Red Flags for Speech Delay Parents Should Not Ignore
By Michelle McGuinness, M.S., CCC SLP | Aldea Medically reviewed by Sharonda Oppong Addae
Every child develops communication skills at their own pace, but many parents notice small differences and wonder whether their child's speech and language development is progressing as expected.
This is where spotting speech delay red flags becomes important. It helps you recognize what is expected at different ages and identify when your child may benefit from additional support.
The earlier you understand what to look for, the easier it becomes to decide what steps may help your child.
Keep reading to learn the early signs of speech delay by age, the communication milestones to watch for, and when it may be time to seek an evaluation.
Key takeaways
Speech delay red flags are patterns, not single moments: one missed milestone doesn't always indicate a problem, but ongoing concerns across communication skills deserve your attention.
Loss of communication skills is an important warning sign: if your child stops using words, sounds, gestures, or social skills they previously had, it's worth seeking guidance.
Communication involves more than spoken words: understanding language, using gestures, responding to others, and sharing attention are all important parts of development.
Early evaluation can provide clarity: a speech-language evaluation can help you understand your child's strengths, challenges, and possible next steps.
You don't need to wait for a serious concern: if something about your child's communication doesn't feel right, seeking information early can help you make informed decisions.
What are speech delay red flags?
Speech delay red flags are early signs that your child's communication development may need closer attention. These signs can involve how your child understands language, uses words, interacts with others, or develops new communication skills over time.
A red flag doesn't mean your child has a diagnosis. Instead, it signals that taking a closer look may be helpful.
In early childhood, communication develops in three patterns. They include:
Expressive language: the words, phrases, and sentences your child uses to communicate.
Receptive language: the words, instructions, and ideas your child understands.
Social communication: how your child uses communication to interact, share attention, and connect with others.
Let's see the three communication development patterns in detail.
1. Expressive language: how your child communicates
Expressive language refers to how your child uses communication to share thoughts, needs, and ideas.
This includes:
Vocabulary: the words your child understands and uses.
Word combinations: joining words together to create phrases such as "more juice" or "mommy go."
Sentence development: gradually moving from single words to longer phrases.
Speech clarity: producing sounds and words in a way others can understand.
A child with expressive language concerns may understand what others say but have difficulty expressing themselves with words.
2. Receptive language: how your child understands
Receptive language refers to your child's ability to understand spoken language.
This includes skills such as:
Following directions: understanding requests like "bring your shoes" or "give me the ball."
Recognizing familiar words: identifying people, objects, and everyday items.
Responding to questions: showing understanding through words, gestures, or actions.
Some children understand much more than they can say. However, understanding language and using language are separate skills, so consider both when looking at development.
3. Social communication: how your child connects with others
Social communication describes how children use communication during interactions.
Examples include:
Sharing attention: looking at something and sharing that experience with another person.
Using gestures: pointing, waving, showing objects, or reaching to communicate.
Imitating others: copying sounds, actions, or simple behaviors.
Taking turns: participating in early back-and-forth interactions.
These skills often develop before children use many spoken words. Differences in social communication can sometimes appear before speech delays become obvious.
Red flags for speech delay by age
Speech delay red flags can look different depending on your child’s age and stage of development. While every child learns to communicate at their own pace, certain signs may suggest that your child's speech and language skills need closer attention.
These signs may include having fewer words than expected, not combining words, limited attempts to communicate, difficulty understanding language, or losing words and skills your child previously used.
Speech delay red flags at 6 to 9 months
At this age, communication is mostly built through sounds, gestures, facial expressions, and interactions with caregivers. Babies aren't expected to use words yet, but they're building the foundations for later speech.
Possible concerns may include:
Limited babbling: your child isn't making repeated sounds such as "ba-ba," "da-da," or other consonant sounds.
Little response to sounds: your child doesn't turn toward familiar voices or sounds.
Limited social interaction: your child rarely smiles back, makes facial expressions, or engages during face-to-face interactions.
Few attempts to communicate: your child rarely makes sounds, gestures, or movements to get your attention.
Important note: At this stage, no single behavior confirms a speech delay. Instead, look at the overall pattern of how your child responds, interacts, and communicates. So don't worry if your baby isn't making any expected sounds.
Speech delay red flags at 12 months
By 12 months, many children use gestures, respond to familiar people, and experiment with sounds that lead to early words.
Consider seeking guidance if your child:
Isn't babbling: your child isn't combining sounds or experimenting with different vocalizations.
Doesn't respond to their name: your child rarely turns, looks, or reacts when you call them.
Doesn't use gestures: your child isn't pointing, waving, reaching, or showing objects to communicate.
Doesn't use meaningful sounds: your child doesn't use consistent sounds to represent people, objects, or needs.
Doesn't share attention: your child doesn't look where you point or show interest in sharing experiences with you.
Gestures such as pointing and waving are important early communication skills because children often use them before they have many spoken words.
