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Speech Development in Babies and Toddlers

Sabrina H.
Speech-Language Pathologist
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Join Speech-Language Pathologist, Sabrina Horvath, for a Q&A about speech and language development in infants, toddlers and young children. Sabrina is here to talk about infant understanding of language, first words, typical speech development and more.

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Bilingual 15 month old


Hi Sabrina,
Is there anything particular that I should be doing to help develop speech in my toddler aside from reading and talking to her? She learns one language from me, another from my husband.
She has about 3-4 basic words now. I know that she won't really start accruing words until 18 months but I just want to make sure that I am doing all that I possibly can for her development right now.
Thank you,


Hi Maria,

You are already doing two of the best things that you can to help your daughter learn language! My suggestions would be, rather than to “do more”, to “be smart” in how you talk with and read with your child:
In talking with your child, don’t be afraid to be a little repetitive in what you say. When you say something a few times over (e.g. “There’s the truck! You have the truck! Look at that truck!”), you are giving her multiple opportunities to learn new words, and you are giving her lots of different sentence structures for her to dissect and learn from. Also make sure that you give her some time to process what you are saying by pausing; not every second of playtime has to be filled with language! Talking about ‘the here and the now’ – labeling what she is doing, taking the word that she uses and putting it into a sentence – helps her to match the words you are using to what they label.
When reading, don’t be afraid to deviate from the actual text of the book and talk about the pictures, particularly at early ages when attention is much shorter. This is called “shared reading.” You are doing the same thing you want to be doing with talking to her—sharing an experience, and using language to discuss it. As she gets older, she will want more of the story and less of the pictures; both are great ways to use books!

Hope this helps!


Great advice, thank you!


15 month old doesn't say anything except mama and dada



My daughter is 15m old and she doesn't say anything else except mama and dada. She comes when her name is called but if I ask her to "go to daddy" or "come to momma", she doesn't do it. When she is hungry she doesn't point to anything, she just comes to me and cries some and I have to figure out if it's that she is sleepy or hungry. She dorsnt point to milk or juice or anything that she wants. She points only in the directions she wants u to talk in if your carrying her. I read to her and talk to her by using objects and repeating the names. Is there anything else I should do? Is this a concern for EI program? She babbles a lot but just random. Sorry for the long message :)


Can I ask a couple of follow-up questions before I answer?
1) How does your daughter do with eye contact? Will she look at you and smile if she sees something she likes?
2) Do you think your daughter knows the labels of a few objects, even if she isn't saying them? For example, if you said "Give me the ball!" would she know which one the ball is, even if she doesn't follow the direction to give it to you?


1. Yes, she is very good at eye contact and often does that. For example, if she is playing with Daddy and is having fun she will look over to me and smile or laugh

2. I don't know exactly. I know she knows what some items represent. For example, she will take the remote control and point to the TV to turn it on. She gets very happy when Baby Einstein comes on.

She also presses apps on my husbands phone. We limit her TV time to only an hour or so a day but she really likes TV. Could this b an issue?

She may know the labels of other things but it's hard to tell. When I say "let's play with toys" she follows me but I'm not sure if she knows what I'm saying to her.


Hi Lizandra,

Children don’t typically have very many words at 15 months of age; in fact, some children don’t have any at all! I am glad to hear that she is making good eye contact; it is a very important communication skill! This means that she is interested in sharing things with you and in interacting, which is of course the reason why we use language.

I would recommend that you start using baby signs with your daughter; they often help children learn more words and (in turn) become more verbal. Think about what it feels like to go to a foreign country and hear (non-English) locals talk. If you don’t know the language, it can be hard to tell where one word stops and the next one begins! Now imagine trying to learn a particular word when you can’t even tell where words begin and end; this is the challenge of infants. They hear a stream of sounds and have to pull from it the exact sequence of sounds (i.e., the word) that matches the thing that they are learning to name. This is a difficult thing to do! The advantage of baby signs is that they are visual, and therefore easier for children to pick up on. You are demonstrating a discrete, purposeful movement, and children will learn to associate that movement (sign) with the object in time. Then, as they become better with connecting things in the world with their signs, they will transition into learning to say the words.

If you continue to have concerns, I would talk to your pediatrician about your child’s development. I always think it’s better to address your concerns than to continue to wonder and worry. In the meantime, give baby signs a try!

