Speech Delay

Children progress at different rates, and determining whether your child is just a late bloomer or needs professional help from a speech therapist isn’t always easy.

Babies coo right from the start, but it’s not until months later when they begin to babble. As toddlers advance and learn new words their parent’s hearts soar because these sounds indicate that comprehension is developing too! By 2 years old children have a vocabulary of about 50-100 words; by 3 this has increased dramatically with 1000 more words to add to their speech or language development.

When a toddler doesn’t meet these speech milestones they may have a speech delay. As many as 10% of preschool children have this common developmental problem.

Please Note: While we are calling it a “speech delay” here, what is actually being referred to is a language delay. Speech is the physical act of producing sounds and saying words. A toddler who has a speech delay may be difficult to understand. Kids with a language delay might make the right sounds and their pronunciation of words may be fine, but they may not have the age-appropriate vocabulary or have difficulty forming phrases or sentences at a developmentally appropriate level.

The speech therapists at Therapy Works Together put together this informational guide to help you better understand speech delay including common signs & symptoms, speech delay treatment, speech therapy for language delay, red flags and when to get the help from a speech therapist and more.

  • Does your child have a speech delay?
  • How do speech therapists diagnose a speech delay?
  • What causes a speech delay?
  • How can parents support speech delay treatment?

  • Are You Meeting Your Speech Therapist for a Speech Delay? Ask these questions.

Does Your Child Have a Speech Delay?

Is there a more serious problem your toddler is having or are they developing in a typical way with age-appropriate language skills? It is hard for parents to find the right sources. So we have included the table below point out some common signs and symptoms by age group that may be red flags for a language delay.

12 months:

  • Your child does not use gestures (pointing, waving goodbye)

18 months:

  • Your child is preferring gestures over vocalizations to communicate
  • Your child has trouble imitating sounds
  • Your child has difficulty understanding simple verbal requests (“go get the ball”)

24 months:

  • Your child can only imitate speech or physical actions
  • Your child does not produce words or phrases on their own
  • Your child only makes some sounds or words repeatedly and does not use verbal language to communicate more than their immediate needs
  • Your child is not following simple directions

36 months:

  • Your child’s vocabulary does not consist of at least 200 words
  • Your child does not name objects to request them
  • It is difficult for people that know your child to understand them


How Do Speech Therapists Diagnose a Speech Delay?

If you think that your toddler might have a problem with speech and language skills, it’s important to see a speech therapist. During the initial evaluation, you will be asked how well your child can communicate (gestures, verbalization, eye contact). A speech therapist that is an expert in pediatric speech-language disorders is best.

The speech therapist may evaluate:

  • Receptive language skills – what your child understands
  • Expressive language skills – what your child says (vocabulary, grammar, length of sentences)
  • Speech development – how their speech or articulation sounds (do we understand the words your child is saying)
  • Oral-Motor skills – How are the parts of the mouth working for eating and swallowing

The speech therapist will look at all of these skills and depending on results may recommend speech therapy for your child.


What Can Cause a Speech Delay?

Perhaps your child is developing at their own pace, but there are a number of reasons they could be delayed in their speech and language development. There are some other underlying causes of these delays that may be worth ruling out. They include but are not limited to:

  • Hearing Loss: Many toddlers have frequent ear infections and this is often overlooked as the cause of a speech delay. A common sign of hearing loss is that your child  will acknowledge a gesture towards an object but not when you name the object. Hearing loss could be very subtle but have an impact which is why a speech therapist may recommend a hearing evaluation before speech therapy starts.
  • Autism Spectrum Disorder: Speech, language, and communication issues may be due to an underlying medical diagnosis of Autism Spectrum Disorder.
  • Neurological Problems: Certain neurological diagnoses, like traumatic brain injury, cerebral palsy etc. can affect communication development.
  • A Note on Lack of Stimulation: We are programmed as humans to learn language from those around us. While other websites might report that lack of stimulation may cause a delay, it would need to be a severe lack to have an effect on a child. A typically developing child would have to have no contact with other people to not develop communication skills. It is unusual for parents to be at fault that their child has a speech delay.


How Parents Can Support Speech Delay Treatment?

