How to tell if your child has a speech, language or communication need [UPDATE 2019]

How to tell if your child has a speech, language or communication need [UPDATE 2019]

How to tell if your child has a speech, language or communication need?

Children develop speech, language and communication skills at different rates, some develop quickly, while others may take longer. You are the expert in your child. You know their likes and dislikes and motivations for communicating with others. This article explains what language milestones you should look out for and when to refer to a Speech and Language Therapist.

Some children’s language skills don’t develop at the same rate, or in the same way, as other children of the same age.  You may notice that your child isn’t meeting the language developmental milestones for their age. This might be because they can’t say what they want to or they don’t understand the words that are being used.

Your child’s language skills might be developing as you would expect, however they have unclear speech or difficulty pronouncing certain speech sounds in words – this is known as a speech sound disorder. You can read about the different types of speech sound disorders here.

Take a look at our FREE speech skills inbox training programme – designed to help with unclear speech.

Your child may need support with other aspects of their communication:

  • Looking and listening – children need to be able to learn to look at an adult and to listen in order to learn to communicate. They learn to listen to sounds around them including sounds that make up words. Children do not automatically know how to listen, it needs to be learned like any other skill.


  • Social communication – using communication for social reasons for example knowing how to start, maintain and finish an interaction, being able to ask for help, turn taking in conversation and understanding and using non-verbal communication appropriately.


  • Play – pretend play is particularly important as it when they start to recreate their own and others actions, for example putting food on plate and feeding teddy.


  • Understanding of language – understanding is often over-estimated by parents and carers. This is because a child can follow an instruction using non-verbal understanding, for example by gestures and following cues from the situation. By 2 years, children are starting to be able to follow instructions containing two key words, for example ‘let’s give teddy an apple”.


Language development can be thought of as a wall – each brick supports the other bricks and strengthens the whole wall, just as each communication skill supports the development of other communication skills.


What language milestones should you look out for?

By 1 year old most babies will:

  • Look for and be able to find where a sound is coming from
  • Start to use gestures to communicate such as wave goodbye and point to request
  • Babble and take turns talking with you
  • Say at least 1 word


By 18 months most toddlers will:

  • Play alone, although they will like to be near a familiar adult
  • Engage in simple pretend play
  • Follow 1 step instructions
  • Babble and use at least 20 single words (although they may not be clear)
  • Copy gestures and words from adults


By 2 years most toddlers will:

  • Engage in pretend play, for example by feeding teddy
  • Follow 2 step instructions
  • Say around 50 words
  • Start to use 2-word phrases, for example ‘daddy go’ and ‘all gone’


You can read more about the stages of speech and language development here .

We have a FREE inbox training programme for late talkers designed for use by parents at home.


Speech sound development

  • By 18 months a child’s speech is normally 25% intelligible
  • By 24 months a child’s speech is normally 50-75% intelligible
  • By 36 months a child’s speech is normally 75-100% intelligible (Bowen, 2011)

(Intelligibility, in this instance, refers to the how much an unfamiliar listener can understand rather than a close family member)

Find out if your child’s speech errors are age appropriate here.

Learn more about our free Speech Sounds inbox programme.


When should I refer to Speech and Language Therapy?

The right time to seek advice about your child is when have any concerns about their communication development.

  • If your baby doesn’t respond to sound or isn’t making any vocalisations


  • By 12 months if your child is not yet attempting to communicate (this includes non-verbal communication i.e. pointing, simple gestures, looking at you then to an object then back to you) for different reasons, for example to request or make their needs known, to comment on an item of interest


  • By 18 months if your child has difficulty following simple instructions and/or has difficulty imitating sounds


  • By 2 years if your child is not yet engaging in pretend play, communicating with single words or following 1 step instructions


Top tips for doing your own research

There’s a lot of information out there, if you are searching for answers, make sure you keep the following things in mind…

  • Always look for the author’s credentials, are they an expert in the field?
  • Check the date of publication, is it current or will knowledge have moved on?
  • Check if the research study has been peer reviewed – this means it has been evaluated by peers who have expertise in the subject area
  • Use your common sense – beware of clickbait titles
  • Ask for help – ask a Speech and Language Therapist about evidenced interventions


If you have any concerns about your child’s speech and language development speak to your Health Visitor or GP.

