Speech Delay Signs by Age: When to Ask for an Assessment

Communication includes gestures, understanding, speech and interaction. Milestone lists help you organise concerns, but one item cannot diagnose a delay or autism. ASHA explains that development varies and recommends assessment when a child is missing many milestones in their age range.

Use the age ranges below alongside the linked original checklists. Record examples from ordinary play and family routines, including the languages your child hears. A professional can interpret the pattern and discuss whether a speech-language assessment, hearing check or broader developmental review is appropriate.

ASHA's 13–18-month checklist includes pointing, following familiar directions, and using or understanding words for familiar people and objects. If several of these are absent or you are worried about responses to speech or sound, share the observations with your child's clinician.

For your appointment notes, describe how your child asks for a favourite activity, whether they look for a familiar object when asked, and which gestures or sounds you recognise. Avoid repeatedly testing the child to create a score; examples from an ordinary day are more informative than a pressured performance.

ASHA's 19–24-month guidance includes a vocabulary of at least 50 words understood and used, and combining two or more words. These are age-range reference points, not a standalone diagnosis. If words and combinations are limited, discuss the overall communication picture rather than simply waiting for a birthday.

Bring examples from all the languages your child uses. Note whether a combination is produced spontaneously to communicate or is a repeated phrase whose meaning is unclear. You do not need a perfect vocabulary count before asking for help, and multilingual exposure alone does not explain a communication disorder.

ASHA describes more frequent word combinations during this period and notes that speech may still be hard for unfamiliar listeners to understand. Difficulty being understood should be considered alongside language use and understanding; occasional sound errors are different from having very few ways to communicate.

Ask nursery staff for one or two specific examples rather than a general label such as 'quiet'. Record whether your child can request help, share an idea or respond during a familiar activity, and whether the difficulty changes between home and nursery.

Compare your child's communication with ASHA's 3–4-year checklist and discuss several missing skills or persistent difficulty making themselves understood. Sound development also depends on the languages spoken. An English sound checklist should not be treated as a diagnostic test for a Tamil-speaking child.

Tell the SLP what unfamiliar listeners understand, what teachers notice, and whether the child becomes frustrated or avoids speaking. If previously acquired communication skills have been lost, tell your child's doctor promptly rather than waiting for a routine therapy appointment.

Bring the child's age, hearing or developmental reports if available, a short list of communication examples and the languages used at home and school. Ask what the assessment covers, whether hearing needs further evaluation, and how any recommended goals will be reviewed.

DARC's Chennai speech therapy pages explain the service and the Ashok Nagar and Pallikaranai pathways. The next step is to clarify the concern with an appropriate professional, not to assume a fixed therapy frequency from a checklist. Developmental guidance here is educational and does not replace assessment.