5 Red Flags That Your Child Might Need a Speech Assessment

If you're reading this, there's a good chance you've been lying awake at night wondering whether your child's speech is where it should be. Maybe your toddler isn't saying as many words as other children their age. Maybe they're not responding when you call their name. Maybe you've mentioned it to a friend or family member and they've said, "Oh, they'll catch up — don't worry."

You're not overreacting. And you're definitely not alone.

Concerns about speech and language development are one of the most common reasons parents seek professional advice. The truth is, most parents I speak to have had that nagging feeling for a while before they actually reach out. The good news? There's a lot you can do — and the earlier you look into it, the better.

Not sure where your child's speech and language is right now? Our free quiz can help you check whether things are on track for their age.

What Does Typical Speech Development Look Like?

Before we talk about speech delay red flags, it helps to know what's broadly typical. I say "broadly" because every child is different — some children are early talkers, some take their time, and that's completely normal. These milestones are a general guide, not a rigid checklist. If you'd like the full timeline, see When Should My Toddler Start Talking?.

• 1 to 1.5 years: Your child's first few words start appearing — things like "mama," "dada," "no," or "more." They might not be perfectly clear, and that's fine at this stage. They should also be pointing, waving, and showing you things.

• 2 to 2.5 years: You'd expect to hear lots of single words — and they should be starting to put two words together, like "mummy help," "red car," or "more juice." They should understand simple instructions like "get your shoes."

• 3 years: Most children are using three-word combinations and starting to form short sentences. Their vocabulary is growing quickly, and other people (not just you) should be able to understand a good portion of what they say.

• 3 to 3.5 years: By this age, most speech sounds should be clear, with a few exceptions. You might still hear the odd sound substitution, but overall, they should be fairly easy to understand.

• 4 to 5 years: Very few sounds should still be unclear. You should understand almost everything your child says, even out of context. They should be telling you about their day, asking questions, and having proper back-and-forth conversations.

It's worth saying again — these are guidelines. Some children hit these milestones early, some a little later. What we're looking for are patterns, not isolated moments. If your child is a bit behind on one thing but doing well in other areas of communication, that's different from a child who's behind across the board.

Key takeaway: Milestones give you a helpful reference point, but they're not a pass-or-fail test. What matters most is the overall pattern of your child's communication.

What Are the Red Flags to Watch For?

So, when should you actually be concerned? These are five signs your child might need a speech therapy assessment. Noticing one or two of these doesn't necessarily mean there's a problem — but it does mean it's worth looking into.

1. Your Child Isn't Using Words by 18 Months

By around 18 months, most children have at least a handful of words they use regularly. If your child is relying almost entirely on gestures — pointing, pulling your hand, crying to communicate — and not really using any recognisable words yet, that's something to pay attention to.

Some children are "late talkers" who do catch up on their own. But here's the thing: we can't always predict which children will catch up and which ones won't. An early assessment doesn't commit you to anything — it just gives you a clearer picture of where your child is and whether they might benefit from some support. If you're unsure whether to keep waiting, this guide on "Wait and See" or Act Now can help.

2. Your Toddler Isn't Responding to Their Name

This is one that parents often notice but aren't sure what to make of. If your toddler is not responding to their name consistently — and I don't mean every single time, because toddlers are easily distracted — but if they rarely look up or acknowledge you when you say their name, that's worth exploring.

Not responding to their name can be linked to several things. It might be a hearing concern, it might relate to attention and focus, or it could be an early sign of social communication difficulties (like autism). It doesn't automatically mean any of those things, but it's one of those signs where a professional can help you work out what's going on.

Key takeaway: A toddler not responding to their name doesn't always mean something is wrong — but it's one of those things that's always worth checking.

3. You Can't Understand Most of What Your Child Says by Age 3

If your child is talking — maybe even talking a lot — but you're struggling to understand what they're saying, that's a red flag worth paying attention to. By around three years old, familiar adults (that's you, grandparents, nursery staff) should be able to understand most of what your child says.

If you find yourself constantly translating for other people, or if even you are only catching bits and pieces, it might be that their speech sounds aren't developing as expected. This is different from a language delay — they might have plenty of words and ideas, but the sounds aren't coming out clearly enough for others to understand. If this sounds familiar, My Child Says "Tat" Instead of "Cat": Should I Worry? explains typical sound patterns by age.

This can be really frustrating for children. Imagine having something to say and nobody understanding you. That frustration often shows up as tantrums, withdrawal, or children going quiet because it's easier than trying and not being understood.

4. Your Child Isn't Putting Words Together by Age 2.5

Single words are brilliant — they show your child is making connections between words and meanings. But by around two to two and a half, we'd hope to see them starting to combine words. Things like "daddy gone," "big dog," or "want milk."

If your child has a good bank of single words but isn't joining them together yet, or if they're still mostly using single words well past their second birthday, it might be worth having a conversation with a speech and language therapist. It could just be that they need a little more time, but it could also mean they'd benefit from some targeted support to help them take that next step. You can also try these practical strategies from How to Help Your Late Talker at Home.

5. Your Child Doesn't Seem to Understand What You Say

This one often gets overlooked because parents tend to focus on what children are saying rather than what they're understanding. But understanding — what we call receptive language — is just as important, and difficulties with understanding can be harder to spot.

Signs to look for include:

• Not following simple instructions appropriate for their age (like "put it in the bin" or "get your coat")
• Seeming confused when you ask them questions
• Relying heavily on watching what other children do rather than understanding verbal instructions
• Not responding to familiar phrases or routine language

If your child's understanding seems behind, that's actually one of the more important red flags to act on. Children need to understand language before they can use it, so a gap in comprehension can affect everything that comes after.

Key takeaway: Understanding is the foundation of communication. If your child struggles to follow what you're saying, seeking professional advice sooner rather than later can make a real difference.