Written by Aine Barrett, Speech and Language Therapist

Related articles and programmes

12 YouTube videos for teaching speech, language and communication skills

How can speech and language therapy help my child?

How can I access speech and language therapy?



Best 8 books for boosting your toddlers vocabulary

Best 8 books for boosting your toddlers vocabulary

Brain building happens when you and your little one are interacting with each other. A baby’s brain is wired to grow from birth and during your child’s earliest years, their brain makes 1 million neural connections every single second (NSPCC, 2019). Every time you read aloud to your child and respond positively to their babbles and gestures, those neural connections are being built and strengthened. So when we talk about the best 8 books we’re taking this into consideration.

3.5 words learnt every day

Between the ages of one and five, children learn (on average) approximately 3.5 words everyday (Dickinson et al. 2012). In order for this to happen, children need lots of exposure to language (especially those words they don’t hear in everyday life!) In a previous post ‘The best 2 books for developing language skillswe talked about how to support your child’s language development using repetition. In this post, we review our favourite books for boosting your toddler’s vocabulary.

Have fun bringing the stories to life – use animated voices for the characters, make the sounds of the animals, giggle at the jokes or you could create your own story sacks’.   Abandon your agenda and let your child lead the story, you can read more about the Hanen approach here.

1.The Very Hungry Caterpillar  By Eric Carle

The story follows the journey of a hungry caterpillar as he eats his way through a varied and very large quantity of food until he is full and builds himself a cocoon before emerging as a butterfly. The story is easy to follow for children of any age and it provides opportunity to work on different language skills. It is great for learning new vocabulary of food items, describing words, colours and numbers.

After you have read the book together a couple of times try using OWL  (Observe, Wait, Listen) or leave a gap of 10 seconds for your child to try to fill in the missing word at the end of a sentence. For those children already using sentences, the book can be used to introduce the concept of sequences and talk about the lifecycle of a butterfly – the perfect book for late Spring and Summer to carry on the conversation when playing outside.

Take a look at the book

2. The Very Lazy Ladybird By Isobel Finn & Jack Tickle

This picture book tells the story of a ladybird so lazy that she doesn’t know how to fly so she catches a ride on each animal that passes by. This story is perfect for working on action words and describing words as well as the names and sounds for different animals. Once your child is familiar with the story you could copy some of the pictures from the book and take it in turns to describe what is happening.

For single word users, model 2 word phrases (i.e. ‘monkey swinging’) or for those already using short phrases introduce longer sentences (i.e. ‘the monkey is swinging in the tree’). You could turn this activity into a game  using skittles (place the pictures under the skittles and take it in turns to roll the ball), fishing rods or a treasure hunt.

Take a look at the book


3. Brown Bear, Brown Bear, What do you see? By Eric Carle

Children see a variety of animals, each one a different colour and a teacher looking at them. This book’s simple and repetitive language is ideal for working on expanding utterances and using 2 word phrases (i.e. ‘green frog’ or ‘I see’).

Once your child is familiar with the story you could place objects or pictures around your home to reinforce understanding of the subjective pronoun and encourage longer sentences (e.g. ‘I see a green frog’).

Check out the book

4. Dinosaur Farm By Frann Preston-Gannon

This story describes a day in the life of a farmer and his pet dino-dog on their dinosaur farm.  The farmer has to work hard to take care of his dinosaurs and there is lots to do everyday. The illustrations are perfect for getting little ones involved with the story by encouraging them to describe what they see and what is happening as well as make predictions about what might happen (i.e. ‘Oh no, the farmer forgot to close the gate. What do you think is going to happen next?)

The BookTrust has a fantastic online resource with reading tips and book recommendations for children of all ages. You can search for books by theme so you can find a book your child will love whether they have a special interest in dinosaurs, fairies or penguins.

Check it out

5. Dinosaur Roar  By Henrietta & Paul Stickland

This picture book teaches children about all the different types of dinosaurs and uses rhyming text to describe what they look like. This book is perfect for working on adjectives and opposites (i.e. ‘long vs short’ and ‘weak vs strong’).

