Speech delays in children: When to be concerned

Should I be concerned if my 2-year-old daughter can't talk yet? Instead, she just grunts and points a lot.

- No name / No state given

Mayo Clinic pediatrician Jay Hoecker, M.D., and colleagues answer select questions from readers.

Answer

Most children are saying simple words, such as "mama" and "dada" by age 1. But it's important to remember that children vary greatly in their speech development. Even so, a doctor would likely be concerned if a 2-year-old was not yet speaking. Children at this age can typically:

Point to an object when it's named
Recognize names of familiar people, objects and body parts
Say about 50 words
Use simple phrases by linking two words, such as "me up" (for "pick me up")
Use simple pronouns (he, she, me) and prepositions (with, by)

A child whose speech isn't progressing should be checked by a doctor. Speech delays occur in up to 10 percent of young children. Causes include:

Being a twin
Slow development
Mental retardation
Autism

In addition, children living in bilingual homes may experience some speech delays as they learn to interpret and use two languages. This is normal.

If you have concerns about your child's speech development, talk with your doctor. He or she may refer you to a speech-language pathologist for evaluation.