Speech Delay in a 2 Year Old: When to Worry and What to Do
Most 2 year olds put two words together, like "more milk," and point to pictures in a book when you ask. If your child is not doing these things by 24 months, talk with your pediatrician and ask for a speech and language evaluation. Many late talkers catch up, but an early check is free in California for children under 3 and tells you where your child stands.
We know this is a worrying time for parents. Every child grows at their own pace, and a delay is not anyone's fault. This post explains the milestones, what the research says about late talkers, and the steps to take in Burbank and Los Angeles County.
Quad Therapy Inc. is a California therapy company founded by a licensed physical therapist. We provide in-home therapy so patients can get care without clinic wait lines, and we place qualified therapists with clinics, schools, and facilities that need staff.
Key facts
At least 75% of children say two words together by 24 months, based on the CDC and American Academy of Pediatrics milestones.
10 to 20% of 2 year olds are late talkers, according to the American Speech-Language-Hearing Association (ASHA).
50 to 70% of late talkers catch up to other children by late preschool or school age.
25% delay in one area of development can qualify a child under 3 for California Early Start.
45 days is the deadline for Early Start to finish the evaluation and family plan after a referral, at no cost for the evaluation.
When should I worry about my toddler's speech?
Talk with your child's doctor if your child is not putting two words together by 24 months. The CDC and the American Academy of Pediatrics updated their milestones in 2022, as described in Zubler and colleagues in Pediatrics. Each milestone is something at least 75% of children do by that age, so missing one is a real reason to check, not a reason to panic.
By 18 months, most children try to say 3 or more words besides "mama" or "dada" and follow simple directions without gestures. By 24 months, most children:
Say at least two words together, like "more milk"
Point to things in a book when you ask, like "Where is the dog?"
Point to at least two body parts when you ask
Use gestures beyond waving and pointing, like nodding yes or blowing a kiss
By 30 months, most children say about 50 words and use words like "I," "me," or "we." Call your pediatrician right away if your child loses words or skills they used to have, does not respond to their name, or does not seem to understand simple words.
What is a late talker?
A late talker is a toddler whose talking starts late while other areas, like movement and play, are on track. ASHA's practice portal on late language emergence describes a common definition: fewer than 50 words and no two-word phrases by 24 months.
About 10 to 20% of 2 year olds fit this description. Boys are about 3 times more likely to be late talkers than girls. A family history matters too: in one large study, 23% of children with a family history of late talking were late talkers, compared with 12% of children without that history. Late talking is also more common in twins and in children born early or small.
Can a child grow out of a speech delay?
Many do. About 50 to 70% of late talkers catch up to other children by late preschool or school age, according to ASHA. That still leaves a large group who do not catch up on their own. One study found that at age 7, about 20% of children who were late talkers had a language disorder, compared with 11% of other children.
Some signs point to better odds. A 2017 review of 20 studies with 2,134 children found that late talkers who understood more words and had bigger vocabularies as toddlers tended to talk better later. A child who understands a lot but says little is in a different place than a child who also struggles to understand. An evaluation helps you tell the difference, so waiting and hoping is not the safest plan.
Does speaking two languages cause speech delay?
No. ASHA says learning two languages does not cause late talking, and bilingual children learn words at the same rate as other children when you count both languages together. Many families in Los Angeles County speak Spanish, Armenian, Korean, Tagalog, or another language at home. Keep speaking the language you know best. ASHA states that switching to one language should not be advised as a response to a speech delay.
A good evaluation looks at all the languages your child hears. Tell the speech-language pathologist (SLP) which words your child says in each language.
What happens at a speech evaluation for a toddler?
A speech-language pathologist (SLP) evaluates how your child understands language, how they express themselves with words and gestures, the sounds they make, and how they play and interact. Most of the visit looks like play. The SLP will also ask about your child's birth, health, and family history, and may use standard tests made for toddlers.
Hearing comes first, because a child who cannot hear well cannot learn to talk well. An SLP can do a pass or fail hearing screening. If your child does not pass, or cannot finish the screening, the SLP will refer you to an audiologist for a full hearing test. Only an audiologist does full hearing testing.
A speech delay alone does not mean a child has autism. The American Academy of Pediatrics recommends that doctors screen all children for autism at 18 and 24 months. If the SLP notices signs that need a closer look, they will share them with you and your pediatrician.
Does speech therapy work for toddlers?
Yes, especially when parents are part of it. A 2019 review in JAMA Pediatrics of 76 studies found that when therapists coach parents to use language strategies at home, children's language improves. The gains were small to moderate for children at risk of a language delay and large for children with a diagnosed language disorder.