What Can You Do at Home Right Now?

While you're working out whether to seek an assessment, there's plenty you can start doing at home today. These are strategies I recommend to almost every family I work with — they're simple, practical, and they work.

1. Set up "special time" every day. This is 10 to 15 minutes of one-on-one time where you sit on the floor with your child, have a couple of toys out, and let them lead the play. Turn off the TV, put your phone away, and just be present. Follow what they're interested in. This builds shared attention and creates natural opportunities for communication — without any pressure.

2. Follow your child's lead. Instead of asking lots of questions or directing the play ("what's this?", "say ball"), watch what your child is doing and comment on it. If they're pushing a car, you might say, "the car's going fast!" If they pick up a block, say "block!" This is called modelling language — you're showing them what words go with what they're already interested in.

3. Get face to face. This sounds simple, but it makes a huge difference. Get down to your child's level so they can see your face, your mouth, and your expressions. Children learn an enormous amount from watching how we talk, and they can't do that if we're standing above them or across the room.

4. Reduce the questions. I know this feels counterintuitive — you want to encourage them to talk. But constant questions ("what's that?", "what colour is it?", "can you say...?") can actually put pressure on children and make them less likely to communicate. Instead, try commenting and narrating. Describe what's happening, what you see, what they're doing. Give them the words without demanding they repeat them.

5. Use simple language at the right level. A good rule of thumb is to use sentences that are one step ahead of where your child is. If they're using single words, you use two-word phrases. If they're using two-word phrases, you use short sentences. This gives them a model they can actually reach, rather than something that feels too far ahead.

6. Read together — and make it interactive. You don't need to read every word on the page. Point at pictures, name things, make sound effects, let them turn the pages. Books are brilliant for building vocabulary, but only if your child is engaged — not if they're squirming to get away. Follow their interest, even if that means spending five minutes on one page.

Every child is different, and what works beautifully for one family might need tweaking for another. If you'd like strategies tailored specifically to your child, a quick assessment can give you a personalised plan and clear next steps.

When Should You Seek Professional Help?

If you've noticed any of the red flags above — or if you've just got a gut feeling that something isn't quite right — it's always worth getting a professional opinion. Parents know their child better than anyone, and that instinct is worth listening to.

You can start by speaking to your health visitor or GP, who can refer you to NHS speech and language therapy. It's worth knowing, though, that NHS waiting times for speech therapy can be 8 to 10 months or more in many areas. That's a long time when your child is at a stage where they're developing rapidly. If that applies to you, NHS Speech Therapy Waiting List Too Long? Your Options outlines what you can do while waiting.

That's one of the reasons I set up Two Golden Words — to give families an option that doesn't involve months of waiting and wondering. A private assessment doesn't have to replace NHS support; for many families, it works alongside it.

What does an assessment actually involve?

You can read a full step-by-step explanation in What Happens in a Speech Therapy Assessment?, but in short:

It's not as intimidating as it sounds. An initial assessment typically includes a detailed conversation with you about your child's history, development, and what you've been noticing at home. We also look at how your child communicates — through a play-based observation that feels natural, not like a test.

After the assessment, you'll get a written report with clear, personalised recommendations — not generic advice, but specific strategies for your child and your family. If onward referrals are needed (for things like hearing tests, autism assessment, or occupational therapy), we'll guide you through that process too.

The goal is always to leave you feeling clearer about where your child is and what to do next.

Frequently Asked Questions

Is it normal for a two-year-old not to talk much?

It depends. Some two-year-olds are naturally quieter talkers who catch up on their own. But by two to two and a half, we'd generally expect to hear lots of single words and the beginnings of two-word combinations. If your child has very few words or no words at all by age two, it's worth speaking to a professional — even just to get some reassurance and guidance.

Should I be worried if my toddler isn't responding to their name?

It's definitely something to look into. A toddler not consistently responding to their name can sometimes relate to hearing, attention, or social communication. It doesn't mean something is definitely wrong, but it's one of those things where an assessment can give you useful information and peace of mind.

Will my child just grow out of their speech delay?

Some children do. But the honest answer is that we can't always predict which children will catch up without support and which ones won't. What we do know is that early intervention is always better — if your child does need help, getting it sooner means they'll have more time to make progress before school. And if they don't need help, an assessment will confirm that and put your mind at ease.

Can online speech therapy really work for young children?

This is something parents ask me all the time, and I completely understand the concern. The key thing to know is that a lot of what we do in early speech therapy is actually parent coaching — we're teaching you the strategies to use at home, every day, during play and daily routines. Your child doesn't need to sit on a screen for 30 minutes. Online therapy removes the stress of travel, the anxiety of new environments (which is especially helpful for children with additional needs), and it means sessions happen in your child's own home, where they're most comfortable. For practical parent-led techniques, How to Help Your Late Talker at Home is a good next read.

How do I know if my child's problem is "serious enough" for speech therapy?

There's no minimum threshold. If you're worried, that's reason enough to seek advice. A good assessment doesn't just identify problems — it can also confirm that your child is developing well, which is valuable in itself. You don't need to wait until things feel serious. In fact, the earlier you look into it, the easier it usually is to make a difference.

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You know your child better than anyone. If something feels off — even if everyone around you is saying "they'll grow out of it" — trust that feeling. Getting a professional opinion doesn't mean there's something wrong. It means you're being proactive, and that's something to feel good about.

If you're not sure where to start, book a free chat and we can talk through what you're noticing. No pressure, no commitment — just a conversation.

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Related Reading

• What Happens in a Speech Therapy Assessment?
• "Wait and See" or Act Now?
• Is My 2 Year Old's Speech Normal?
• My Child Says "Tat" Instead of "Cat": Should I Worry?