New insights highlight early signs of speech delay that warrant prompt assessment

Experts emphasise the importance of distinguishing between normal late talkers and signs of wider developmental issues in toddlers, urging early evaluation for effective intervention.

Parents often worry when a toddler is slow to start speaking, but specialists say the key is to tell the difference between a child who is simply late to talk and one whose speech delay may point to a wider developmental problem. Natalia Yershova, a neurologist at Pirogov University in Moscow, told KP.RU that doctors look first at whether a child is following the usual developmental path in other areas, such as movement, play and understanding speech.

If a child has normal hearing, responds to requests, remembers skills already learned and is meeting physical milestones, doctors may wait and watch for a while. Yershova said family history can matter too, since some children are later talkers without having an underlying illness. In those cases, families are often advised to strengthen the child’s language environment and work on speech stimulation before moving to more invasive checks.

But certain warning signs should prompt prompt medical review. According to Yershova, these include no cooing by three to four months, no babbling by around eight months, poor understanding of speech at 18 months, or losing words after having already learned them. Other concerning signs are speech that develops without eye contact, gestures or facial expression, or delays that appear alongside other neurological features, such as walking on tiptoe after age two and a half, frequent dropping of objects or unusual coordination.

Several medical groups agree that early assessment matters. Guidance from the American Academy of Pediatrics and Cleveland Clinic says parents should ask for a hearing test and speech-language evaluation if a toddler is not using simple phrases by about age two, or if speech remains hard for others to understand by age three. Healthline and other paediatric resources also note that speech delay can sometimes be linked to neurological conditions, hearing problems or developmental disorders, which is why waiting too long can delay help. Yershova said that by age three, children who are not building vocabulary, are adding fewer than five new words over three months or are not beginning to form phrases should be seen by a neurologist.