Should I be concerned that my 2-year-old doesn't say many words and is hard to understand?
Answer From Jay L. Hoecker, M.D.
Talk to your child's health care provider if you can understand only a few or none of your 2-year-old's words. A delay using words or talking can be an early sign of other issues. Your toddler's provider can refer you to health professionals who test children for these issues.
Every child grows and develops at their own pace. But toddler speech development tends to follow a fairly set path. For example, by age 2, most children can:
- Use simple two-word phrases, such as "more milk."
- Ask one- or two-word questions, such as "Go bye-bye?"
- Follow simple commands and understand simple questions.
- Speak about 50 to 100 words.
- Be understood at least half the time by adults who don't know the child.
Between the ages of 2 and 3, most children:
- Speak in two- and three-word phrases or sentences.
- Use at least 200 words and as many as 1,000 words.
- Ask questions that start with who, what, where or why, such as "Where is mommy?"
- Say their first name when asked.
- Refer to themselves with pronouns, such as I, me, my or mine.
- Can be understood most of the time by familiar listeners, such as family members.
If your child might have a condition that causes a speech delay, your child's health care provider may suggest that you see a hearing or speech professional.
For example, hearing problems are checked by an audiologist. A speech-language pathologist checks for communication problems. If your child hears or speaks two languages, see a bilingual speech-language pathologist so your child can get tested in both languages.
In the United States, you can get your child tested through a government-funded early intervention program. This offers services and support to children with delays in development or disabilities. Each state and territory has an early intervention program, and some programs include speech therapy.
The way speech delay is treated in toddlers depends on the cause. When treated early, these delays and the problems that can cause them often get better over time.
Show References
- Kliegman RM, et al. Language development and communication disorders. In: Nelson Textbook of Pediatrics. 21st ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Jan. 24, 2023.
- One to two years: What should my child be able to do? American Speech-Language-Hearing Association. http://www.asha.org/public/speech/development/12.htm. Accessed Jan. 24, 2023.
- Speech and language concerns. Pediatric Care Online. https://publications.aap.org/pediatriccare. Accessed Jan. 24, 2023.
- Is your toddler communicating with you? Pediatric Patient Education. https://publications.aap.org/patiented. Accessed Jan. 24, 2023.
- Kliegman RM, et al. The second year. In: Nelson Textbook of Pediatrics. 21st ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Jan. 24, 2023.
- Hoecker JL (expert opinion). Mayo Clinic. Feb. 22, 2019.
- Important milestones: Your child by three years. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/actearly/milestones/milestones-3yr.html. Accessed Jan. 24, 2023.
- What is early intervention? Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/actearly/parents/states.html. Accessed Jan. 27, 2023.
Original article: https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/toddler-speech-development/faq-20057847