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

Last updated 2026-07-09

What are the actual speech milestones for toddlers?

The American Academy of Pediatrics and the American Speech-Language-Hearing Association publish speech milestones that most clinicians use as a screening tool. They aren't a pass/fail test. They're probability thresholds. Children who fall below them are more likely to have an underlying delay, so they get a closer look.^[1][2]

Here's what research and clinical consensus say to watch for:

These numbers come from large population studies. No child hits every marker exactly on schedule, and variation is real. But if your toddler is two and not talking, or producing far fewer than 50 words at 24 months, that gap matters clinically.^[2]

One thing parents miss all the time: comprehension develops ahead of expression. A 12-month-old who says nothing but clearly gets "no," follows simple instructions, and looks when you call their name is telling you something different than a 12-month-old who neither speaks nor responds. Both deserve attention. The picture is not the same.

My toddler is two and not talking. How worried should I be?

Concerned enough to act, not panicked. About 10 to 15% of 2-year-olds are "late talkers," meaning a limited vocabulary with no other developmental concerns.^[3] Roughly half of those late talkers catch up on their own by school age. The other half don't, and the children who struggle most later are the ones who got the least support early.

Here's the catch. At age 2, nobody can reliably tell you which group your child belongs to. A "wait and see" approach spends real time during the most neuroplastic window your child will ever have. The research is clear: intervention started before age 3 produces better language outcomes than the same therapy started later.^[4]

What you're seeing matters too. A 24-month-old with zero words, no pointing, no social engagement, limited eye contact, and rigid play needs a faster, different response than a 24-month-old who has 20 words, shows you things, laughs at peek-a-boo, and just happens to be behind on word count. Neither child should be told to wait. But the first one needs a developmental pediatrician in the loop quickly, because those co-occurring signs point to a broader evaluation.

You don't need to diagnose your child. You need to start the process.

What causes a toddler to be late talking?

There's no single cause, and for many late talkers, a clear explanation never shows up. That can feel frustrating. It changes nothing about what actually helps.

Some of the more common contributing factors:

Expressive language delay without other concerns. The child understands well, communicates in other ways (gestures, eye contact, pointing), and just produces fewer words. This is the classic "late talker" profile.

Receptive-expressive delay. Both understanding and production are behind. This pattern needs a more thorough evaluation.

Hearing loss. A child who can't clearly hear speech has a harder time reproducing it. Hearing should be tested early and formally. Passing a newborn screen doesn't rule out later hearing problems.

Childhood apraxia of speech (CAS). A motor planning problem where the child knows what they want to say but can't reliably coordinate the movements to say it. Kids with CAS often have very inconsistent output. Our article on childhood apraxia of speech shows what that looks like.^[5]

Autism spectrum condition. Language delay is one feature of autism, not the defining one. The pattern of social communication, play, and sensory behavior matters more than word count alone. See autism spectrum speech therapy for how communication development differs.

Environmental and input factors. Children who hear less language, less back-and-forth interaction, or more screen time in place of conversation do have higher rates of language delay. This isn't about blame. It's about what's modifiable.

Multilingual environments. Bilingual children may have smaller vocabularies in each language but comparable total word counts across languages. A bilingual child is not delayed just because they say fewer English words.^[6]

When should I call the doctor or a speech therapist?

Don't wait for the next scheduled well-child visit if you're already worried. Call now. The AAP recommends developmental surveillance at every well-child visit and formal screening at 9, 18, and 24 or 30 months.^[1] If you're between visits and something feels off, that's reason enough to call.

The clearest signals to act immediately:

• No babbling by 12 months
• No words at all by 16 months
• No two-word phrases by 24 months
• Any loss of words or skills the child already had, at any age (this one is urgent, past concerning)
• You or a caregiver can't understand at least 50% of what your 24-month-old says

You can also go straight to a speech-language pathologist without a pediatrician referral in most U.S. states. ASHA keeps a "Find a Provider" directory on their main site.^[2] If your child is under 3, calling your state's early intervention program is the most direct path, and it bypasses insurance and wait times for the first evaluation.