Speech delay red flags at 15 to 18 months
Between 15 and 18 months, many toddlers begin using more meaningful words and communicating their needs more clearly.
Consider an evaluation if your child:
Has no meaningful words by 16 months: your child isn't using words consistently to communicate.
Uses very few words by 18 months: your child has a limited vocabulary and isn't adding new words.
Doesn't imitate sounds or actions: your child rarely copies words, sounds, gestures, or simple actions during play.
Doesn't follow simple directions: your child struggles with familiar instructions such as "come here" or "give me the toy."
Has stopped gaining communication skills: your child was learning new sounds or words but has stopped progressing.
The American Academy of Pediatrics recommends ongoing developmental surveillance and screening because early identification of developmental concerns can help children access evaluations, early intervention, and appropriate support sooner.
Speech delay red flags at 18 to 24 months
Between 18 months and 2 years, children often experience rapid growth in vocabulary and early phrases.
Consider seeking support if your child:
Has fewer words than expected: your child's vocabulary is not growing or remains very limited.
Isn't combining words by age 2: your child isn't using simple phrases such as "more milk," "mommy go," or "big truck."
Relies mostly on gestures: your child points, pulls, or reaches instead of using words even when communication opportunities are available.
Has difficulty understanding simple language: your child struggles with familiar instructions or questions.
Shows frequent frustration during communication: your child becomes upset because they cannot express needs or ideas.
Has lost previously learned skills: your child stops using words, sounds, or gestures they previously used.
If you're unsure whether your child's vocabulary is developing as expected, you can read Aldea's guide: How many words should a 2-year-old say?
Speech delay red flags at age 3
By age 3, children usually use longer phrases, ask questions, and participate in more conversations.
Consider seeking guidance if your child:
Uses very few words: your child's vocabulary remains much smaller than expected for their age.
Doesn't use short sentences: your child isn't combining several words to express ideas.
Is difficult for others to understand: unfamiliar listeners struggle to understand most of what your child says.
Doesn't ask questions: your child rarely uses words to seek information or interact.
Has difficulty participating in conversations: your child struggles with back-and-forth communication.
Avoids communication because it feels difficult: your child becomes frustrated or withdraws during attempts to communicate.
At this age, language development should continue becoming more complex. A lack of progress over time can be more meaningful than one isolated milestone.
Speech delay red flags vs typical development: how to tell the difference
Many parents wonder whether a behavior is part of normal development or a sign that their child needs support. The difference usually comes down to the pattern, consistency, and progress over time.
A child may have an occasional delay in one area and continue developing normally. However, ongoing concerns across several areas or a lack of progress are worth discussing.
Area | Typical development | Possible concern |
|---|---|---|
Vocabulary at 18 months | Uses some meaningful words and continues learning new ones | Uses very few words or vocabulary growth has stopped |
Word combinations at 2 years | Begins combining words such as "more juice" or "mommy go" | Uses only single words or relies mainly on gestures |
Gestures | Points, waves, shows objects, and uses actions to communicate | Rarely uses gestures to communicate |
Social interaction | Shares attention, imitates, and responds to others | Limited engagement or difficulty sharing experiences |
Progress over time | Continues gaining new communication skills | Skills remain the same or decrease |
What causes speech and language delays?
Speech and language delays can happen for many different reasons. In some cases, an underlying cause exists. In other cases, a child may simply need extra support developing communication skills.
Common factors that may contribute to speech or language delays include:
1. Hearing difficulties
Hearing plays an important role in speech development. Even mild hearing loss caused by recurring ear infections or fluid buildup can affect how a child hears sounds and learns language.
A hearing evaluation is often part of a speech delay assessment because children need consistent access to sounds to develop speech skills.
2. Family history
Research has found that children with a family history of language impairment may experience more language difficulties than children without that history.
If speech or language difficulties run in your family, sharing this information during a speech evaluation can help professionals better understand your child's development and recommend appropriate support.
3. Premature birth
Children born prematurely may develop communication skills at a different pace.
For children born before 37 weeks, professionals often consider corrected age during early development because they compare skills based on the expected due date rather than the birth date.
4. Developmental language disorder
Some children have ongoing difficulty learning and using language without another known developmental condition.
Developmental language disorder (DLD) can affect:
Vocabulary development: learning and using new words.
Sentence building: combining words and expressing ideas.
Understanding language: following directions and understanding concepts.
Children with DLD can have typical intelligence and may benefit from speech-language support.
5. Autism spectrum disorder
Some children with autism experience differences in communication, including delayed speech, limited social communication, or differences in how they use language.
When speech concerns appear alongside social communication differences, a broader developmental evaluation can help identify the right support.
6. Childhood apraxia of speech
Childhood apraxia of speech is a motor speech disorder that affects how children plan and coordinate the movements needed for speech.
Signs may include:
Difficulty saying words consistently.
Trouble moving smoothly between sounds.
