat. These numbers come from studies on mostly English-speaking, higher-income populations. Bilingual children, children from homes with fewer books and less verbal interaction, and children with certain cultural communication styles may hit the numbers slightly differently. The two-word combination milestone holds up well across languages, but the exact word counts vary from study to study.

Should I wait and see, or get help now?

The pediatric guidance on this has shifted clearly in one direction over the past decade: evaluate early, don't wait. ^[1] The old "let's check back at the three-year visit" approach is no longer considered best practice, partly because early intervention funding runs out at age 3 and partly because the evidence for earlier treatment being more effective is now fairly strong.

If your child is 26 months old and not meeting the milestones described above, here's a simple decision tree.

Fewer than 25 words and no word combinations: request an evaluation immediately. This is not borderline.

25 to 50 words but no combinations yet: request an evaluation. You may hear "let's wait until 30 months" from some pediatricians. You are allowed to push back and ask for a referral anyway, or go directly through your state's early intervention program.

50+ words and starting to combine them inconsistently: watch closely for the next four to six weeks, but if combinations aren't solidifying by 28 months, evaluate then.

Waiting costs you nothing if the child is fine. Getting an evaluation and being told everything looks great is the best possible outcome. The evaluation itself is free under age 3 if you go through early intervention. ^[6]

Parents of 27, 28, and 29 month olds reading this: the same math applies. The closer you are to that third birthday, the more urgency there is to act, because the free services end and private therapy costs a lot more.

How do I get a free speech evaluation before my child turns 3?

In the United States, the Individuals with Disabilities Education Act (IDEA), specifically Part C, guarantees free evaluation and services for children under 36 months who have a developmental delay or are at risk of one. ^[6] Every state has an early intervention (EI) program that administers this. You do not need a pediatrician's referral to contact them directly, though a referral can speed things up.

To get started:

1. Search "[your state] early intervention" or call the CDC's main line (800-CDC-INFO) to get your state's contact. 2. Call and say your child is under 3 and you have concerns about speech and language development. 3. They are required to respond within 45 days, though many programs move faster than that. 4. The evaluation is free. If services are recommended, they are provided at low or no cost on a sliding scale based on family income.

Once your child turns 3, eligibility shifts to the school district under IDEA Part B, which covers ages 3 through 21. The process is different: you contact your local school district's special education office and request a psychoeducational evaluation in writing. ^[6] Services may still be free, but the setting and structure change from home-based to school-based.

Learn more about what the process looks like in practice at early intervention.

If you want to move faster than the EI timeline allows, or if you prefer a private route, a certified speech-language pathologist (SLP) in private practice can evaluate your child and often has shorter wait times. Expect to pay $200 to $500 for a private evaluation without insurance, though many insurance plans cover this with a referral. ^[7]

What can I do at home while I wait for an evaluation?

The research on parent-implemented language strategies is genuinely encouraging. A meta-analysis of parent-mediated interventions found significant gains in expressive vocabulary and communication for late-talking toddlers. ^[8] You don't need to be a therapist to use these techniques, but you do need to use them consistently, which is harder than it sounds with a busy toddler.

The strategies that have the most evidence behind them:

Follow the child's lead. Sit at their level, watch what they're looking at, and talk about that thing. Not what you want them to look at. What they're already interested in. This sounds obvious, but most adults spend a lot of time redirecting toddlers toward what the adult wants to discuss.

Expand what they say. If your child says "ball," you say "roll the ball" or "big ball." You're modeling one step above where they are, not demanding they imitate you.

Reduce questions, increase comments. "What's that?" is harder for a late talker than you'd think, because it forces retrieval under pressure. Instead, say "Oh, a truck. The truck is loud." Let them respond if they want to, but don't put the conversational burden on them constantly.

Pause and wait. After you model something, stop talking. Give them 10 to 15 seconds. This is uncomfortable for most adults. It works.

Read books with repetition. Books with predictable, repeated phrases give children a low-pressure chance to fill in a word they've heard many times. "Brown Bear, Brown Bear" is a cliche for a reason.

These strategies help no matter what the eventual diagnosis, or no-diagnosis, turns out to be. They also don't interfere with formal therapy. SLPs generally want parents doing this at home in parallel.

Could my child's speech delay be related to autism?

Speech and language delay is one of the most common early signs of autism spectrum disorder, but the relationship isn't simple. Many children with autism have significant language delays. Many children with language delays do not have autism. A speech delay alone is not a diagnostic indicator either way.

The signs that raise more specific concern for autism alongside a speech delay include not pointing to show you things (as opposed to just requesting) by 14 months, not following a point when you point at something, limited back-and-forth social smiling, very restricted play patterns, unusual attachment to objects, and repetitive motor movements like hand-flapping or spinning. ^[9] If your 26-month-old has a speech delay and several of these, that combination warrants an autism-specific evaluation, more than a speech evaluation alone.