What happens next in speech therapy and what a speech therapist does is its own subject, but the short version: a licensed SLP runs a standardized assessment, looks at comprehension and expression separately, and gives you a starting point.

How do I get early intervention services for my toddler?

Early intervention (EI) is a federally mandated program under the Individuals with Disabilities Education Act (IDEA), Part C. It covers children from birth up to the third birthday. The evaluation is free to families, and therapy is either free or on a sliding scale depending on your state.^[4][7]

The IDEA statute says early intervention services must be provided "in natural environments to the maximum extent appropriate."^[7] That means the SLP usually comes to your home or your child's daycare. That's genuinely better for toddlers, who pick up and use new skills fastest in familiar places.

How to start:

1. Find your state's Part C contact through the CDC or your pediatrician. The CDC's "Learn the Signs, Act Early" page links to all state programs.^[8] 2. Call and request an evaluation. You don't need a diagnosis or a referral. 3. The program must complete an evaluation within 45 days of your call. 4. If your child qualifies, they get an Individualized Family Service Plan (IFSP) with specific therapy goals.

If your child turns 3 before services start, or you want to continue past age 3, the program hands off to school-based services under IDEA Part B, run by the school district. Start that transition a few months before the third birthday.

EI is one of the most underused resources in pediatric development. Many families don't know they can self-refer, or they wait because the pediatrician said to wait. You can call EI and start the process while you also follow your pediatrician's guidance. Those aren't mutually exclusive.

For a full guide to the system, see our article on early intervention.

What can I do at home to help my late talker?

You are your child's most frequent communication partner. That matters. Research finds that parent-implemented language strategies, done with fidelity, produce real gains in expressive vocabulary and how often a child communicates.^[9]

The most evidence-supported approaches for home:

Follow the child's lead. Get on the floor, watch what your child is into, and talk about that thing. "Oh, you found the truck. Truck. Big truck. The truck goes fast." Narrate their attention, not your agenda.

Use telegraphic expansion. If your child says "ball," you say "red ball" or "throw the ball." You're modeling the next level, just slightly above where they are. Don't demand a repeat. Put the words in the air.

Fewer questions, more comments. "What's this?" is a performance demand. "That's a dog!" is an invitation. Late talkers often shut down under constant questioning. Flip the ratio.

Pause and wait. After a word or a comment, pause 5 to 10 seconds and look at your child expectantly. Clinicians call this a "communication temptation." Many toddlers fill the silence once they know you're waiting.

Read together daily. The joint attention and vocabulary exposure from shared book reading are well-documented. Point, label, pause. You don't have to read the words on the page. Just talk about the pictures.

Cut screen time. The AAP recommends no screen time for children under 18 months (except video chatting) and only limited, high-quality programming for 18- to 24-month-olds with a caregiver watching alongside.^[1] Passive screen time displaces the back-and-forth that builds language.

One caveat. These strategies support language development, but they don't replace a professional evaluation if your child meets the criteria above. Think of them as what you do while you get your child evaluated, and what you do between therapy sessions.

Could my toddler be autistic if they're not talking?

Language delay is one of the most common early signs parents notice, but autism is a communication and social development condition, not a speech condition. Word count alone doesn't tell you whether a child is autistic.

The signs that push evaluators toward considering autism alongside a language delay: limited or unusual eye contact, not pointing to share interest (as opposed to pointing to ask for things), not responding consistently to their own name by 12 months, repetitive or restricted play, strong distress around sensory input, and unusual attachment to specific objects or routines.^[10]

Some autistic children are very verbal. Some non-autistic children are severely delayed in speech. The two things correlate. They don't define each other.

