Every parent remembers their child's first real word, and every milestone after that one feels just as important. So when talking seems to be taking longer than expected, or your child just doesn't sound quite like their peers, it's natural to wonder what's normal and what isn't.
Maybe you've caught yourself searching late at night, trying to figure out whether this is a passing phase or something worth a professional opinion.
At Bjorem Speech, we spend our days thinking about how kids learn to talk, and we want to walk you through the signs your child needs speech therapy so you can feel confident about what to do next.
What this article covers:
What Is Speech Therapy?
Speech therapy is a hands-on treatment led by a speech-language pathologist, or SLP, that helps children speak clearly, understand language, and communicate with confidence. An SLP starts by evaluating how a child talks, listens, and expresses themselves, then builds a plan around that specific child's needs. It isn't only about pronunciation.
An SLP might also work on vocabulary, sentence building, following directions, or the natural back-and-forth of conversation, usually through play, books, and simple games that don't feel like work to a child.
Signs Your Child Might Need Speech Therapy
Development moves at its own pace for every child, but a few patterns of missed milestones tend to signal that extra support could help. They could be early signs of childhood apraxia of speech or other speech disorders.
- Limited vocabulary for their age: A toddler who is stuck at just a handful of words for months, well behind where peers typically are, may need a closer look at expressive language. Clinicians commonly flag fewer than 50 words by 24 months as a marker worth monitoring (Rescorla, 1989).
- Trouble combining words into sentences: By age three, most kids link words into short phrases. A toddler who isn't yet combining two words together by around age two, on top of a limited vocabulary, fits the criteria researchers use to describe late language emergence (Rescorla, 1989).
- Difficulty being understood: Mispronouncing a few sounds is normal, but speech that's consistently hard to understand, even for family, can signal an articulation or phonological disorder. Research on intelligibility norms suggests most children should be understood by strangers most of the time by around age four (Coplan & Gleason, 1988).
- Avoiding talking or pulling back socially: Some kids quietly opt out of conversation when communicating feels frustrating, which can look like shyness but often isn't. Studies on children with language disorders have found that social withdrawal is a common response to peer interaction difficulties (Cullen, Billingham, & St Clair, 2024).
- Struggling to follow directions: A child who often seems lost during simple instructions may be dealing with a receptive language issue rather than distraction, and comprehension difficulties are linked to weaker outcomes than expressive delays alone (American Speech-Language-Hearing Association, n.d.).
- Losing skills they once had: If speech that was once there suddenly disappears, don't wait - evaluate right away rather than taking a wait-and-see approach. Loss of previously acquired language is a pattern researchers take seriously enough to study its timing and prevalence directly (Barger, Campbell, & McDonough, 2013).
- Persistent stuttering: Bumpy speech is common in young kids, but stuttering that's increasing, or comes with visible frustration, is worth a fluency evaluation. Most stuttering begins before age three, and the risk of a new onset drops considerably after age four (Yairi & Ambrose, 2005).
If you have concerns about any of the signs above, then don't wait - evaluate. Learn how to get speech therapy for my child.
What Does Speech Therapy Treat?
Speech therapy treats a wide range of speech, language, and communication disorders in both children and adults.
On the speech side, it addresses articulation disorders (sounds that are dropped, substituted, or distorted), fluency disorders like stuttering, and apraxia of speech in children, a motor planning issue that makes it hard to coordinate the mouth movements needed for clear speech.
On the language side, it covers expressive language delays or disorders (trouble putting thoughts into words) and receptive language disorders (trouble understanding what others say).
Speech therapy also treats voice and resonance disorders, such as chronic hoarseness or a voice that sounds overly nasal, as well as social or pragmatic language challenges, like difficulty reading social cues or holding a conversation. In some cases, therapists also work with feeding and swallowing difficulties, especially in young children.
If you're wondering how to help a child with speech apraxia, an evaluation from an SLP is the best thing to start with. At home, tools built for repetition, like the apraxia cards and practice sets we've designed at Bjorem Speech, help reinforce whatever a child is working on in session.
Conclusion
Noticing these signs doesn't mean something is wrong with your child. It means you're paying attention, and that's exactly what helps kids build clearer, more confident communication over time.
Every child develops on their own timeline, but a pattern that keeps showing up, rather than a single missed milestone, is usually the clue that it's time to get an expert opinion. If any of this sounds familiar, don't wait to reach out for an evaluation.
When you're ready to support that progress at home, our tools at Bjorem Speech are designed by speech therapists, so you can practice with your child using the same approach they'd use in session.
Sources:
- American Speech-Language-Hearing Association (ASHA). Late Language Emergence. Practice Portal, drawing on Paul (1991) and Rescorla (1989). https://www.asha.org/practice-portal/clinical-topics/late-language-emergence/
- Barger, B. D., Campbell, J. M., & McDonough, J. D. (2013). Prevalence and onset of regression within autism spectrum disorders: A meta-analytic review. Journal of Autism and Developmental Disorders, 43(4), 817 to 828. https://doi.org/10.1007/s10803-012-1621-x
- Coplan, J., & Gleason, J. R. (1988). Unclear speech: Recognition and significance of unintelligible speech in preschool children. Pediatrics, 82(3), 447 to 452. https://doi.org/10.1542/peds.82.3.447
- Cullen, H., Billingham, S., & St Clair, M. C. (2024). How do children with language disorder perceive their peer interactions? A qualitative investigation. International Journal of Language & Communication Disorders. https://pmc.ncbi.nlm.nih.gov/articles/PMC11365031/
- Rescorla, L. (1989). The Language Development Survey: A screening tool for delayed language in toddlers. Journal of Speech and Hearing Disorders, 54(4), 587 to 599. https://doi.org/10.1044/jshd.5404.587
- Yairi, E., & Ambrose, N. (2005). Early childhood stuttering: For clinicians by clinicians. Pro-Ed. Summarized in "The Age Factor in Stuttering," Stuttering Foundation. https://www.stutteringhelp.org/content/age-factor-stuttering