Leave a gap at the end of the sentence to allow your little one to complete the sentence using a new describing word (i.e. ‘dinosaur spiky, dinosaur …’ The illustrations are ideal for starting conversations and talking introducing the concept of same and different so they can then begin to apply them to other things in their environment (e.g. ‘the tree is tall’).

Get the book

6. Bear on a Bike By Hannah Shaw

Rhyme and repetition is used to tell the story of Bear as he tries out different forms of transportation and has an adventure with each one. The illustrations provide plenty of opportunity for your child to initiate and lead conversations about the story and understand and use new vocabulary for transportation, animals and food.

It also allows for you to talk about sequences and the order of events in a story i.e. first bear is on the bike, then the bus etc.

Check it out.

7. The Tiger Who Came to Tea By Judith Kerr

A girl called Sophie is having tea with her mother in their kitchen when they are joined by a tiger who eats all the food in the house. After your child has become familiar with the story you could create your own afternoon tea or picnic with toy food and drink items from the story and practise re-telling the story.

When you are reading the story and looking at the pictures together you could ask questions about what is happening, guess what the tiger is thinking or make predictions about what the mother or father might say or do.

Take a look. 

8. Wow! Said the Owl  By Tim Hopgood

The story of a curious little owl who wants to see what the world looks like during the day. It is a great story for learning new vocabulary about weather, nature and colours. It is the perfect book for using as inspiration for arts and crafts activities – stick pictures of the owl into different backgrounds and talk about where the owl is and what they can see (e.g. ‘the owl is sitting in the tree/there is lots of clouds in the sky’).

See the book

Written by Aine Barrett, Speech and Language Therapist

Related articles:

Best two books for language development

How colourful semantics can help with language skills

The colour monster – a great book for teaching emotional awareness

Met us at the NDNA Event Series in the North

Met us at the NDNA Event Series in the North

We will be taking to the road in March and April to deliver our top ten tips for late talkers at the National Day Nurseries Association event series. If your nursery is a member of NDNA and you live north of the Watford Gap – come and see us!

We will also be giving a sneak review of our new programme SparkleVR.

  • 5 March, East Midlands, Leicester, Leicester Racecourse – book now
  • 6 March, West Midlands, Wolverhampton, Molineux Stadium – book now
  • 12 March, North West, Bolton, Bolton Whites Hotel – book now
  • 13 March, Yorkshire and the Humber, Leeds, Holiday Inn Leeds Garforth – book now
  • 4 April, North East, Newcastle, St James’ Park – book now
Ask an early years teacher – speech and language in their eyes

Ask an early years teacher – speech and language in their eyes

This week we interview Eleanor, a nursery manager with over 20 years of experience working in nurseries and pre-schools.  I was lucky enough to spend half an hour with her, hearing all about her experiences working with pre-school children, and learning some fresh ideas to support communication development along the way.  Who wouldn’t love a bedtime stories session?!

What is your job?

I am a nursery manager, working with children aged 2-4 years old.  I’ve been managing this nursery for the last year and a half.  Working with this age group is wonderful because they are so enthusiastic, and they learn so fast.  Every day I watch the children learning something new.


What does speech, language and communication mean to you as an early years teacher? 

It is a really major part of the work we do, we are encouraging the children to communicate throughout their time with us.  For some children that’s not yet verbally, so we use gesture lots, and we use Makaton (, or find out more about Makaton and sign language in our article). As children are learning to use spoken language we spend a lot of time helping them to extend their vocabulary, and working to improve their grammatical structures.  We hope to give them the skills so that they can use language to express their needs rather than some of the other methods that two year olds frequently use!


How do Speech and Language therapists help children in early years settings? 

There are two main ways we work together.  Sometimes we will refer children to Speech and Language Therapy, and the therapist will either see the child individually, or more usually in a group, at a clinic or health centre.  We often get helpful feedback and suggestions of how we can continue the work in the nursery which we love.  Occasionally the therapist will come and work in the nursery if it’s not possible for the parent to take the child to sessions elsewhere.

I have also been part of projects where Speech and Language Therapists have worked in nurseries, producing materials jointly and encouraging our staff to watch their teaching sessions so that our team can replicate the techniques.


