5 Signs Your Child Might Need Speech Therapy
5 Signs Your Child Might Need Speech Therapy
Every parent has that moment where they wonder: "Is this normal... or should I be worried?"
Maybe your child isn't talking as much as their cousins. Maybe preschool sent home a note. Maybe you've just had a quiet feeling in the back of your mind for months.
The tricky part about speech development is that there's a pretty wide range of "typical" — which makes it genuinely hard to know when to act and when to wait.
Here are 5 signs, straight from a pediatric speech-language pathologist, that it's time to stop wondering and get an evaluation.
Sign #1: They're Behind on Key Milestones
Speech development follows a general timeline, and while every child has their own pace, there are benchmarks that tell us a lot.
Here's a quick snapshot:
By 12 months: 1–2 words ("mama," "dada"), babbles with varied sounds, responds to their name
By 18 months: 10–20 consistent words, follows simple 1-step directions
By 2 years: 50+ words, starting to put 2 words together ("more milk," "daddy go")
By 3 years: 200+ words, speaks in sentences, strangers can understand about 75% of what they say
If your child is significantly behind in any of these areas, that's not a "wait and see" situation. The earlier speech therapy starts, the better the outcomes — especially in the critical window before age 3.
Sign #2: They're Hard to Understand — Even for You
By age 2, parents and familiar caregivers should be able to understand most of what their child says. By age 3, strangers should understand at least 75% of their speech. By age 4, speech should be mostly clear to everyone.
If you find yourself regularly acting as a "translator" for your child — or if even you can't understand them much of the time — that's worth evaluating.
Unclear speech can be caused by difficulty with specific sounds (like saying "wabbit" instead of "rabbit"), overall motor coordination of the mouth and tongue, or something called a phonological disorder — where a child's brain isn't organizing speech sounds the way it should.
All of these are very treatable with the right support.
Sign #3: They've Stopped Making Progress — or Lost Skills They Had
This one's important. If your child was saying words and then stopped — even just a handful of words — that's always worth bringing to a professional immediately.
Regression (losing skills) can be a sign of several things, and it's the kind of thing you don't want to watch and wait on.
Even if there's no regression, a child who has plateaued for several months — stuck at the same word count, not adding new words, not combining words — is telling you something. Progress should be consistent, even if slow.
Sign #4: They Mostly Point, Pull, or Use You to Communicate
It's completely normal for toddlers to gesture — pointing is actually an important early communication milestone. But if your child is mostly relying on grabbing your hand, pointing, grunting, or looking at you to speak for them, with very few or no words to pair with those gestures, that's a pattern worth addressing.
Communication involves words and gesture, and early speech therapy can help children who are relying heavily on nonverbal communication start bridging into verbal language.
Sign #5: Frustration Is Getting in the Way
Does your child melt down frequently when they can't be understood? Do they give up trying to communicate? Do they seem to have a lot to say but just can't get it out?
When communication is hard, it affects everything — play, friendships, learning, behavior, and self-confidence. Children who can't express themselves often show it through frustration, big emotions, or withdrawal.
Speech therapy isn't just about words. It's about giving your child a way to connect with the world around them — and that changes everything.
What About the "Wait and See" Approach?
You've probably heard it from a pediatrician or a well-meaning family member: "Every kid develops differently. They'll talk when they're ready."
And yes — some children do catch up on their own. But research is clear that early intervention produces significantly better outcomes than waiting. The neural pathways for language are most flexible and responsive in the first few years of life. Waiting until preschool or kindergarten to address a delay that showed up at 18 months means missing the window when therapy is most effective.
A speech evaluation doesn't commit you to anything. It just gives you information. And having that information early means you can act early — or feel genuinely reassured that everything is on track.
What to Do Next
If any of these signs feel familiar, the next step is a comprehensive speech-language evaluation. This is a thorough assessment (not just a quick screening) that looks at how your child understands language, produces language, uses speech sounds, and communicates socially.
At Eat. Play. Love. OT, we offer in-home and telehealth speech evaluations throughout San Diego County.
We are in-network with United Healthcare, Optum, Tricare West, and Cigna/ASH. We are also a contracted provider with SDRC Early Start (vendor HQ2449).
Book a free consultation here → We'll help you figure out whether an evaluation makes sense for your child, and what the process would look like.
You don't have to wonder anymore.
Related reading:
Is My Child a Late Talker? A Guide for San Diego Parents