Autism can be reliably diagnosed as early as 18 to 24 months by an experienced clinician, and the evidence strongly supports that earlier diagnosis leads to better outcomes when paired with appropriate support. ^[9] You can ask your pediatrician for a referral to a developmental pediatrician or a multidisciplinary autism evaluation team. Wait times for these evaluations can be long, sometimes six months to a year in some regions, which is another reason to start the process now.

You can learn more about what speech therapy looks like specifically for autistic children at autism spectrum speech therapy.

What does a speech-language pathologist actually do with a toddler this age?

A lot of parents picture a clinical room with flashcards and a therapist pointing at pictures. Early childhood speech therapy rarely looks like that, and the good kind definitely doesn't.

With a 26 to 30 month old, an SLP typically starts with an evaluation that involves watching the child play, asking parents structured questions about what words the child uses and understands, and sometimes using standardized tools like the Preschool Language Scales (PLS-5) or the Receptive-Expressive Emergent Language Test (REEL-4). ^[3] These give a standard score that shows where the child falls relative to peers.

Therapy sessions for this age are play-based. The SLP gets on the floor, uses the child's preferred toys, and builds situations that naturally pull for communication. They're also coaching the parent, because a weekly 30 to 60 minute session matters far less than what happens the other 167 hours of the week.

If the evaluation reveals apraxia of speech, the treatment approach is different: it requires motor-based, highly repetitive practice, and more frequent sessions (three to five times per week is sometimes recommended). ^[10] That's a different conversation than a straightforward expressive delay, and it's one reason getting a good evaluation matters more than just starting any therapy.

For families who can't reach an in-person SLP quickly, online speech therapy through a certified SLP (not an app, an actual licensed therapist via telehealth) is an ASHA-supported option that research has found effective for young children. ^[3] It's not a replacement for in-person if that's available, but it beats doing nothing while you sit on a waitlist.

If you want to supplement between sessions, tools like the Little Words app (littlewords.ai/start) are built to support parent-child interaction strategies at home, specifically for kids with language delays and neurodivergent profiles. It's a supplement, not a substitute for an SLP.

What if my child is bilingual, is that why they're not talking?

Bilingualism is one of the most common explanations parents hear when they raise concerns about a late-talking toddler, and it gets used incorrectly to justify waiting.

Here's the honest picture. Bilingual children do sometimes have slightly smaller vocabularies in each individual language compared to monolingual peers, because they're learning two systems at once. Their total conceptual vocabulary (words across both languages combined) is generally comparable to monolingual children. ^[11] And this part matters: bilingualism does not cause language disorders. If a child is significantly delayed in both languages, that points to a language delay or disorder, not to the bilingual environment.

The two-word combination milestone applies across languages. A bilingual 26-month-old who isn't combining words in either language, who doesn't seem to understand much in either language, or who is significantly behind the milestone markers described earlier should be evaluated. The evaluation ideally includes assessment in both languages, and you have the right to request that.

If you only have access to an English-speaking SLP, ask them to gather parent report data on the child's home language, since standardized tools like the Bilingual English Spanish Assessment (BESA) exist for this purpose.

When should I be worried about hearing loss?

Hearing is the foundation of spoken language, and this is one of the first things a clinician should rule out. An undetected hearing loss, even a partial one, can look exactly like a speech or language delay.

Newborn hearing screening catches severe to profound losses in most cases, but mild to moderate hearing loss, or hearing loss that develops after birth (from recurrent ear infections, for example), can be missed. ^[12] A child who has had frequent ear infections in the first two years of life has a real chance of intermittent conductive hearing loss, basically hearing everything through water for stretches of time. That disrupts the input the brain receives during the years when language learning is fastest.

If your 26-month-old is not talking, one of the first requests you should make is an audiological evaluation. This is different from the informal hearing check a pediatrician does in the office. You want a full audiogram with a pediatric audiologist. This is also free under early intervention if your child qualifies.

Signs of possible hearing difficulty in a toddler: not startling at loud sounds, not responding to their name consistently (especially from behind), watching your face very intently as if lip-reading, or behaving noticeably better when you're face to face compared to calling from another room.

What if my pediatrician says to wait and see?

This still happens, and it's frustrating. Pediatricians vary widely in their comfort with developmental screening, and some still use age 3 as their informal intervention threshold.

You have two options that don't require the pediatrician's buy-in. First, contact your state's early intervention program directly. Parents can self-refer. You do not need a doctor's note. Second, contact a private SLP directly and schedule a private evaluation.

If you want to go through your insurance, a written referral from the pediatrician helps, but it's not legally required for you to access early intervention. If the pediatrician is resistant, you can say: "I'd like a referral for a speech-language evaluation for my child. I understand you may not be concerned, but I'd like the evaluation anyway." You're allowed to ask for this.