Thanks for your question and good luck with signing!


Thank you


Speech delay or normal spectrum of development for an almost 2 year old?


Hi Sabrina,
Thanks for answering questions today! My son is 22 months, and according to most of the literature we have been given, he is slightly behind on the speech curve. He is very shy in unfamiliar situations (anything that's not part of his normal routine) and when we took him to the pediatrician at 18 months, he was more or less silent, even though he "chatters" quite a bit at home. The doctor recommended a hearing test and an EI assessment, which I have been hesitant to do because my gut tells me he is doing just fine, but of course I don't want to short-change him if he does need help. His receptive language is definitely strong, and he can follow two-part instructions easily, will go into the other room to get a specific toy when asked, responds/looks up when you call his name, etc., so I have zero concerns about his hearing. At home, he babbles constantly, looking at us and telling "stories", pointing and gesturing, but there are very few words he uses intelligibly. He does have about 20 or so words that he uses regularly although at least half of them would not be understood by someone who doesn't know him well. He does not put words together yet at all, even when they are both words that he uses consistently--for example, he will say either "mama" or "up", but not "mama up" even when prompted, when that is what he is asking for. He will also attempt to repeat things when asked at times, but in these cases his attempts are often nowhere near the word itself. If you ask him to say any two-syllable word he doesn't know already, he will often make a very similar "ah-ahh" type of noise, as if he wants to appease you but doesn't really try to mimic the sounds themselves. He does repeat back specific sounds when we work on those, so he will copy you saying "fff fff fff" or "sss sss sss" but then he does not respond when asked to put that together to form a word. He also makes several animal noises such as "baa" and "quack" but he won't really even attempt to say the names of the animals themselves.
I realize this is a pretty long question, but based on these details would you say we should consider EI for him at this point? Should he have more words by now, is there anything we should be doing differently with him at home? We do read to him a lot, and we try to work on sounds and words as I've mentioned, but I wonder if we are going about it the wrong way?
Thank you!


Hi Brett,

Thanks for providing such detail! It sounds like you’ve already done a fair bit of research on language development, but I’m happy to try to provide some additional information.

Regarding hearing: It sounds like his hearing is fine (no pun intended!). Hearing tests are often recommended for children who are showing some signs of delay in order to rule out hearing loss as the cause of any problems, which is probably why your pediatrician recommended it to you. Provided your son is not failing any hearing screenings, and if you have no concerns about his hearing, I agree with you that it is probably not worth pursuing at this time.

Regarding comprehension of language: Your son appears to have some good receptive language skills. You do not sound worried about where he is in the process of developing receptive language, and given the examples that you listed I would agree with you that this is a strength.

Regarding language production: Children show a great deal of variability in what they are capable of right around two years of age, so determining whether children are delayed is hard to do without a formal evaluation. You’ve listed several strengths to your son’s production so far, but there are also some weaknesses that you’ve highlighted. Your son’s pointing and gesturing are both great signs for intention to communicate. He wants to interact, and he’s finding ways to share information with you! Where I see some cause for concern is in his ability to actually say words. This is moving away from “language” (i.e., a system for sharing ideas) and into “speech” (i.e., the motor action of moving the mouth to form words). Where your son may be having difficulty is in his speech development. A couple of points stand out to me: first, your son has extreme difficulty repeating words, and the attempts are “nowhere near the word itself.” Second, he seems to have extreme difficulty combining things he can produce (like individual sounds or individual words) into a larger combination. Both of these indicate to me your son may be having some difficulty with the motor movements of speech production.

So is there actually a problem? I can’t give you a definite answer without evaluating him. There may be. On the other hand, many typically developing children have smaller vocabularies and aren’t combining words at 22 months. He may well be “just fine,” as your gut is telling you. My recommendation would be to seek out an evaluation to look a little more closely at your son’s speech. He may well have no problems. My concern, though, is that many children that I have seen with speech problems at this age become very frustrated with trying to communicate, because they know what they want to say (their language is good), but they can’t say it (their speech is poor). Your son’s language skills are strong, and if there are speech problems I worry that he will very soon become frustrated. I think you may also find a formal evaluation helpful; even if your son does not have any problems (which would not be a bad outcome at all!), you will come away understanding more about your son’s skills.