  • Speak with your child from birth; they are listening
  • When a baby coos or babbling respond with smiles, eye contact and words
  • Games like peek-a-boo and patty-cake are great for developing communication skills
  • Narrate what you are doing as you go through your day. Your child is listening
  • Read books; point to pictures and describe what your child points to in a book
  • Sing with your child and make it fun. Dance and jump if your child wants to; we all learn with our bodies as well. You don’t need special toys to have fun and improve speech or language skills
  • Expand on your child’s phrases and sentences to make them just a bit longer. If your child says “big doggie,” you can say, “big brown doggie”
  • Give your child the words they are looking for; if your child is whining because they are hungry, say “you are hungry, right?”
  • Give your child attention and patience; if you ask them a question, get on their level and give them the time to reply
  • Ignore grammatical errors in your child’s sentences; model the correct form when you repeat them


Are You Meeting Your Speech Therapist for a Speech Delay? Ask these Questions:

  • Why do you think my child is not talking?
  • What is normal for a child this age?
  • Could it be that my child has a hearing loss? Another medical diagnosis? How can we tell?
  • What can I do at home to help my child?


How Can Therapy Works Together Evaluate and Treat All Ages Online?

Therapy Works  Together helps families connect online with a licensed and certified speech therapist that is a trained expert in diagnosing and treating a variety of speech, language and communication issues. Speech therapy is delivered online at home with video conferencing applications.

The age of our clients as well as their diagnosis and goals is important in determining how speech therapy online will be delivered.

Speech therapy for babies and toddlers: For kids age 0-3, we usually work on early communication skills like joint attention, social communication, or increasing language skills in late-talking toddlers.

Parents work with their assigned speech-language pathologist, usually in a parent coaching model, to learn tips and strategies that speech therapists use so they can be adept at practicing teaching their child after the session is over and at home. You can read more here about how important it is for parents to be involved in their child’s speech therapy at home.

Speech therapy for preschoolers: For kids age 3-6, speech therapists target age-appropriate articulation, language delays, reading readiness, and more. Parents join in for online video sessions with the child so that both learn the speech strategies and skills from the speech therapist. Learning how to use these skills after the session helps kids improve.

Speech therapy for school age kids: for children age 7 and up, speech therapists might work on academic skills, increasing vocabulary, social skills for kids with autism, stuttering, and more. Children, this age can come to online video sessions on their own. Our speech therapists keep parents informed by sharing tips and homework.

Speech therapy for adults: Adults attend speech therapy sessions online after becoming stroke patients, for stuttering, for accent modification, and more. They come to sessions on their own from the comfort of their home or office. Often, they bring a caregiver or family members to learn strategies if they will need help communicating with others.

Read More

A team of certified speech therapists online who are experts in your needs.

Our licensed and certified speech therapists can help with speech or language issues for kids and adults, stuttering, social skills, articulation issues and more. With Therapy Works Together, you get the same high quality and expertise in online speech therapy as with face to face therapy, but with the convenience and affordability you want.

How it Works

Free Phone Consultation
  • Tell us about your needs during your free phone consultation

  • Sessions are affordable, convenient & at home

Book Your Session with an Expert
  • Convenient times available, even nights and weekends

  • Speech therapists with an average of 10 years experience

Start Speech Therapy at Home
  • Live video sessions at home

  • Great for all ages

  • Exercises to practice between sessions

The Benefits of Therapy Works Together

Therapy Works TogetherTraditional & Other Online Services
More Affordable


As high as $250/Session

Licensed expert speech therapists



Convenient to attend

Online sessions from home, office, school

Usually 9-5, commute required

Scheduling is easy & flexible

Easy, flexible scheduling online

Rescheduling may require a fee

Communicate Easily Online with Your Therapist Online

Text and communicate online with your therapist securely online

Not usually available

Hassle Free & Honest Billing

We bill for sessions only after completed

Memberships and subscriptions; You may be charged for sessions not attended

Traditional & Other Online Services
More Affordable $59/Session Up to $250/Session up to
Licensed experts speech therapists
Convenient to attend
Scheduling is easy & flelxible
Communicate Easily Online with Yout Therapist Online
Hassle Free & Honest Billing

“Ellenore was the perfect fit for my son. She helped him achieve his goals, which in turn helped him with his confidence.”

– K.S., August 2021

Ellenore M.A., CCC-SLP

“We learned strategies from Tricia and pretty quickly my son was talking just like any other three year old”

– L.M., July 2021

Tricia M.S., CCC-SLP

“My child has been working with Jessica and she is amazing and so patient.”

– J.F., September 2021

Jessica M.A., CCC-SLP

“She is patient and genuinely cares about my son. She has been a wonderful support for my son and our family”

– M.A., June 2021

therapist-online2 (1)
Natalie M.S., CCC-SLP