What Speech Therapists Really Look For (And What Parents Need to Know)

“Is my toddler just a late bloomer, or should I be concerned?”

This is the question that keeps many parents awake at night. As a speech and language therapist with over 25 years of experience, I’ve learned that the difference between normal variation and concerning signs isn’t always obvious—even to professionals.

But there are specific patterns I look for that can help distinguish between a child who needs time and one who needs support. Let me share what I’ve learned from working with thousands of families.

Understanding Late Talking: More Than Just Fewer Words

A late talker is typically defined as a toddler between 18-30 months who has a limited spoken vocabulary for their age, but is developing normally in other areas—play, social skills, thinking, and motor development.

Here’s what many parents don’t realise: up to 15-20% of toddlers are late talkers, and about 70-80% of them will catch up on their own by age 3-4. But the key question is: how do we identify the 20-30% who won’t catch up without support?

The Clinical Red Flags: When to Be Concerned

After 25 years of assessments, these are the signs that prompt immediate action in my clinic:

Age-Specific Red Flags:

By 12 months:

No babbling with consonant-vowel combinations (ba-ba, da-da)
No gestures like waving or pointing
Not responding to their name consistently

By 18 months:

Fewer than 10 words (including animal sounds and approximations)
No pointing to things they want or find interesting
Not following simple instructions like “get your shoes”
No attempts at imitation of sounds or actions

By 24 months:

Fewer than 50 words
No two-word combinations (“more milk,” “daddy go”)
Limited understanding of language
No pretend play emerging

The Most Concerning Pattern: The Silent Toddler

The children I worry about most are those who are quiet in all areas—they’re not babbling, not using gestures, not attempting to communicate through sounds or actions. This often indicates a more significant communication difficulty.

Normal Variation: When Late Talking Is Typical

Some children are simply on their own timeline. Here’s when I’m more reassured:

Positive Signs That Suggest Normal Variation:

Strong Understanding:

Follows multi-step instructions (“Get your coat and bring it to mummy”)
Points to body parts when asked
Responds appropriately to questions with actions even if not words

Active Communication Attempts:

Uses lots of gestures and pointing
Takes you by the hand to show you things
Tries to communicate even without words

Social Engagement:

Makes good eye contact during interactions
Shows you things they find interesting
Engages in back-and-forth play

Emerging Skills:

Babbling that sounds like conversation
Attempting word approximations
Using sounds consistently for specific things

The “Einstein Syndrome” Myth: Brilliant But Quiet?

Parents often ask me about highly intelligent children who are late talkers—sometimes called “Einstein Syndrome.” While this can happen, intelligence doesn’t negate the need for support.

Even brilliant children benefit from speech therapy if they’re struggling to communicate. I’ve worked with mathematically gifted toddlers who needed help expressing their amazing ideas, and artistic children who were frustrated because they couldn’t share their creativity through words.

The key: Don’t let assumptions about intelligence delay getting support if needed.

Gender and Birth Order: The Real Impact

Boys vs Girls: Boys are 2-3 times more likely to be late talkers than girls. This is partly due to different developmental patterns, but it doesn’t mean we should have lower expectations for boys.

Birth Order Effects: Second and third children sometimes talk later, especially if older siblings “translate” for them. While this can be normal, it’s important to ensure younger children have opportunities to communicate for themselves.

When “Busy” Becomes a Concern

I often hear: “My child is too busy to talk—they’re always on the go!”

While active children may focus their energy on physical development, being busy shouldn’t prevent communication development. In fact, very active children who aren’t talking may be showing us they need alternative ways to communicate their needs and experiences.

The Bilingual Factor: Twice the Complexity

Bilingual children may appear to have smaller vocabularies in each language, but when you count words across both languages, they’re often on track. However, they should still be:

Understanding instructions in both languages
Using gestures and social communication
Showing typical play and social development

Red flag for bilingual children: If communication difficulties exist across both languages and in non-verbal areas.

Assessment Red Flags: Beyond Just Words

When I assess toddlers, I look beyond vocabulary size:

Communication Intent:

Does the child try to communicate, even without words?
Do they repair communication when misunderstood?
Are they motivated to share experiences?

Play Skills:

Are they developing imaginative play?
Can they use objects functionally?
Do they engage in social play routines?

Learning Patterns:

Do they learn from demonstration?
Can they imitate new actions?
Are they curious about their environment?

The Parent Intuition Factor

Here’s something I’ve learned: parental concern is often the best predictor of whether a child needs support. Research shows that when parents are worried about their child’s communication, they’re right about 70-80% of the time.

Trust your instincts. If something feels different about your child’s communication development, it’s worth investigating.

UK-Specific Guidance: Navigating the System

When to Contact Your Health Visitor or GP:

Your child isn’t meeting age-appropriate milestones
You have persistent concerns despite reassurance
Your child is showing regression in any skills
Communication difficulties are affecting daily life

What to Expect:

Hearing test: Essential first step to rule out hearing loss
Developmental assessment: Looking at all areas of development
Speech therapy referral: If communication-specific support is needed

Private vs NHS Options:

With NHS waiting times averaging 20-26 weeks, many families choose private assessment for:

Faster access to professional opinion
Detailed analysis and strategies
Peace of mind during the waiting period

Supporting Your Late Talker at Home

While waiting for professional support, here’s what makes the biggest difference:

Create Communication Opportunities:

Pause and wait for responses during daily routines
Offer choices to encourage decision-making
Keep favourite items visible but just out of reach

Use the Power of Repetition:

Repeat key words throughout the day in different contexts
Use simple, clear language
Emphasise important words with your voice

Follow Their Interests:

Talk about what captures their attention
Join their play without taking over
Use their favourite activities as learning opportunities

The Early Intervention Advantage

Research consistently shows that earlier support leads to better outcomes with less intensive intervention needed. This is why I always recommend action over waiting when parents have concerns.

Even if your child is ultimately a “late bloomer,” the strategies from speech therapy benefit all children and can:

Reduce frustration for both child and family
Prevent secondary issues with behaviour or confidence
Provide parents with evidence-based techniques
Create stronger communication foundations

Moving Forward: Your Next Steps

If you’re reading this and recognising some concerning patterns:

Document your observations using a communication diary
Try some home strategies while seeking professional advice
Contact your health visitor or GP for referral guidance
Trust your parental instincts – they’re usually right
Remember that seeking help is protective, not pathological

The Bottom Line

Late talking exists on a spectrum from normal variation to significant delay. The key is understanding your individual child’s pattern and responding appropriately.

Some children are late bloomers who flourish with time and patience. Others are showing us they need different strategies to unlock their communication potential. Professional assessment helps distinguish between these scenarios and provides the roadmap for supporting your child’s unique journey.

Remember: Getting an evaluation doesn’t mean there’s something “wrong” with your child. It means you’re being proactive about giving them the best possible start in their communication journey.

If you’re concerned about your toddler’s communication development, my Early Years Communication & Sensory Tracker can help you understand their current profile and identify next steps. Early support creates the strongest foundation for lifelong communication success.

Ready to support your child’s communication journey? Book a consultation to discuss your specific concerns and receive personalised strategies for your family.

Late Talking Signs in Toddlers: Red Flags vs Normal Variation