Lots of kids are 'late talkers'. Here's when to take action

As a speech pathologist, university lecturer and parent of young children, I often get asked a version of the following:

My child isn’t talking yet. Is that a problem? And is it my fault?

There is never a simple “yes” or “no” response, as more information is always needed. But by the end of the conversation, I nearly always end up saying “it’s worth looking into”.

The “wait-and-see” approach for late talkers – those who seem to be lagging behind the spoken communication of their peers – recommended by previous generations has shifted as we learn more about early childhood and how intervention can help.

Who are late talkers?

Late talkers are children who do not speak by the usual time that others are off and chattering. They do not have a diagnosis or “primary cause” such as autism spectrum disorder, an intellectual disability or hearing loss.

Late talking is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders so clinical cut-offs vary. The most common definition is that late talkers do not have 50 words and/or do not use two-word combinations by two years of age. Others believe this definition is inadequate.

Research tends to divide this population into two categories, those children who only have issues using words (that is, they understand words) and those who have issues with both expression and comprehension.

Late talking is fairly common, with 13–20% of two-year-olds meeting the criteria. Children are generally assessed for late talking between two and three years via observation by a speech pathologist and parent reports. Parents are asked to provide details of any speech or language disorders in the family, how their child communicates and checklists of the words they understand or speak.

This information is then compared to a large sample of children, to see if they fall within the “normal range” for the number of words they know and use.

Read more: Talking to babies may contribute to brain development – here's how to do it

Will my late talker grow out of it?

Around 50% of children will “out-grow” their language difficulties. This explains why the “wait-and-see” recommendation has been popular for many years. But there are several problems with this approach.

Firstly, late talkers may not fully catch up. “Late bloomers” have been found to underperform in language and literacy measures in the later primary school years and beyond. So, while a late talker may improve, they may face ongoing but perhaps more subtle difficulties at a later age, when language skills are critical to academic success and socialisation. Seeking early treatment may mitigate this risk.

Secondly, late talking can have negative impacts for the child during their toddler years. A child who has few words may seem frustrated, withdrawn or aggressive. Such behaviours are more common among late talkers, likely because they lack the words to express feelings or wants. Parents may feel their children’s participation in family life and school or day care is being limited. Treatment may help the child to catch up to their peers and/or find alternate ways to communicate, which can improve participation.

Lastly, but most importantly, the presence of early language difficulties is a significant risk factor for ongoing language difficulties, often diagnosed as developmental language disorder.

This disorder occurs in at least one in five late talkers and can have substantial lifelong impacts on everyday functioning. Academic performance at school, self-esteem, mental health and employment opportunities are all negatively associated with a developmental language disorder diagnosis.

The tricky part is we cannot accurately predict which late talkers will go on to develop typical language skills, and which ones will later be diagnosed with developmental language disorder.