Thanks for your question. Best of luck!


Hi Sabrina,
Thank you so much for your very thoughtful response! I am going to schedule a formal assessment for him to see what we can learn from it.


Narration vs baby words


Hello! My daughter is four months old. I speak to her normally (narrating our day, asking her questions, reading to her). Do you think that she will be slower to speak words because I don't practice baby sounds (repeating mama, papa etc) with her? What do you recommend as far as the most natural way to develop speech?


Hi Katie,

What a great question! This is actually something that we research in my lab!
It may surprise you to learn, but “baby talk” or “motherese” (as it is sometimes called) is not the same across all cultures. The babbling back and forth, as you described, is something that is done in the United Sates and across much of Europe, but it is not done universally. In some cultures it is even considered inappropriate! Regardless of the norms, children in all of these cultures learn language just fine.

At present, your daughter is mostly concerned with learning the sounds of her language, and in discovering the rules about how the can be combined. (All languages have rules about sounds and sound combinations, called “phonology”. We know these unconsciously as native speakers.) Your daughter will be successful in this task simply by listening. Using narration will not “impede” this part of her language development.

Regarding word-learning specifically: My only recommendation is that you not be so concerned with narration that you are giving your daughter sentences that are overly complex. To learn words, children need to be able to pull apart the sentence and process it. Young children, particularly, have difficulty pulling apart long and complex sentences (e.g., “That big, round, red ball in the corner is bouncing up and down slowly!”), and if they can’t pull it apart they can’t learn new words from it. Don’t overthink this idea! Just go with your intuition about speaking to her clearly, and she’ll be just fine!


Thank you so much, this is extremely helpful!


Tongue out


Sometimes my 18 month old talks with his tongue out more in his mouth, usually when he is tired, is this normal? His words are more slurred then, but otherwise he usually talks fine.


Hi Katy,

Your child is still learning how to move his mouth and tongue in order to create sounds, and exploring his mouth is a part of that. Having said that, I would recommend talking with your pediatrician about what you are seeing. Does your son also have difficulty with chewing and swallowing when he is tired?

Your son may well be playing around with sounds, as children do when they are learning language. However, it is worth having your pediatrician take a good look at the structures of his mouth to make sure everything is developing as it should. Better to discuss these with your doctor than to wonder and worry!

Thanks for your question!


Thank you, I appreciate it! He doesn't usually have difficulty chewing or swallowing when he is tired. He just started this random tongue thing in the last week so hoping it's just a phase! I'll take your advice and bring it up to the pediatrician just in case though too. Thank you!


Toddler Frustration


Our 3 yr old speaks well but when frustrated or upset she has trouble communicating and will sometimes scream or point to what she wants. Is it that she can't communicate in a state of frustration or is this something else? I'm not sure if she's just acting up because she isn't getting her way or if she's overwhelmed with emotions that she can't quite communicate.


Hi Paula,

Many children have difficulty communicating when they are frustrated; you are by no means the only parent to struggle with this! Some children will "act up" to get their way, but the situation you are describing is one where many children struggle to communicate. First, your child is at an age where she can recognize her own emotions (i.e., she knows she's upset and she can't be easily distracted into feeling better), but she probably doesn't have a great way to label how she's feeling. Most three-year olds can't label their emotions. She may also not always know exactly why she is upset. Something is wrong, but expressing exactly what is going on might be a little beyond her capacity.

In these situations, I recommend doing what you can to lessen the communication demands on her. You may want to try using questions where she can answer with yes or no or just one word: e.g., "Do you need some help?" I would also make a point of labeling her emotions for her, like "You look upset!" As she continues to develop in language, she will learn to label her feelings as you have modeled. She will also, with time, become better at communicating when and why she is frustrated.

Best of luck!


Thank you!!!

Our Q&A is now over.


Thank you, Sabrina! Sabrina works at the Boston University Child Language Lab where they study language development in young kids. If you’re in the Boston area there are a lot of great opportunities to participate in studies. You can learn more here:


Gestures & Communication


My 2yr old often points at things, or more often somewhere in the general vicinity of things, he either wants to eat, play with or know what a certain something is. This leads to frustration on his part because I either don't know what particuar thing he is trying to point at or, I do this a lot, tell him to go show me what he is talking about and get him to try and use his words to tell me. I probe with questions like "Do you want some milk? This is a toaster, etc." What can I do to help him and I better communicate?!


