Does Your Child Need to See a Speech Therapist?

By Elise Duryea M.A., CCC-SLP September 2, 2014
“My child isn’t talking.” “How do I know if my child needs speech therapy?” “Why is my friend’s child, who is the same age as mine, talking so much more?” 

Have you ever asked your friend, spouse or pediatrician these questions? Or maybe you have stayed awake at night wondering if your child is “normal.”  If any of this sounds familiar, you are not alone.  As a mom of two boys and a Speech-Language Pathologist with almost 20 years of experience, I have worked with hundreds of children with all different abilities and disabilities, and if there’s one thing that I am sure of it's that the only thing that is predictable about children is that they are unpredictable!
That said, below are five guidelines to better equip you to decide if your child needs a professional opinion or just a little more time.  However, I must give you my standard words of caution -- these skills are just guidelines! It does not mean that every child will do them at the exact point in development. Rather, they should give you an idea of skills you should look for once your child reaches two. 
  • Between 2 and 2-1/2 years of age, children should use approximately 200 words.  Their speech is 50-75% intelligible to friends and family who know the child well (even more intelligible to mom and dad), and they should be combining 2-3 words together to form a short phrases such as “I want more.”  They use articles such as ‘a’ and ‘the’, and some pronouns.  Their vocabulary is constantly growing.
  • At or around this age, children should be able to ask basic questions such as “Mommy home?” and can answer “where” and “what….doing” questions.  
  • In terms of comprehension, children should understand approximately 500 words.  They can listen to a short story read to them and point to items in the book when asked simple questions like, “Where is the_____.”  
  • Children should be able to carry out a series of related commands such as, “Find your shoes and bring them to Daddy.” They are learning to clean up (even though they may not like to!), and take turns in simple games and routines.
One of the most important things to keep in mind when you have a 2-year-old is that they have unstable emotions, are impatient, and act out in frustration when they are unable to express themselves.  In other words, tantrums and meltdowns are not only normal, but to be expected!  The less language they have at this age, the greater and more frequent these outbursts may be.  
Again, these skills are merely guidelines.  Not every child will have reached them by two or so, while other may have exceeded them.  If you have concerns that your child is not close to meeting some of the skills that are expected for his/her age, don’t be shy about asking your pediatrician.  If they don’t have an answer that satisfies you, keep searching. Contact a Speech and Language Pathologist. Send me an email at  Remember, a mother’s intuition is almost always right. 
American Speech-Language Hearing Association:
About Elise:
Elise Duryea M.A., CCC-SLP has been a NY State Licensed Speech-Language Pathologist for almost 20 years.  She received her Master of Arts from New York University and is a certified member of ASHA (American Speech and Hearing Association).  She has a private practice with an office in Sag Harbor, N.Y.   Elise provides evaluations, individual and group therapy, and is a PROMPT certified clinician.  She works with children who have language delays, articulation and motor speech disorders, feeding disorders, stuttering, and many other neurological or developmental disabilities.  She also provides in-home consultation services and parent training for those who want to learn how to maximize the resources they have in their home for enhancing their child’s language development.  Find out more about Elise at