This is why toddler speech therapy often happens at home, during play, meals, and bath time. Your SLP will show you simple things to do every day, such as:
Talk about what your child is doing and looking at, using short sentences
Wait a few seconds after you ask a question, so your child has time to try
Add one word to what your child says. If they say "ball," you say "big ball"
Read together every day and let your child point and turn pages
Keep screens off for children under 18 months, except video chats with family, as ASHA advises
These habits help every child, but they do not replace an evaluation if you are worried.
How do I get a free speech evaluation in California?
Children under 3 can get a free evaluation through California Early Start, the state's early intervention program run through regional centers. Anyone can make a referral, including a parent, so you do not need a doctor's order. A child qualifies with a 25% or greater delay in one area, such as communication. Family income and immigration status do not affect eligibility.
Within 45 days of the referral, Early Start must complete the evaluation and, if your child qualifies, write an Individualized Family Service Plan (IFSP). There is no charge for the evaluation, assessment, or service coordination. To find your regional center, call the Early Start BabyLine at 800-515-2229 or email [email protected].
Early Start ends at age 3. About 90 days before the third birthday, the team plans the move to services through your school district or other programs. This is one more reason not to wait until 3 to ask for help.
Does my pediatrician screen for speech delay?
Your pediatrician watches development at every well visit, but there is no single required speech screening test. In 2024, the U.S. Preventive Services Task Force said there is not enough evidence to recommend for or against routine speech screening for children whose parents have no concerns. That statement does not apply when you have a concern. If you are worried, say so clearly at the visit and ask for a referral.
Can my child get speech therapy at home in Burbank?
Yes. Quad Therapy Inc. provides in-home speech therapy for children in Burbank and across Los Angeles County, including Glendale, Pasadena, North Hollywood, and the San Fernando Valley. Toddlers often do best in a familiar place with their own toys, and parents can join every session. You can learn more about Quad Therapy Inc. on our website. Some children with speech delays also have fine motor, feeding, or play needs that an occupational therapist can help with. Read our post on occupational therapy vs physical therapy to learn how those services differ.
Frequently asked questions
How many words should a 2 year old say?
There is a wide normal range. Most children say about 50 words by 30 months, and fewer than 50 words with no two-word phrases at 24 months is a common sign of a late talker.
Should I wait until my child is 3 to see if they catch up?
No. About 30 to 50% of late talkers do not catch up on their own, and California Early Start ends at age 3. An evaluation is free through Early Start and does not commit you to therapy.
Do I need a doctor's referral for Early Start?
No. Anyone can refer a child to Early Start, including parents. Call the Early Start BabyLine at 800-515-2229 to find your regional center.
Should we stop speaking our home language?
No. Speaking two languages does not cause speech delay. Keep using the language you speak most comfortably with your child.
Does a speech delay mean my child has autism?
Not by itself. Many late talkers develop typically in every other way. Your pediatrician screens for autism at 18 and 24 months and can refer you for a full evaluation if needed.
About Quad Therapy
Quad Therapy Inc. is a therapy company in Burbank, California, founded by a licensed physical therapist. We go to the patient. Our licensed therapists provide [SERVICES] in the home, and we staff clinics, schools, and facilities with qualified therapists. Every service is provided by a clinician licensed by the matching California board and stays within that board's scope of practice. To schedule a visit or ask about staffing, call (855) 313-3201 or visit quadtherapy.com. Our office is at 455 N Moss St, Suite 102, Burbank, CA 91502.
Next step: if your 2 year old is not putting words together yet, write down the words your child says this week and bring the list to your pediatrician. You can also call us at (855) 313-3201 to ask about an in-home speech evaluation.
This article is for education. It is not medical advice. Talk with a licensed clinician about your situation.
Sources
Zubler JM, Wiggins LD, Macias MM, et al. Evidence-informed milestones for developmental surveillance tools. Pediatrics. 2022;149(3):e2021052138. Clinical report. doi.org
Centers for Disease Control and Prevention. Important milestones: your child by two years. cdc.gov
American Speech-Language-Hearing Association. Late language emergence (practice portal). asha.org
Fisher EL. A systematic review and meta-analysis of predictors of expressive-language outcomes among late talkers. J Speech Lang Hear Res. 2017;60(10):2935-2948. Systematic review. doi.org
Roberts MY, Curtis PR, Sone BJ, Hampton LH. Association of parent training with child language development: a systematic review and meta-analysis. JAMA Pediatr. 2019;173(7):671-680. Systematic review. Northwestern University summary
Hyman SL, Levy SE, Myers SM; Council on Children with Disabilities. Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics. 2020;145(1):e20193447. Clinical report. doi.org
U.S. Preventive Services Task Force. Screening for speech and language delay and disorders in children 5 years or younger. JAMA. 2024. Recommendation statement. uspreventiveservicestaskforce.org
California Department of Developmental Services. Early Start frequently asked questions, December 2025. dds.ca.gov