A noticeable gap between understanding language and producing speech.
A speech-language pathologist can evaluate whether a child's speech difficulties may involve motor planning.
7. Limited opportunities for language interaction
Children learn language through regular interaction with caregivers and others.
Talking, reading, playing, and responding to your child's communication attempts all provide opportunities for language growth.
A child's environment is only one factor in development, but frequent, meaningful communication experiences support language learning.
How speech and language delays are evaluated
A speech-language evaluation examines how your child understands language, communicates needs, interacts with others, and uses speech.
Who evaluates speech and language delays?
Several professionals may support the evaluation process depending on your child’s needs.
Speech-language pathologist (SLP): evaluates speech, language, communication skills, and provides therapy when needed.
Audiologist: checks hearing to determine whether hearing differences may affect communication development.
Developmental pediatrician: evaluates broader developmental concerns, including autism and other developmental conditions.
Child psychologist: may assess cognitive development, behavior, learning, and social communication.
What happens during a speech evaluation?
A speech-language evaluation usually includes several parts:
Parent interview: the SLP learns about your child’s development, communication history, and your concerns.
Observation: the professional watches how your child communicates during play and everyday interactions.
Language assessment: the professional evaluates your child's understanding and use of words.
Speech assessment: the professional examines speech sounds, clarity, and how your child produces words.
Social communication assessment: the professional may review interaction, gestures, imitation, and shared attention.
The evaluation helps create a clearer picture of your child's communication strengths and areas where support may help.
What happens after a speech evaluation?
After the evaluation, the provider may recommend different next steps depending on your child’s needs.
Recommendations may include:
Speech therapy: support for speech, language, and communication skills.
Early Intervention services: support for children under age 3.
Parent strategies: activities you can use during daily routines to encourage communication.
Additional evaluations: such as hearing, developmental, or autism assessments if needed.
An evaluation doesn't label your child. It gives you information that can help you make informed decisions about support.
Common misconceptions about speech delay
Parents receive a lot of advice about when children "should" start talking. Some of it can be reassuring, but it can also make it harder to know when a concern deserves a closer look.
Let's clear up some common misconceptions.
"My child is just a late talker. They'll catch up."
Some late talkers do catch up with their peers. However, not every child follows the same developmental path, and you can't always tell from vocabulary alone who will catch up without additional support.
Your child's language understanding, use of gestures, social communication, family history, and progress over time can all provide useful information.
If you're trying to understand the difference, read our guide on Late talkers: Do they catch up or is it a speech delay?.
"Boys just talk later."
Early language development can vary by child, but being a boy isn't a reason to dismiss a persistent communication concern.
The same developmental milestones can help you monitor whether your child is gaining communication skills over time. If your son isn't meeting expected milestones or you're concerned about his progress, it's reasonable to seek an evaluation.
"My child understands everything, so I don't need to worry."
Understanding language is encouraging, but receptive and expressive language are different skills.
Your child may understand instructions, recognize familiar words, and know what you're saying while still having difficulty expressing thoughts and needs through spoken language.
If there's a significant difference between what your child understands and what they can communicate, a speech-language evaluation can help you understand why.
"My child is smart, so it can't be a speech delay."
Speech and language difficulties can occur in children with a wide range of cognitive abilities.
A child can solve problems, learn quickly, remember information, and show strong skills in other areas while still needing support with speech or language.
Looking at your child's communication skills separately can help you avoid overlooking an area where support may be useful.
"Speech therapy is only for severe delays."
Speech-language pathologists work with children who have many different communication needs, from relatively mild speech sound or expressive language difficulties to more complex communication disorders.
An evaluation can determine whether your child needs therapy and, if so, what type and level of support would be appropriate.
"I should wait until my child turns 3."
You don't have to wait until age 3 to raise concerns about communication development.
Developmental monitoring and early intervention begin during infancy and toddlerhood. If your child isn't meeting expected milestones, has stopped making progress, or has lost skills, discussing your concerns earlier can help you understand whether further evaluation is needed.
"Bilingualism is causing my child's speech delay."
Learning two or more languages doesn't cause a speech or language disorder.
Bilingual children develop language across all the languages they use, so evaluating only one language can underestimate what they know. When a true language disorder is present, difficulties typically appear across the child's languages rather than being caused by bilingual exposure.
ASHA specifically states that using more than one language doesn't confuse children or cause speech or language problems.
If your child is growing up with more than one language, Aldea’s guide to bilingual child development explains what you can expect and which signs deserve a closer look.
How Aldea helps families in Florida understand speech concerns
Aldea helps families in Florida navigate this process by connecting parents with trusted pediatric specialists, including speech-language pathologists and developmental professionals.
Whether you're concerned about your toddler's first words, language development, communication skills, or possible developmental differences, Aldea helps you find the right resources and support based on your child's needs.
Not sure where your child stands? Take Aldea's free speech screener to understand your child's communication development better better.