House Calls Questions

Maren Thacker, M.A., CCC-SLP



Speech Pathologist
Palomar Health Rehabilitation Services

My 18-month-old son doesn’t say words as clearly as his 14-month-old cousin. Should I be worried?

Answer: Parents always want to know if their child is developing “on schedule.” Language development begins at birth and continues with each child progressing at his or her own speed. That means that some children will start speaking clearly sooner than others.


Generally, parents can expect their one-year-old to follow simple directions and point at objects when asked. This indicates comprehension of spoken words. When a toddler is 18 to 24 months old, she should have a vocabulary of about 30 words. Watch for an explosion of language skill development over the coming months because by the time they are 2 ½ years old, most children will know and use approximately 200 different words!

We don’t what causes speech delay, but it could be related to frequent early ear infections. Some parents think they might be overreacting and hesitate to report concerns about their child’s language ability. If you feel that your child is not moving ahead with speech and language skills, ask your pediatrician about a referral for a speech and language evaluation.

The initial assessment evaluates your child’s comprehension and use of the spoken language. If a speech delay is identified, speech therapy sessions twice weekly help strengthen skills. Each session features interactive, play-based therapies that involve the child and parent.

While it’s never too late to start speech therapy, early intervention helps your child be ready for preschool or kindergarten by building important language skills that are needed for success in school and later in life.