Hi Brittany,

From your son's perspective, he is making clear gestures to indicate to you what he wants. He is initiating communication (by pointing), and he as a very clear idea of what he is trying to say in his mind. It is easy to understand why he might be frustrated, then; he's trying to communicate and it's not working as well as he wants it to! It is natural in the process of language development for communication to sometimes break down, and it is not uncommon for children to sometimes become frustrated when they can't express what they want to.

When we use words, we take away some of the ambiguity that comes with just pointing. A child pointing at a refrigerator could mean many things; I child saying "I want milk!" is generally much clearer. As children are able, they replace these gestures with words. Is your son using his words to indicate what he wants as well? If you think he might be having difficulty using his words (which is why he is using his gestures), or if you think he has more frustration with communication than other children his age, you might want to talk to your pediatrician about his language development.

If, however, he is using many words and word combinations, this may be a case where he has more in his mind than he can yet express. As I said, all children have a gap between what they understand and what they can say, and some level of frustration is not uncommon. In order to ease frustration, I would continue to use those probing questions. Add to this a model of what he can say next time instead of pointing. For example, if he points to the refrigerator, you may ask, "Do you want milk or juice?" After you determine that he wants milk, model the sentence he could have said: "I want milk." When his frustration at not being understood in these moments is already high, I would focus less on pushing him to use his words and more on modeling better ways to communicate. Hopefully the next time around he will be more willing to try to use his words from the outset.

Thanks for your question!


Advice for aspiring tri-lingual baby


My husband and I both speak English, I speak Russian, and he speaks Hebrew and we'd like for our 17 month old daughter to learn all three, but are wondering how feasible this is. We do not speak each other's language so her exposure to Russian and Hebrew is limited and not consistent (it's not possible for me to always speak Russian and for him to always speak Hebrew to her given that we need to all communicate). Her other social interactions are all primarily in English although she gets some exposure from other family members. What's the best way for us to encourage her to learn all three languages? When we're speaking to her in one language should we translate from one to another using the words she already knows (for e.g. when she says shoe, saying yes shoe and repeating it in Russian too)? Or are we better off having a specific Russian-only/Hebrew-only time such as meals? Can we read English and Russian/Hebrew books to her back to back? Is it critical for us to get her involved in Russian/Hebrew activities or find a nanny that speaks one of those languages? Thank you in advance for any advice.


Hi Nina,

As you are no doubt aware, in many countries around the world children grow up speaking multiple languages. In such cases, bilingualism (or trilingualism) is a necessary skill because of the cultural context. So, your child absolutely has the cognitive capacity to be trilingual, if that is your wish. The challenge, as you have identified, is that the United States is a (mostly) monolingual country, and you are going to have to work to incorporate Russian and Hebrew. Chontelle gave some excellent advice to families in a Q&A a couple of weeks ago; you may want to check out her responses.

Your daughter is going to have ample opportunity to learn English, living in an English-speaking country, so I would focus as much attention as you can on promoting Russian and Hebrew. All of the ideas and activities you suggested would be beneficial in promoting these two languages. As much as possible, you should speak to her in Russian and have your husband speak to her in Hebrew. You should also have designated activities (e.g. play time, reading) that are just in one language of these two languages. It is not that children cannot learn both languages if they are being mixed; but you’d be surprised how quickly “mixed” languages become mostly or all English if families are not careful! I also like the idea of Russian and Hebrew activities; this diversifies the number of people with whom she will use the language, and it gives her a context in which to use it.

The bottom line is there is no one formula to achieve trilingualism. What you have to do (and it seems you are already doing it!) is be willing to work to create opportunities for non-English language learning. Without concerted effort on your part, your daughter would likely learn English but not much else. Creating these opportunities is the key to raising a successful trilingual!

Best of luck!




At what age will a child grow out of using echolelia amd delayed echolelia


Hi Amy,

Can I ask what sort of echolalia you are seeing? Children will repeat language that they have heard as "practice", but you are right in thinking that sometimes they are delayed in moving past this stage.