10 Signs Your Child May Need Speech Therapy
A child may need speech therapy if they are not babbling by 12 months, have no words by 16 months or no two-word phrases by 24 months, are hard to understand after 3, or lose words. Each is a reason to book an assessment.
Every child develops at their own pace, and that's completely normal. However, there are key milestones that serve as guideposts for healthy speech and language development.
When a child consistently misses these milestones, professional evaluation, and often speech therapy, can make an enormous difference.
As a speech-language pathologist with 13+ years of experience at Poorvam Care in Bangalore, I've helped many families recognise these early signs and take action at the right time.
Here are the 10 signs every parent should watch for. Two or more of them? An assessment gives you a plain answer.
- Not babbling by 12 months
- No single words by 16 months
- No two-word phrases by 24 months
- Difficulty understanding simple instructions
- Unclear speech after age 3
- Losing words or phrases they used to say
- Frequent tantrums because they cannot say what they want
- A small vocabulary for their age
- Difficulty telling simple stories at 4 to 5
- Difficulty with eye contact, turn-taking or responding to their name
1. Not babbling by 12 months
Babbling, those repetitive sounds like "ba-ba-ba" or "ma-ma-ma", is a baby's way of practising speech. By around 12 months, most babies babble freely and experiment with different sounds.
If your baby is quiet and rarely produces babble sounds, this could be an early indicator of a speech or language delay. Early evaluation can help rule out hearing issues and other concerns.
Frequent ear infections, not turning to sounds, or babble that stops can all point to hearing. Our sister clinic Poorvam Hearing tests babies and children in Electronic City.
2. No single words by 16 months
By 16 months, most children say at least a handful of recognisable words, simple ones like "mama", "dada", "no" or "ball".
If your toddler hasn't produced any consistent first words by this age, it's time to consult a speech-language pathologist. Early intervention at this stage can significantly improve outcomes.
3. No two-word phrases by 24 months
At 24 months, children typically start combining two words together: "more juice", "big dog", "daddy go". If your 2-year-old is not yet doing this, it's a meaningful red flag for expressive language delay.
A professional assessment can identify where the communication breakdown is occurring and create a targeted therapy plan. Read more on speech therapy for 2-year-olds.
4. Difficulty understanding simple instructions
Language development is a two-way street. It involves both expression (speaking) and comprehension (understanding).
If your child frequently seems confused when you give simple, one-step instructions like "Come here" or "Give me the ball", this could indicate a receptive language delay, which is just as important to address as expressive delays.
5. Unclear speech after age 3
By age 3, strangers should be able to understand at least 75% of what your child says. By age 4, speech should be almost entirely clear.
If family members and familiar people still struggle to understand your child regularly after age 3, a speech-language pathologist can assess articulation and phonological development and provide targeted intervention.
6. Speech or language regression
If your child was hitting milestones and then suddenly stopped using words or phrases they previously used, this regression is a serious sign that warrants immediate evaluation.
While some mild regression can occur during stressful life events (like a new sibling), consistent loss of language skills should never be ignored. In some cases, it can be an early indicator of autism spectrum disorder or other developmental conditions.
A child who stops using words they had, stops babbling, or loses other skills should be seen by a paediatrician or developmental paediatrician as well as a speech therapist.
7. Frequent frustration or tantrums due to communication
Children who cannot express their needs verbally often resort to tantrums, crying, pointing, or pulling adults towards what they want.
While all toddlers have occasional tantrums, frequent communication-driven frustration suggests your child's language skills are not keeping pace with their desire to express themselves. Speech therapy can help bridge this gap effectively.
8. Limited vocabulary for their age
At 18 months, children typically have 10–20 words. By 24 months, this usually grows to 50+ words. By age 3, most children know hundreds of words.
If your child's vocabulary seems significantly smaller than their peers', or if you're having to "fill in" most of their communication for them, a vocabulary and language assessment is warranted.
9. Difficulty telling simple stories or recounting events
By age 4–5, children should be able to recount what happened during their day or tell simple stories with a beginning, middle and end.
Difficulty organising thoughts into narrative speech can indicate language processing or formulation challenges that benefit greatly from structured speech therapy targeting higher-level language skills.
10. Social communication difficulties
Speech therapy isn't only about articulation and vocabulary. It also covers pragmatic language: how we use language in social situations.
If your child has difficulty making eye contact during conversation, doesn't respond to their name, struggles with back-and-forth conversation, or misses social cues, these are important signs related to pragmatic language development that a speech therapist can address. See speech therapy for autism.
What to do if you notice these signs
If you've recognised one or more of these signs in your child, the most important thing you can do is act early. Research consistently shows that early intervention, ideally before age 5, leads to better outcomes. Why early intervention matters.
A speech-language pathologist will conduct a thorough assessment of your child's speech, language and communication skills, and create an individualised therapy plan.
At Poorvam Care in Electronic City, Bangalore, our team of RCI-registered therapists offers speech and language evaluations and evidence-based therapy for children aged 18 months–14 years. We take a play-based, family-centred approach, so your child feels comfortable and engaged throughout.
Don't wait and wonder: early action can change how your child communicates. Book a consultation and let us help you understand exactly where your child stands and what steps to take next. More on speech therapy in Electronic City.
Related articles
More plain-language guides from our therapists, and the therapy this article is about.
- Speech therapy for 2-year-oldsWhat most 2-year-olds say and understand, the red flags worth an assessment, and what play-based speech therapy at this age looks like.
- Why early intervention mattersWhy the first five years matter so much for the brain, what the research shows, and what waiting and seeing can cost.
- Speech therapy for speech delayFor children who are late to talk, with what to expect by each age.
Questions parents ask about this
At what age should I worry about my child's speech?
Book an assessment if your baby is not babbling by 12 months, has no single words by 16 months, or is not joining two words by 24 months. A child of any age who loses words they used to say should be seen soon.
Can a hearing problem cause speech delay?
Yes. A child who cannot hear speech clearly will be slow to copy it, so hearing is checked first when speech is late. Our sister clinic, Poorvam Hearing, tests babies and children in Electronic City.
What happens at a speech assessment at Poorvam Care?
A speech-language pathologist plays with your child and checks understanding, talking, sounds and social communication, and listens to what you have noticed. You leave with a plain answer and, if therapy is needed, a plan with goals and how many sessions a week.
Need expert guidance?
Tell us what you have noticed. We call back within one working day to plan a first assessment at Electronic City Phase 1 or Phase 2.