How do I know if my 18–24-month-old has a language delay?

Although parents of infants and toddlers usually receive basic communication screeners and developmental milestone checklists during their child's 18-month and 24-month pediatric visits, many families are unsure when to seek help if they suspect their child is a 'late talker' compared to peers. Some specific questions on a basic communication screener, like 'How many words does your child use and understand?' can be challenging to answer accurately, particularly if parents aren't provided with clear instructions and extra time to observe their child and collect this information.

To assist families in understanding their child's speech and language development, we have summarized key communication milestones that most typically developing children achieve between 18-24 months of age. For each skill, we offer basic strategies to help parents determine whether or not their child has reached these specific speech and language milestones.

When reviewing milestone checklists, it’s important to keep in mind that every child is unique and children might acquire some of these skills several months before or after the "expected" age range. These milestones are meant to be a general guideline for parents, reflecting the typical stages of language development in children. If parents have specific questions or concerns about any of these communication skills, it is recommended that they consult with their Pediatrician and/or a licensed Speech Language Pathologist.

The following communication milestones were adapted from the American Speech Language & Hearing Association, CDC website as well as the Rosetti Infant-Toddler Language Scale:

18-24 Months: Typical Language Milestones

Receptive Language – Refers to how your child understands the language(s) spoken in your home.

Receptive Vocabulary: How many words should my child understand at this age?

At this age, a child should understand at least 200-300 words across various categories.

For instance, a child should comprehend words associated with family members (such as mommy, daddy), basic body parts, the types of food they typically consume (like crackers, milk), familiar animals, clothing, household items, and a number of verbs (simple 'action' words like eat, drink, sleep).

Tip: Parents can quickly gauge their child’s receptive vocabulary by knowing their expressive word count (discussed below). Generally, children comprehend more words than they can articulate. To assess a child's receptive vocabulary, engage in joint play and ask, ‘give me + word’ to see if they can identify and hand you the item you mentioned. Additionally, use the phrase ‘Show me + noun/verb’ during structured activities like reading, coloring, and snack time, when your child’s attention is more focused, allowing them to point to the objects and actions you name.

Comprehension of Questions: Understands 'Who, What, Where"

Most children at this age should understand basic ‘Who, what, where’ questions. They should also be able to answer concrete 'yes' and 'no' questions verbally, or gesturally (e.g. by shaking their head yes/no).

Tip: During joint play or while reading to your toddler, ask simple questions in context (based on what your child can see) such as, “Where is baby?”, “Who is driving?”, “What is that?” Avoid looking at or pointing to the correct answer (for instance, maintain eye contact with your child instead of where they 'should' be looking).

Following Directions: Can follow simple one-step directions.

Tip: Without providing any physical gestures such as pointing, showing or ‘acting out’ the actions, give your child simple commands using concise 2-3 word phrases and routine actions such as: Sit down, hug bear, push car, give me.  Make a list of the verbal commands that your child successfully followed, without any form of gestures or prompts.

Expressive Language – How your child uses language to communicate with others.

Word Count: By 24 months of age, a child should be using between 50-200 words from a variety of different categories.

Between 18 and 24 months, a child's expressive vocabulary should be growing rapidly. When we are measuring a child's expressive vocabulary, we are focusing on the words that the child is using independently and meaningfully, without any modeling or prompting from adults.

Tip: We strongly encourage parents of infants and toddlers to maintain a "Common First Words" list in a shared area of their home (such as on the fridge), allowing family members to mark off words on the list as they hear their child saying (e.g., during play or when making requests). This practice is very useful for caregivers and professionals to identify the total number of words the child knows as well as the word categories that they may not yet use or understand. You can download an example of a free Spanish/English First Words checklist from Speech and Language at Home.

Note: When assessing a child's word count, we do not penalize for incorrect pronunciation, as most words at this age are simply basic 'approximations.' If a child consistently uses the same pronunciation in the appropriate context (e.g., saying ‘nana’ whenever they see a ‘banana’ or ‘di’ when they are digging), it will be counted as a word they know and can use.

2 Word Phrases: should begin combining 2-word phrases independently.

Tip: True two-word combinations occur when children start to express two distinct ideas. Therefore, common expressions like 'night night' and 'bye bye' aren't considered two-word utterances in terms of language development. Examples of early two-word combinations that children might start using include 'more milk', 'give me', and 'mommy up.' At this stage, it's beneficial for parents to model two-word verb phrases for children to hear, especially when a child is attempting to request certain actions. To combine words, children must first be familiar with a variety of words in their receptive and expressive vocabulary, including nouns, verbs, adjectives, and early prepositions.

ABOUT US:

Sunny Spot Speech provides private speech therapy services and evaluations for kids in home, online, at your child's preschool, daycare, private school, or at another community location throughout Los Angeles' San Fernando Valley. We have an incredible and growing team of bilingual (Spanish and English speaking) Los Angeles based Speech Language Pathologists who are knowledgeable in the assessment and treatment of a wide range of communicative disorders, including (but not limited to) children with Language Disorders and Developmental Delays, Hearing Loss, AAC users, Fluency disorders, Articulation and Phonological Disorders, Childhood Apraxia of Speech, and Gestalt Language Processors.

We are accepting new pediatric speech therapy clients in the following Los Angeles locations: Northridge, Granada Hills, Encino, Tarzana, Woodland Hills, Sherman Oaks, Studio City, Van Nuys, San Fernando, Valley Village, Burbank, Calabasas.

Contact us for a free phone consultation if you’re concerned about your child’s speech, language or communication abilities: Phone: 818-350-3107 or Email: info@sunnyspotspeech.com.