Ask the Expert: My Child Is 2 and Only Says a Few Words, Should I Be Concerned?

If your child is about 2 years old and only says a few words, you may be concerned that he has a speech delay or disorder. Here, Manhattan speech-language pathologist Heather Boerner explains what parents should do in this case.

The most common questions I get are definitely about speech development and speech milestones. What I always say to a parent, if they’re concerned about speech and language development, is to come and get a screening. Parents have really good intuition. If they suspect a problem, when they’re looking at their child’s peers and notice their child isn’t reaching those milestones and they have a concern that there’s an issue or delay, they’re usually right. And even in the case where their intuition is wrong, they should come in and get a speech and language screening just to be sure. We can easily observe a child within a classroom or their home, or they can come to our center and we’ll watch them play for a half hour. We can quickly and easily determine if there’s a need for a further, more comprehensive speech and language evaluation. We look at how they’re communicating—are they using words? Pointing? Are they engaging in appropriate play? Can they follow directions?

When we recommend a more comprehensive evaluation, we can perform a battery of standardized tests to determine if the child’s speech and communication skills are delayed or disordered. We compare the child’s functioning to their same-aged peers. We look at several different areas when we evaluate, including all areas of communication. The first area is speech, and we look at how a child produces sound. We also look at a child’s language—how the child is understanding and comprehending language is called receptive language. We also look at how the child is expressing their ideas, thoughts, and needs, which is what we refer to as expressive language. Another thing we look at is articulation, which is the clarity with which they’re producing their words—how accurately they’re producing each consonant and vowel in the English language. Then we also look at their voice, so we will observe vocal quality, pitch, and volume. And then we may also do what’s called an oral muscular examination, which looks at the child’s entire oral musculature to examine his range of motion, coordination, and the strength of his lips, tongue, jaw, and all facial muscles.

If the parent comes with feeding concerns, we’ll also observe the child during mealtime to identify any areas of concern.

Heather Boerner, MA, CCC/SLP, is a pediatric speech-language pathologist and the founder of Chatty Child Speech Therapy, PLLC in Manhattan. Boerner graduated from New York University with an MA in speech-language pathology and a minor in education, and she is licensed to teach speech- and hearing-disabled students.