If you're seeing social communication differences alongside the speech delay, the next step is a request for a developmental pediatrician evaluation or a referral to an autism diagnostic center, on top of speech therapy. Waiting for a formal autism diagnosis before starting speech services is a common mistake. Therapy can and should start before any diagnosis is confirmed.

For families working through both, autism spectrum speech therapy covers the approaches that work best when social communication is part of the picture.

What is AAC and should my nonverbal toddler use it?

Augmentative and alternative communication (AAC) covers any tool or strategy that helps a person communicate beyond natural speech. That includes picture boards, sign language, and speech-generating devices.

A stubborn myth says that giving a nonverbal or minimally verbal child an AAC tool will kill their motivation to talk. The research says the opposite: AAC supports speech development and does not suppress it.^[11] Children who have a reliable way to communicate are less frustrated, more engaged, and more likely to develop speech alongside the tool.

For a toddler who isn't talking, low-tech options like core vocabulary boards, PECS (Picture Exchange Communication System), or basic sign language can start immediately and at low cost. High-tech speech-generating devices fit better once a team has done a formal AAC assessment.

Your child's SLP should lead the AAC conversation. If you're not getting an evaluation soon, sign language is a safe, zero-cost place to start at home. Signs like "more," "eat," "up," and "all done" are easy to teach and cut frustration right away.

For a closer look at the technology and what the options actually are, see our guide to aac devices.

This is also where tools like the Little Words app can bridge the gap at home. It's built for kids with communication delays, and it keeps practice going between therapy sessions. You can take a short quiz to see if it fits your situation.

How long does it take for a late talker to catch up?

There's no single answer. It depends on the underlying cause, the size of the gap, when therapy starts, and how much support happens at home.

For children with expressive-only delays (good comprehension, good social communication, just limited output), many studies report that 50 to 70% resolve by kindergarten with or without formal therapy. The children who started therapy earlier, and whose parents used supported strategies consistently, did better.^[3]

For children with broader delays, apraxia, or co-occurring conditions, catch-up takes longer and is harder to predict. Some children make dramatic gains in 6 to 12 months of early therapy. Others work on communication skills through elementary school and beyond.

The honest thing to tell a parent: start now, track progress every 3 to 4 months with your SLP, and don't let "some kids take longer" become a reason to stop asking questions when progress stalls.

Progress in speech therapy gets measured with standardized assessments like the PLS-5 (Preschool Language Scales) or the REEL-4, which give age-equivalent scores. Ask your SLP to share those numbers at each reassessment. If a child has been in therapy for 6 months and the gap relative to age peers hasn't narrowed, something in the approach may need to change.

What does a speech therapy evaluation for a toddler look like?

Most parents are surprised by how play-based a pediatric speech evaluation is. A good SLP working with a toddler won't sit across a table and drill questions. They get on the floor with toys and watch.

A full evaluation usually includes:

Parent interview. You describe your child's communication history: first words, current words, how they ask for things, what frustrates them, how they play.

Hearing screening or referral. Before anything else, hearing has to be ruled out as a factor.

Standardized testing. Age-appropriate tests measure receptive vocabulary (can they point to the cup?), expressive vocabulary (can they name the cup?), sentence structure, and speech sound accuracy.

Observation. The SLP watches how your child communicates during play. Do they initiate? Do they use gestures? Do they share attention?

The whole thing usually takes 60 to 90 minutes. At the end you should get a report with scores, a description of what the evaluator saw, and a recommendation. If therapy is recommended, ask for the frequency, the goals, and how progress will be measured.

Private evaluations typically cost $200 to $600 depending on location, though insurance often covers them with a diagnosis code. Early intervention evaluations are federally required to be free.^[7]

What if my pediatrician keeps telling me to wait and see?

This happens a lot. "Let's check again at the next visit" is sometimes right and sometimes not. The AAP's own guidelines say that when a parent raises a concern about speech, that concern alone should trigger action, including a referral.^[1] Parental concern has been shown to predict actual delay.

