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“My two year old only has four or five words but understands everything.  Is this normal?”

This is one of the most common questions I am asked as a Paediatric Speech Pathologist.  Firstly, let’s talk about the concept of receptive language and expressive language.  Receptive language is what a child understands, how they break down/follow instructions and generally how they make sense of early conversation.  Expressive language is what is coming out – their vocabulary, understanding of grammar and how they get their meaning across.  The issue of a late talker generally applies to their expressive language, however it can impact their receptive language too.

So, what is a late talker?  A late talker is a child who has less than fifty words at the age of twenty four months.  At the critical ‘two year marker’ a child should typically have more than fifty words and should be starting to put two words together.  Typically, children develop their language around their needs.  Words such as bottle, teddy, Mummy, Daddy, bikkie develop first because these are things that children need.  After this, describing words and action words start to develop.  These different word types help children put together two word utterances and this is the beginning of short sentences (eg. ‘cow run’ ‘big cow’ ‘cow eat’).  If they have a variety of word types at the age of two, this puts them in a good position to develop longer utterances.

So, let’s clarify some things.  When I use the term ‘fifty words’, these words do not necessarily have to be a perfect production, it just has to be consistent (eg. ‘water’ could be ‘wawa’) .  Whilst these words should develop into clearer productions after two, they don’t have to be perfect initially.

What causes delayed language development in children?  There are many causes including family history, prematurity, low birth weight, developmental disorders and repeated ear infections but sometimes, we just don’t know why.  Will they grow out of it?  This is a really tricky question.  The answer is, yes some children will grow out of it but some children will need specific intervention from a Speech Pathologist to help them develop language.  Research suggests that 13% of children are late talkers and that these children (if left untreated) are significantly at risk of further language and literacy difficulties once they start school.

Can I just wait and see?  Boys talk later so I won’t do anything.  She’s just being lazy.  My husband didn’t talk until he was four and then spoke in complete sentences.  I hear statements like this with alarming frequency and it is……alarming.  My answer is no, you cannot wait and see.  Get it checked out.  If your child doesn’t start speaking until they are over three years, then they have so much more to catch up on.  If you have a block of sessions with a Speech Pathologist to assess your child and get a baseline for their language skills, then you are pro-actively intervening.  We can show you ways to help develop their language and give them a ‘push’ as well as tell you exactly what is expected of a child at certain ages.  Remember, these milestones are normed on Australian children so whilst we allow for variation in development, we know what they should be able to do and when.

If you are concerned about the number of words your child has, keep a notebook handy and write down everything they say consistently over a one week period.  If they don’t have fifty words, have a chat to your local Speech Pathologist for advice, early intervention is key.