Hulya MehmetA Speech and Language Therapist’s Expert Guide for UK Parents
Are you wondering why your 18-month-old isn’t talking yet? You’re not alone. As a speech and language therapist with over 25 years of experience working with families, I understand the worry that comes when your toddler’s communication seems different from their peers.
The question I hear most often in my clinic is: “My 18-month-old is not talking—should I be worried, or should I wait and see?”
Let me share what I’ve learned from working with thousands of families, including my own experience as a parent navigating communication challenges.
What’s Expected at 18 Months: The Clinical Reality
By 18 months, most children typically have 10-20 clear words and are beginning to combine two words together, like “all gone” or “daddy bye-bye.” They should also understand simple instructions and use gestures to communicate their needs.
But here’s what many parents don’t realise: there’s a significant range of normal development.
In my practice, I see children who fit perfectly into these milestones, and others who are taking their own unique path. The key is understanding when variation is typical and when it signals something that needs support.
When to Worry: The Red Flags That Matter
After 25 years of clinical experience, these are the signs that prompt me to recommend immediate evaluation:
Immediate Concern Signs:
- No words at all by 18 months
- Not responding to their name consistently
- No pointing or gestures to communicate needs
- Limited understanding of simple instructions like “give me the ball”
- Not showing or sharing enjoyment with you
- Significant regression – losing words or skills they once had
The “Not Talking But Understands Everything” Scenario
One of the most common situations I encounter is the 18-month-old who clearly understands everything but isn’t speaking. Parents often ask: “Should I worry if my child understands but doesn’t talk?”
The answer depends on the bigger picture. If your child:
- Responds to their name consistently
- Points to things they want
- Shows you things that interest them
- Follows simple instructions
- Engages in back-and-forth play
Then they may simply be a late talker who will catch up with time and support.
However, if understanding is paired with limited social engagement or unusual behaviours, this warrants professional evaluation.
When to Wait: Understanding Normal Variation
Some children are naturally quieter and take longer to find their voice. This can be completely normal when other developmental areas are on track.
Signs that waiting may be appropriate:
- Strong understanding of language
- Active use of gestures and pointing
- Social engagement and eye contact
- Playing appropriately with toys
- Meeting other developmental milestones
Remember: Even if waiting is appropriate, there’s no harm in seeking an early evaluation for peace of mind and practical strategies.
The UK Healthcare Journey: What to Expect
Your First Steps:
- Contact your Health Visitor or GP – they can assess and refer if needed
- Request a hearing test – ruling out hearing issues is essential
- Ask for a speech and language therapy referral – early intervention is key
NHS Pathway Reality:
Average wait times for NHS speech therapy assessment can be 20-26 weeks. While you’re waiting:
- Implement home strategies (I’ll share these below)
- Consider private assessment if concerns are significant
- Keep a communication diary to track progress
What You Can Do At Home Right Now
Based on my clinical experience and research, here are the most effective strategies:
1. The Power of Narration
Describe what you’re doing throughout the day: “I’m putting on your shoes. Left foot, right foot. Now we’re ready to go outside!”
2. Create Communication Opportunities
- Keep favourite snacks in sight but out of reach
- Pause during familiar songs for your child to fill in words
- Give choices: “Do you want the red cup or blue cup?”
3. Follow Their Lead
If your child is interested in cars, use cars for language learning. The more engaged they are, the more they’ll learn.
4. The 18-Month Magic Number
Aim for your child to hear the same word 18 times in different contexts before expecting them to use it. Repetition in natural contexts is key.
My Professional Perspective: Why Early Support Matters
In my experience, 70-80% of late talkers do catch up on their own. But here’s why I don’t recommend the “wait and see” approach:
- Earlier intervention requires less intensive support
- Brain plasticity is highest before age 3
- Reduces frustration for both child and family
- Professional assessment provides invaluable peace of mind
- Strategies benefit all children, even typical developers
Is It Autism or Late Talking? The Question Every Parent Asks
This is perhaps the most common concern I address. As the author of “Is it Autism? Or Late Talking?”, I understand this anxiety deeply.
Key differentiators to consider:
- Social engagement: Does your child seek to share experiences with you?
- Joint attention: Do they look where you’re pointing and point to show you things?
- Play skills: Are they developing imaginative play or are they rigid in their routines?
- Sensory responses: Do they have unusual reactions to sounds, textures, or lights?
The distinction isn’t always clear-cut, which is why professional evaluation is so valuable.
Your Child’s Communication Journey
Every child’s path to communication is unique. Some children are early talkers, others take their time, and some need additional support along the way. What matters most is providing the right environment and support for your individual child.
In my clinic, I’ve seen “late talkers” become eloquent speakers, and children with early autism signs develop rich communication skills with the right support. The key is understanding your child’s individual needs and responding appropriately.
When to Trust Your Parental Instinct
As both a therapist and a mother, I know that parental intuition is powerful. If something feels different about your child’s communication, trust that feeling. You know your child better than anyone.
Even if professionals suggest waiting, you have the right to:
- Seek a second opinion
- Request early intervention services
- Access private assessment
- Implement supportive strategies at home
Moving Forward with Confidence
Remember, seeking help isn’t about “fixing” your child—it’s about understanding their unique needs and providing the best support for their communication journey.
Whether your 18-month-old is a late talker who needs time and encouragement, or a child who would benefit from professional support, early action creates the best outcomes.
Your next steps:
- Use my Early Years Communication & Sensory Tracker to understand your child’s current profile
- Implement the home strategies above
- Contact your health visitor or GP if concerns persist
- Trust your instincts—you are your child’s best advocate
Hulya Mehmet is a Consultant Speech and Language Therapist with over 25 years of experience and author of “Is it Autism? Or Late Talking?” She provides specialist support for families across London and online throughout the UK.
Need personalised guidance for your child’s communication journey? Book a consultation to discuss your specific concerns and receive tailored strategies for your family.