If you've been told to wait and you're still worried, you have options. Ask for a speech therapy referral directly. Self-refer to your state's early intervention program without any doctor involved. See a developmental pediatrician for a second opinion. Pediatricians are excellent generalists, but speech-language pathology is a specialty, and a brief well-child visit is no substitute for a formal evaluation.

The phrase to use: "I'd like a referral for a speech-language evaluation. I understand this might turn out to be nothing, but I want the evaluation while my child is still under 3 so we can access early intervention services if needed."

You are your child's advocate. Polite persistence is the right move.

Are there red flags beyond speech that I should know about?

Yes. Speech delay rarely shows up in a vacuum, and these patterns suggest something more than expressive language delay:

• Loss of language or skills already acquired. A child who had words and lost them needs urgent evaluation, not a wait-and-see.
• Inconsistent response to their own name after 9 months.
• No pointing to show interest (as opposed to pointing to request) by 14 months.
• No back-and-forth "conversation" with sounds and expressions (proto-conversation) by 9 months.
• Very limited imitation of sounds, words, or actions.
• Echolalia that is the primary or only form of speech. Echolalia (repeating phrases verbatim) is a normal part of language development at 18 to 24 months, but when it stays the main way a child communicates, it warrants evaluation. See echolalia for what it looks like and when it matters.
• Motor difficulties alongside speech issues, especially inconsistent, groping attempts at words. This pattern can signal apraxia of speech.

None of these is a diagnosis. All of them are reasons to get a professional involved faster than you otherwise might.

Frequently asked questions

My toddler is 18 months and has no words. Is that a big deal?

Yes, this meets the threshold for referral. ASHA and the AAP both recommend evaluation when a child has no words by 16 months. At 18 months with zero words, request a speech-language evaluation and contact your state's early intervention program now. Don't wait for the 24-month checkup. Earlier help produces better outcomes, and the EI evaluation is free.

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

Speech is the physical production of sounds and words. Language is understanding and using words to communicate. A child can have a speech delay (they understand everything but can't produce clear words), a language delay (limited understanding and expression both), or both. A speech-language pathologist evaluates both areas separately, because they often need different interventions.

Can too much screen time cause a speech delay?

Screen time doesn't cause permanent damage, but heavy passive screen exposure displaces the back-and-forth interaction that builds language. The AAP recommends no solo screen time before 18 months and only limited co-viewing between 18 and 24 months. If a toddler spends hours watching video instead of interacting with people, that's worth changing regardless of other factors.

Should I teach my late talker sign language?

Yes, for most late talkers, basic sign language is a low-risk, zero-cost way to reduce frustration and build communication. Signs like 'more,' 'eat,' 'all done,' and 'help' are easy to teach. Research does not support the idea that signing suppresses speech. Most children drop signs on their own once verbal communication gets easier.

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

This is the classic expressive-only language delay profile. Good comprehension is a strong prognostic sign. It means the auditory and language processing systems are working, and the gap sits in output rather than understanding. Many of these children catch up, especially with early support. Still, 'they understand everything' doesn't remove the need for evaluation. Get assessed so you have a baseline and a plan.

How do I find a speech therapist for my toddler?

For children under 3, the fastest route is your state's early intervention program, which provides free evaluations and often free or reduced-cost therapy. For children over 3 or if you want private services, ASHA's Find a Provider tool at asha.org lists licensed SLPs by location. Ask your pediatrician for a referral, which helps with insurance coverage. You can also self-refer to many private practices directly.

Is my toddler's speech delay my fault?

No. Speech delays have many causes, most of them neurological or related to hearing, not parenting. That said, you can meaningfully influence your child's progress by increasing face-to-face interaction, narrating daily activities, cutting screen time, and learning the strategies an SLP recommends. Guilt is not useful. Action is. Put your energy into the second thing.

What's the difference between a late talker and a child with autism?