Bring a list of your specific observations: how many words your child uses, whether combinations exist, what their comprehension looks like, and any other concerns. Concrete observations are harder to dismiss than "I'm just worried."

The speech therapy page has more detail on how to find and vet a qualified SLP if you're going the private route.

How much does private speech therapy cost, and does insurance cover it?

For families who go the private route (because EI has a wait, the child is over 3, or they want more frequent sessions), costs vary by region and provider.

A private speech evaluation typically runs $200 to $500 without insurance. Individual therapy sessions run $100 to $350 per session depending on the region and whether the SLP is in a private practice, hospital system, or university clinic. ^[7] University training clinics, supervised by licensed SLPs, can be a lot cheaper, sometimes $20 to $60 per session.

Most major commercial insurance plans are required to cover speech therapy if it's deemed medically necessary, and a diagnosis of language delay or disorder generally qualifies. The Affordable Care Act's essential health benefits provision includes habilitative services, which covers speech therapy for developmental conditions in most plans. ^[13] The practical catch is that coverage varies widely: some plans have session limits (20 to 30 per year), some require prior authorization, and some have deductibles high enough that you're paying out of pocket for most of it anyway.

Medicaid covers speech therapy for eligible children, with no session limit in most states under the EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) provision. ^[13] If your child is on Medicaid and your pediatrician isn't referring you, that's a referral you can push for specifically.

Families who are denied coverage can appeal. A letter from a licensed SLP documenting medical necessity is generally what you need for the appeal.

For a sense of what people actually pay, the chart below summarizes key cost benchmarks from publicly available sources.

Frequently asked questions

My toddler is 26 months and not talking at all. Is that serious?

Yes, this warrants immediate evaluation. By 24 months, most children have at least 50 words and are starting to combine them. A 26-month-old with no words is significantly below the typical range. Contact your state's early intervention program today. You can self-refer; no doctor's note required. Services are free under age 3 under IDEA Part C. This is not a wait-and-see situation.

What is the difference between a late talker and a language disorder?

A late talker has delayed expressive language but relatively intact comprehension, social skills, and play. Many late talkers catch up by age 4 or 5. A language disorder is a longer-term difficulty with understanding or using language that persists beyond the typical catch-up window. The distinction often isn't clear at 26 months, which is another reason evaluation matters: a qualified SLP can start mapping where the child falls and track progress over time.

Should a 27-month-old be saying sentences?

Not full sentences, but two-word phrases should be routine by 27 months, and many children are producing three-word strings. "Mommy sit," "more juice," and "big dog" are the kinds of combinations you'd expect. If your 27-month-old is still using single words only, or fewer than 50 words total, that's below the expected range and worth getting evaluated now rather than at the next well visit.

Can watching too much screen time cause a speech delay?

Heavy screen time is associated with less parent-child talk, which does affect language development. The AAP recommends avoiding screen use beyond video chatting for children under 18 to 24 months, and limiting it to one hour a day of high-quality programming for ages 2 to 5. But screens are more likely to slow language than cause a disorder. If your child has a significant delay, the cause is rarely screen time alone.

What if my 28-month-old understands everything but won't talk?

Strong comprehension is genuinely reassuring; it suggests the receptive language system is working and the child is processing language. But expressive delay still warrants evaluation even with good comprehension. Some children with childhood apraxia of speech or expressive-only language delays understand very well but have significant difficulty producing speech. An SLP evaluation looks at both sides and can tell you whether the gap between understanding and speaking is typical or needs support.

Is it too late to get early intervention at 26 months?

No. You have until your child's third birthday to access IDEA Part C early intervention services, which are free. At 26 months you have roughly 10 months of eligibility left. That's enough time for a meaningful amount of therapy. Start the referral this week, because intake and evaluation can take four to six weeks, and you don't want to lose months on a waitlist when your child is this close to the age cutoff.

My 29-month-old isn't talking. What happens after they turn 3?

At age 3, services shift from early intervention to the public school system under IDEA Part B. You contact your local school district's special education department and request an evaluation in writing. The district has 60 days to complete the evaluation in most states. If your child qualifies, they may receive speech therapy through a preschool special education program. Services are still free, but the home-based, parent-coaching model of early intervention typically ends.

Could my toddler's speech delay be caused by tongue tie?

Tongue tie (ankyloglossia) can affect articulation and feeding, but the research on its link to speech delay in toddlers is mixed. It's more clearly tied to breastfeeding difficulties in infancy than to language delays in the second year. If a pediatric SLP or ENT examines your child and finds a structural issue affecting tongue mobility, that's worth addressing. But tongue tie is rarely the primary cause of a significant language delay; receptive language and vocabulary development don't depend on tongue mobility.

How many words should a 26-month-old know?

