Late Talkers: When Is It a Problem?

Q. My son is 27 months old and he doesn't say much besides "mom," "dada," "kitty," and a few other things. But he responds to everything I ask him to do, and if I count from one to five, he holds up his fingers all the way to five. Nevertheless, my family is worried. Should I be?

A. When you're surrounded by concerned people, it's hard to know whether or not to join the club! To figure out if your son is on track, it's important to look at the two aspects of language development. "Receptive vocabulary" refers to the words that a child can understand. The good news is that it sounds like your son's receptive vocabulary is quite good. He's responding appropriately to your requests and can follow simple directions, like holding up his fingers to count to five.

"Expressive vocabulary" refers to the words that your child can say and use to communicate. Between ages 2 and 3, a child's expressive vocabulary will typically increase to about 300 words. Children should be saying new words each month and using two-word sentences, such as "more juice."

According to these benchmarks, your son may be behind in his expressive language development. But don't forget to factor in his ability to communicate with gestures. For example, while a child may not say with words "Mommy, I'm hungry. I want a banana," he may take his mom's hand, walk her to the kitchen, and point to the banana. If your son is doing this kind of complex gesturing to communicate, he's on the right track and the words will likely come soon.

In any case, I would suggest you consult your son's doctor, who can assess whether there is a medical cause for a speech delay. Also you can call your state's "Child Find" office. They provide assessment services for babies, often at no charge, as well as early-intervention services such as speech therapy. It may very well be that an assessment concludes that your child is doing fine and will catch up on his own, but it's good to check things out, if only for reassurance.

In the meantime, to promote your son's language skills, label any sounds he uses for words. For example, if he says "ba" for "ball," you should say, "Yes, that's the ball." Continue to talk and sing to him, ask him questions, point out and identify the people and things that fill his world, and read together.

Claire Lerner, LCSW, is a child development specialist at Zero to Three, a national nonprofit promoting the healthy development of babies and toddlers.

Originally published in American Baby magazine, September 2004.

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

• By Claire Lerner