A late talker typically has limited spoken output but normal or near-normal social engagement: they make eye contact, point to share interest, respond to their name, and want to connect. Autism involves broader differences in social communication, past word count. A child can be both a late talker and autistic. Formal evaluation by a developmental pediatrician or autism diagnostic team is the only way to know.

Can a toddler with speech delay still go to preschool?

Yes. Many children with speech delays attend typical preschool with speech therapy services written into an IEP (after age 3) or IFSP (under age 3). Peer-rich preschool environments can support language development. Talk to your school district and your child's SLP about which supports make sense. A speech delay alone is not a reason to keep a child out of preschool.

How often should a late toddler get speech therapy?

Frequency depends on severity and the child's individual profile. Many toddlers in early intervention get 1 to 2 sessions per week. More sessions are sometimes recommended for children with CAS or significant delays. Home practice with parent-implemented strategies between sessions matters as much as session frequency. Ask your SLP for specific home practice goals after each session.

Will my toddler's late talking affect them in school?

It can. Children with unresolved language delays at kindergarten entry have higher rates of reading difficulty, because reading builds on spoken language skills. This is one of the strongest arguments for acting early. Children who get appropriate speech services before age 5 and close their language gap before kindergarten are far less likely to face downstream academic effects.

Does bilingualism cause speech delays?

No. Bilingual and multilingual children may have smaller vocabularies in each language, but their total vocabulary across all languages is comparable to monolingual peers. A bilingual child should not be diagnosed with a language delay based on English-only word counts. A proper evaluation assesses communication in all languages the child hears. If a delay exists, it shows up in all languages.

Sources

1. American Academy of Pediatrics, Developmental Surveillance and Screening Policy: AAP recommends developmental surveillance at every well-child visit and formal screening at 9, 18, and 24 or 30 months; parental concern alone should trigger action including referral
2. American Speech-Language-Hearing Association (ASHA), Late Language Emergence: ASHA defines late language emergence as fewer than 10 words at 18 months and fewer than 50 words or no two-word combinations at 24 months; maintains Find a Provider directory
3. Rescorla L. (2011). Late talkers: Do good predictors of outcome exist? Developmental Disabilities Research Reviews, 17(2), 141–150.: Approximately 10–15% of 2-year-olds are late talkers; roughly half resolve without intervention by school age, but outcomes are better with early support
4. U.S. Department of Education, IDEA Part C Early Intervention Program: IDEA Part C mandates free early intervention evaluations and services for children birth through age 2 with developmental delays; evaluation must occur within 45 days of referral
5. Childhood Apraxia of Speech Association of North America (CASANA): Childhood apraxia of speech is a motor planning disorder where children have inconsistent speech output and difficulty coordinating movements for speech
6. American Speech-Language-Hearing Association (ASHA), Bilingual Language Development: Bilingual children may have smaller vocabularies in each language but comparable total vocabularies across languages; should not be diagnosed with language delay based on one language alone
7. Individuals with Disabilities Education Act, 20 U.S.C. § 1432 (Part C): IDEA Part C requires early intervention services to be provided in natural environments to the maximum extent appropriate and at no cost to families for evaluation
8. CDC, Learn the Signs Act Early Program: CDC Learn the Signs Act Early provides state-by-state early intervention program contacts and developmental milestone tracking tools for parents
9. Roberts MY, Kaiser AP. (2011). The effectiveness of parent-implemented language interventions. American Journal of Speech-Language Pathology, 20(3), 180–199.: Parent-implemented language strategies produce real gains in expressive vocabulary and communication frequency when applied with fidelity
10. CDC, Autism Spectrum Disorder Signs and Symptoms: Early signs of autism include not responding to name by 12 months, not pointing to share interest by 14 months, and limited eye contact or social engagement alongside language delay
11. Millar DC, Light JC, Schlosser RW. (2006). The impact of AAC on natural speech development. AAC: Augmentative and Alternative Communication, 22(3), 194–209.: AAC use does not suppress natural speech development and is associated with increased communication and speech attempts in children with limited verbal output