What is the best piece of advice a Speech and Language Therapist has ever given you?

One of the most recent pieces of advice that has challenged my thinking was to only speak to a child if they are looking at you.  I think it’s true, children can zone out if there is a steady voice droning on! I do think it is working for the children I’ve tried it with so far.  For it to be very effective, I think the parents would have to be using the same strategy.

Another piece of advice that a Speech and Language Therapist gave me previously was to talk about what the child is doing or playing with.  I think that works for many children!


What advice as an early years teacher do you pass on to parents who are worried about their child’s communication skills?

If a parent came to me worried about their child’s communication, I would give them some honest information about whether or not their worries were well-founded, based on what we know about other children of a similar age.  We would offer to do an assessment within the nursery, and to refer the child on if they needed it.  I would also encourage the parent to speak with their child, sing songs with their child, and have fun with language.


What advice do you pass on to your staff to help children communicate at nursery/pre-school?

To ensure there is a lot of language, a language rich environment, we encourage everybody to extend their sentences so that if a child is giving you one word you’re putting that into a short simple sentence, modelling it.  We encourage the staff to ask open ended questions so that the child can’t just say “yes” or “no” and so they’re using their language to develop the child’s thinking skills at the same time.  We advise the staff to get down to the level of the child so that you’ve got eye contact when you’re talking, and to gauge the simplicity or complexity of their sentences to the ability of the child.


Give me one quick thing parents can do tonight to help their child communicate?


Read them a bed time story.  You don’t just have to read the words!  Talking about the book, looking at the pictures, is really valuable.  At this age the children are only just starting to recognise a few letters or words so thinking about the story is the most valuable thing.  Have storytime in a nice cosy place so it’s a really positive experience for the child.


We did a bedtime stories session in nursery this year.  The children came back at 5pm in their pyjamas with their teddies and a pillow, and listened to stories told by our staff.  One of the Mums told a story too.  The children acted out one of the stories, then afterwards we gave them milk and a biscuit, and they went home to bed.  The reaction from the parents was astonishing, they all loved it!  One parent said that before this, they had no idea why people read bedtime stories, “I’m going to have to do this at home”.  Another parent said “I feel really sleepy now”!


What communication skills do you expect from a 2 year old just starting nursery?

It’s a really wide range – all of our children have some communication skills when they start nursery, even if they are just leading us by the hand when they want something, pointing, or using single words.  Whereas some children can speak in full sentences already.  It is a really wide range, and that’s normal.


What communication skills do you want your 4 years olds to have when they leave nursery?

We’d want them to be able to express their feelings, to ask for things, to be able to ask questions about what they are learning and about the world they are in.  To be able to give their opinions, but to be able to listen as well and to respond to their friends.  I think speech and language skills are the most valuable gift we could give the children in our nursery.  Particularly for disadvantaged children, it’s the best way for them to catch up with their peers.


What’s your favourite toy, and why?

The train track, we use the train track in a couple of ways.  Sometimes we have it set up ready for the children to use, then we’re focusing on the movement of the trains, and using words like ‘over’ and ‘under’.  Usually children would help to construct the railway as well, developing spatial skills and the language of shape.  It certainly seems to be a favourite toy for lots of the children too.

Written by Alys Mathers, Speech and Language Therapist

Related articles

Early Years language booster programme SPARKLE

The importance of play and at what age?

Will sign language slow down my child’s speech?



Can toys supercharge my child’s language skills?

Can toys supercharge my child’s language skills?

Even as adults, toy stores are alluring. Maybe the appeal comes from the flashing lights, the beaming colours and high stacked shelves. Often we are drawn in by the manufacture’s promises and guarantees to help our children develop in EVERY possible way.

There are the teethers that promise to promote language development*, the baby iPad that will teach your crawler to code and the toy pianos that promise to take you from waddler to Wolfgang.

Whether it’s the toy kitchen that says it will increase your child’s social communication through promoting role play, or the shape sorter that gives hopes of expanding your child’s vocabulary, a toy store, any toy store, comes with a million promises. Some more far-fetched than others.

In the UK, the toy industry is worth 3.4 billion. Toy manufactures know that we want the best for our children and they are cashing in on it!