The AAP and CDC milestone guidance describes 50 or more words by 24 months as typical. By 26 to 28 months, many children have significantly more, often 100 to 200+ words, because vocabulary accelerates fast during this period. The exact count matters less than whether the child is combining words and whether their vocabulary is growing. A child stuck at 20 words for several months is a different concern than one at 45 words and clearly adding new ones each week.

What is echolalia and does it mean my child has autism?

Echolalia is the repetition of words or phrases heard from others, like quoting a TV show or repeating your question back to you instead of answering it. It shows up in many typically developing toddlers as a normal early language phase, and it's also common in autistic children. Echolalia alone doesn't indicate autism, but if it's the main way your child communicates at 26 months and no functional language is developing alongside it, that pattern is worth discussing with an SLP. See our full article on echolalia.

Can a 26-month-old use an AAC device instead of speech therapy?

AAC (augmentative and alternative communication) and speech therapy aren't opposites; they're often used together. Research does not support the idea that AAC prevents speech development. For children who are significantly delayed or who have motor speech disorders, AAC can actually support language development by reducing the pressure to speak while still building communication. An SLP who specializes in AAC can assess whether a device or system fits your child. More at aac devices.

My 26-month-old was saying words and then stopped. What does that mean?

Loss of previously acquired words, called regression, is a significant clinical flag and should prompt an evaluation faster than a straightforward delay. Regression, especially combined with changes in social engagement or play, is one of the early signs associated with autism spectrum disorder. It can also follow illness, major life changes, or occur in children with certain metabolic conditions. Don't wait for the next well visit if you've noticed your child losing words they used to have.

Will my child need speech therapy forever if they're delayed at 26 months?

Most children who get early, appropriate intervention do not need lifelong speech therapy. Many late talkers who get support in the toddler years are indistinguishable from peers by kindergarten. Children with more significant disorders, like autism or childhood apraxia of speech, may need support for longer, but the intensity and nature of therapy usually changes over time. Earlier treatment generally means shorter total treatment, which is the core argument for acting now rather than waiting.

Sources

1. American Academy of Pediatrics, Developmental Milestones: 2-Year-Old: By 24 months, the AAP expects at least 50 words and two-word phrases; pediatricians are advised to refer rather than wait when parents have concerns about speech.
2. CDC, Learn the Signs, Act Early: Developmental Milestones: Absence of two-word phrases by 24 months is listed as a developmental concern requiring prompt follow-up.
3. American Speech-Language-Hearing Association (ASHA), Late Language Emergence: ASHA guidance states two-word combinations are expected by age 2 and recommends evaluation rather than watchful waiting when milestones are missed.
4. Rescorla, L. (2011). Late talkers: Do good predictors of outcome exist? Developmental Disabilities Research Reviews: Approximately 13 to 15 percent of 2-year-olds qualify as late talkers; 50 to 70 percent catch up by school age without intervention.
5. CDC, Learn the Signs, Act Early: Developmental Milestones: Vocabulary growth accelerates sharply between 24 and 30 months, the fastest word-learning period in early childhood.
6. U.S. Department of Education, IDEA Part C Early Intervention Program: IDEA Part C guarantees free evaluation and services for children under 36 months with developmental delays; parents may self-refer without a physician's referral.
7. ASHA, Speech-Language Pathology Service Delivery: Private Practice Costs: Private speech evaluations typically cost $200 to $500; individual therapy sessions range from $100 to $350 per session depending on region and setting.
8. Roberts, M.Y. & Kaiser, A.P. (2011). The effectiveness of parent-implemented language interventions: A meta-analysis. American Journal of Speech-Language Pathology: Parent-mediated language interventions show significant positive effects on expressive vocabulary and communication outcomes in late-talking toddlers.
9. CDC, Autism Spectrum Disorder: Signs and Symptoms: Autism can be reliably diagnosed as early as 18 to 24 months; early diagnosis paired with appropriate support leads to better outcomes.
10. Strand, E.A. (2020). Dynamic Temporal and Tactile Cueing: A Treatment Strategy for Childhood Apraxia of Speech. American Journal of Speech-Language Pathology: Childhood apraxia of speech requires motor-based, highly repetitive treatment; three to five sessions per week is often recommended for young children with this diagnosis.
11. Paradis, J., Genesee, F., & Crago, M. (2011). Dual Language Development and Disorders. Brookes Publishing: Bilingual children have comparable total conceptual vocabulary to monolingual peers; bilingualism does not cause language disorders.
12. CDC, Hearing Loss in Children: Mild to moderate or later-onset hearing loss, including that from recurrent ear infections, can be missed by newborn screening and can mimic a language delay.
13. CMS, Medicaid EPSDT: Early and Periodic Screening, Diagnostic, and Treatment: Medicaid covers speech therapy for eligible children under EPSDT with no session limit in most states.