Should I worry if my 18-month-old isn't talking?
Not panic, but don't wait it out either. By 18 months, most children try to say three or more words besides "mama" or "dada." If your child isn't, mention it to your doctor and ask for a hearing test. Many late talkers catch up, but nobody can tell in advance which ones will, and early help is never wasted.
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The short answer: ask now, calmly
The CDC's milestone for 18 months is that most children try to say three or more words besides "mama" or "dada," and follow a one-step direction without a gesture, like "Give it to me." Each item on the CDC checklists is something 75% or more of children do by that age.
So a missed milestone isn't a diagnosis. Most children who miss one turn out fine. But "every child is different, let's wait and see" is a poor fit, because waiting alone doesn't tell you anything. A missed milestone means one thing: ask. Asking costs you nothing.
One situation is different. If your child loses words they used to say, stops babbling or stops making eye contact, don't wait for a checkup. Call your doctor now. There's often an explanation, and you want a professional looking for it soon.
Look at the whole picture, not just words
Talking is one piece. Your doctor will want to know about the rest, so it helps to notice these at home. At 18 months, the CDC says to ask your doctor if your child is not yet:
| Area | Most 18-month-olds |
|---|---|
| Words | Try to say 3 or more words besides "mama" or "dada" |
| Understanding | Follow a one-step direction without gestures ("Give it to me") |
| Pointing | Point to show you something interesting |
| Moving | Walk alone |
A toddler who understands a lot, points to share things with you and is trying to communicate in other ways is giving your doctor useful information. So is a toddler who doesn't. Write down what you see either way.
The CDC also lists some social signs worth raising, such as not responding to their name by 9 months, not playing simple back-and-forth games like pat-a-cake by 12 months, or not pointing to show you something by 18 months. Plenty of children who show one of these aren't autistic. That's why screening exists, and it's routine at this age.
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Late talkers: the honest numbers
About 10% to 20% of 2-year-olds are "late talkers," meaning their language starts late while the rest of their development is on track. Boys are about three times more likely to be late talkers than girls. Roughly half to two-thirds catch up to their peers by late preschool or school age, though many still score a little lower on some language tests.
That's genuinely reassuring: most late talkers do fine. It also explains why waiting isn't a plan. You can't know in advance which children will catch up, and early help has more time to work when it starts early.
If your family speaks more than one language, count words in every language. Children learning two languages follow the same broad pattern, and mixing languages is normal. See does raising a child bilingual cause speech delay.
What to ask your doctor for
- A hearing test. Any time speech is a concern, ask for a hearing test too, even if your baby passed the newborn screen. A child can't copy sounds they can't hear well, and passing the newborn screen doesn't rule out hearing loss that starts later.
- The developmental screen. The AAP recommends developmental screening at 9, 18 and 30 months, and autism screening at 18 and 24 months, or any time a parent has a concern. If your practice skips it, ask: "Can we do the developmental screen today?"
- A speech-language evaluation. Ask how to reach a speech-language pathologist or your local early intervention program.
Before the visit, write your concern in one or two sentences, make a list of the words your child says, and take a short phone video. Toddlers rarely perform on cue in an exam room. In the room, say your concern first. If you hear "let's wait and see," ask: "What would you need to see to be concerned? When should we check again?" Then book that recheck before you leave.
You can call early intervention yourself
In the US, you don't need a doctor's referral to get your child evaluated. The CDC states plainly that a referral is not necessary. You can phone your state's early intervention program yourself (find it at cdc.gov/FindEI) and ask for an evaluation.
Every US state runs an early intervention program for children under 3. The evaluation, a family service plan and a service coordinator are provided at no cost to families. Some states charge a sliding-scale fee for certain services, but services can't be denied because a family can't pay. An evaluation may say your child doesn't qualify. That's still useful information, and you can ask what to watch and when to check again.
What to do at home starting today
- Offer choices. "Apple or banana?" The word is right there for them to grab.
- Wait. Count to five after you speak. A toddler needs time to find words.
- Answer every point. Look where they point, name it, and bring it closer.
- Expand any word or sound. "Ba!" becomes "Ball! A big red ball."
- Sing with a gap. Stop before a key word in a familiar rhyme and wait for any sound.
- Turn off background TV during meals and play.
More ideas in how to get your toddler to talk more and can screen time cause speech delay.
Do this
- Write down every word your child says, in all languages, and take a short video.
- Raise it first thing at the next visit and ask for a hearing test.
- Ask whether the routine 18-month screens were done, and ask for them if not.
- Call your state's early intervention program yourself if you're worried and your child is under 3.
- Offer choice questions and wait five seconds for an answer, every day.
When to ask your doctor
Check with your doctor or midwife first if…
- Your child was born early: ask your doctor which age to use when you check milestones.
- Your child passed the newborn hearing screen but you're unsure they hear well: ask for a hearing test anyway.
- Your family speaks more than one language: count words in all of them.
Call your doctor now if…
- Your child loses words, babbling, eye contact or other skills they used to have: call your doctor now.
- Your child doesn't seem to react to sounds or to your voice: ask for a hearing test as soon as possible.
- Your child doesn't point to show you things or doesn't respond to their name: mention it to your doctor.
- Your child isn't walking alone by 18 months: raise it at the next visit or sooner.
This page is general information, not medical advice. Every pregnancy and every child is different. Ask your doctor, midwife or pediatrician before changing supplements, diet or care.
Grow a Genius
In the book: Chapter 20: The Word Explosion
The book explains late talking and when to check, Chapter 28 shows how to talk to your pediatrician and get early help, and The Milestone Map gives you a calm month-by-month self-check.
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People also ask
Is it normal for an 18-month-old to say only one or two words?
It's below the CDC milestone, which is trying to say three or more words besides "mama" or "dada" by 18 months. Many children who are behind at this age catch up, but it's a good reason to ask your doctor about a hearing test and the developmental screen.
Besides words, what should I mention to the doctor?
How your child understands, points and connects. The CDC lists social signs worth raising, like not pointing to show you things, not responding to their name, or not playing back-and-forth games. Plenty of children who show one are fine. The AAP recommends routine screening at 18 and 24 months for every child, so ask for it.
Will my 18-month-old catch up on talking?
Many do. Roughly half to two-thirds of late talkers catch up by late preschool or school age. But nobody can predict which children will, so getting a hearing test and an evaluation now is the safer path.
Do I need a referral for early intervention?
Not in the US. The CDC says a doctor's referral is not necessary. You can call your state's early intervention program yourself for a child under 3. The evaluation is free for families.