But what does the research on toys say? And is there a connection between marketing and your child’s development?

Toys are fun, but toys are expensive. Do we really need the latest expensive gadgets and gizmos to give our children the very best start?

There is not much evidence to say that we do!

Child psychologist Alison Gopnik is adamant that relying on toys and iPads to give your child a developmental edge ‘fundamentally misunderstands what is happening in development’ and even if products did exist that fulfilled all the promises they made, ‘we would have defeated the whole point of childhood’

Gopnik goes on to assert that many of the toys that we see today are marketed using questionable claims rather than solid science. This is not to say that toys are not useful and that they don’t provide any value. But being wary of their claims and knowing that there are other things that are just as good, perhaps even better for your child’s development, might well be the place to start.


Drop the flashy and save some cashy! Lets get traditional with toys

It can be tempting to buy the noisiest, flashiest, talking toy on the market, but if we are going to buy a toy, what kind of toy is the best?

A 2016 study found that compared with electronic toys, traditional toys e.g. building blocks, puzzles, stacking games and tea sets, yielded higher language interactions. With the traditional toys, parents used more words and there were more conversational turns, more often!

More conversational turns are linked to better language gains (see our article one good turn deserves another). A recent study (2018) from MIT also points the importance of taking time to use your traditional toys. It found that children’s “language centres” in the brain were stronger in relation to the length of conversational turns that parents took. The children also did better on language tests.

Traditional toys therefore provide a platform on which to stage the back and forth conversations, but that communicative edge and language boost, can come from just you and the things you have lying about.


That is right! Traditional toys might be better than electronic ones, but YOU are the best!

Playing is one serious job and it is the first way that we interact with the world.  (see article on the value of play)

Playing with your child, games like peek a boo, pointing to body parts and naming them, talking about what you are doing around the house and making it in to a fun game, are excellent ways to provide the language for your child to soak up.

Using everyday objects, pots pans, spoons and spatulas! Your tiny tot can have lots of fun banging, role playing, and listening to language, not through a battery operated talking machine but through listening to your voice and the everyday language that they will then go on to understand and use.

The adage is true, children are happiest with a cardboard box. Get ‘stacking’, ‘cutting’, ‘tearing’, ‘colouring’, ‘building’, ‘knocking’ and ‘hiding!’ Playing with such objects helps children (and you) to get creative, use their imaginations, motor skills and learn lots of words!

This is not to say that you shouldn’t buy toys! But know, you are your child’s first and best one. Nothing out there on the shelves of a toy store can replace what you can teach your child through playing with them. So, when you do go to buy that expensive, shiny, noisy toy, choose one that you like! As when your child eventually favours the cardboard box, you will have something to enjoy too! 😉

To find out more about how YOU can boost your child’s language – take a look at our SPARKLE programme

Written by Carolyn Fox, Children’s Speech and Language Therapist



Hurray for Play! From 0-3 years and how it aids language development

Hurray for Play! From 0-3 years and how it aids language development

Hurray for play!

Play has been likened to a fertiliser that nourishes the brain ‘with the behavioural equivalent of miracle Gro’ (John Medina 2008).  Play facilitates learning, encourages creativity and imagination, supports and develops our memory, language, social skills, problem solving ability and much more!

Play is the ‘work of childhood’ (Fred Rogers). As children learn about their world through play, understanding how it develops and how we can support it, is crucial.  Entering a child’s world, requires that we meet them at their developmental stage of play. By doing this we will have a good chance of encouraging them to listen and watch, explore and imitate.

State of play

You are being watched! All the time. As your child’s most influential teacher, they will be watching and learning from you continuously. When we play with children, they watch and learn, learn learn!  We play from the moment we are born, and we continue to play in to adulthood. The way we play throughout these stages is however very different and children will pass through distinct play stages from infancy to preschool age.

Let’s take a look at this journey.

Exploratory play. From birth.

From the very first stages of life, children learn about the world using their senses. Did you know that the lips are one of the most sensitive areas of the body? The lips have many receptor cells that send information to the brain. It is no wonder then that children who are just starting to learn about their world, will play by putting objects to their mouths and in their mouths. Exploring objects this way helps children learn about their features and uses. Each time they explore, they will learn something new and keep adding to this information store for later use. It will eventually help them name items using language.

