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.
If you're able to understand only a few or none of your 2-year-old's words, talk to your child's doctor about scheduling an evaluation. Speech delay can be an early sign of other developmental issues.
Although every child grows and develops at his or her own pace, toddler speech development tends to follow a fairly predictable path. For example, by age 2, most children can:
- Use simple phrases, such as "more milk"
- Ask one- to two-word questions, such as "Go bye-bye?"
- Follow simple commands and understand simple questions
- Speak about 50 or more words
- Be understood at least half the time by parents or other primary caregivers
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
- State their first name
- Refer to themselves with pronouns (I, me, my or mine)
- Can be understood most of the time by family or close friends
Your child's doctor will likely consider possible underlying reasons for a speech delay, from hearing problems to developmental disorders. If necessary, he or she might refer your child to a speech-language pathologist, audiologist or a developmental pediatrician.
Treatment options for toddler speech development depend on what's causing the speech delay and its severity. When treated early, however, speech and language delays and disorders generally improve over time.
March 20, 2021
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See more Expert Answers
- Kliegman RM, et al. Language development and communication disorders. In: Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Feb. 14, 2019.
- 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 Feb. 14, 2019.
- McInerny TK, et al., eds. Speech and language concerns. In: American Academy of Pediatrics Textbook of Pediatric Care. 2nd ed. Elk Grove Village, Ill.: American Academy of Pediatrics; 2017. https://www.ebscohost.com/ebooks. Accessed Feb. 19, 2019.
- Hay WW, et al., eds. Child development & behavior. In: Current Diagnosis & Treatment: Pediatrics. 24th ed. New York, N.Y.: McGraw-Hill Education; 2018. https://accessmedicine.mhmedical.com. Accessed Feb. 14, 2019.
- Kliegman RM, et al. The second year. In: Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Feb. 14, 2019.
- Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 22, 2019.