Encouraging play at this stage

Having everyday objects around as well as toys is a useful way to encourage this learning.  Slowly children will learn about how to use objects appropriately. Try giving your child a spare cup, spoon or toothbrush to play with when you are carrying out real activities using these objects.

This is also the stage where your child will be looking at you to exchange smiles with you and play with sounds. As your child learns that their actions receive a reaction from you they will be encouraged to play more.

Exploratory play doesn’t stop here. It will continue throughout the preschool years as your child is introduced to new objects and new functions, although rather than putting things in their mouths, they will be more likely to discover things with their hands!

Play at 9 months

Children will start to use the information they learned from exploring objects and will begin to show you that they know how to use them! Your clever little cookie may pretend to brush their hair with a hair brush or put a toothbrush to their teeth.

Encouraging play at this stage

Continuing to demonstrate the uses of everyday objects will support your child during this stage. Try making a ‘treasure chest’ filled with useful things. What can they find? Take your time to explore what’s inside.

This stage of play provides some good opportunities to develop language as your child may start to act out events. Using repetitive phrases such as ‘brush dolly’s hair’ or ‘give teddy the cup’ will expose your child to the same language over and over as they play.

Play at 18 months

Your child’s play is really developing and evolving now. They will start to understand that one object can represent another object e.g. a miniature spoon represents a real spoon.  They have been busy bees and all that important playing has helped them reach this significant point. Understanding that one thing can represent another thing is key for learning language, as we use words to represent objects. Your child is beginning to master something complex!

If you have ever wondered why a speech and language therapist looks at how your child plays with objects and toys, this is why! Play can tell us a lot about where your child is on their language journey. Often, if there is a delay in play, there is a delay in language. Supporting and moving on your child’s ability to play therefore helps build the foundations required for language.

Encouraging play at this stage

You can help your child to learn that one object represents another by:

  • Playing with real objects and then introducing a miniature version (from a doll house set). You can model what you do with these objects e.g. brush teeth, drink from a cup
  • Play with teddies and dolls using these objects e.g. feed dolly
  • Play matching games. Have a bag of big and small matching objects. Take them out one by one and try and match them.
  • You can also try this with a picture of the object and the real object. Use a feely bag. What can you feel? Does it match the picture? You can use real photos of things that your child uses or generic pictures.
2.5 years Acting out!

Through play, your child will now likely be showing you how they understand the world around them. They will be using their toys, teddies and dolls to act out sequences that they have grasped from watching, playing and doing e.g. giving teddy his milk and putting him to bed. Acting out these sequences is crucial for later when your child will tell you stories.

Encouraging play at this stage

You can help your child at this stage but acting out the sequences with them. Use familiar toys and clear language e.g. ‘Dolly is eating breakfast, now she is getting dressed’.

You can help your child to structure these ideas but using words like ‘first, second, third’ or ‘Now and next’. Make up sequences containing two steps and see if your child can copy you or do their own.

3 years

Your child has come a long way since the stage of exploration and mouthing objects! They can now use their imaginations and act out short sequences and pretend to be different people e.g. doctor, nurse, fireman. This sort of play will further help them expand on their world knowledge and support their understanding of other people’s emotional states.

Encouraging play at this stage

Encourage this sort of play by using fancy dress. Pretend to be different people and create scenarios where your child may have to think about how someone feels e.g. taking on the role of a doctor to help a patient who is unwell or a vet who is helping a scared animal.

Your child’s play skills will continue to develop and evolve now as they mature to school age and onwards.

Learn to play, play to learn!

Playing allows children to explore and learn about their world, it powers the imagination and boosts their creativity. As your child’s best teacher and first playmate you have an amazing role in spurring on all these skills.  Each stage of play is dependent on the stage before and in each stage, they are learning something crucial that will help them navigate their world.

We learn best when we are having fun, so it makes perfect sense that learning is so rapid in these early years!

Written by Carolyn Fox, Children’s Speech and Language Therapist

Related articles:

New Sparkle programme for 1-3 year olds – language booster

How to use rhyme and songs for language – tips from a therapist

Laurel and Yanny – what it reveals about the listening process for children