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Parents of toddlers have been speaking to me in regard to when they should worry if their toddler is not saying many words. Well, let me say a few words about this topic.

It is important for you to know that there is quite a range of variation in speech development in the first two years of life:

¯ By two months of age, babies should be looking into your eyes, cooing, and smiling.

¯ They should be making repetitive sounds like ‘bah’ and ‘dah’ at four to seven months of age.

¯ By eight months of age, they can begin to link meaning to words, phrases and gestures, like “let’s take a bath” or “get into the car” and will respond with laughs and gestures.

¯ And, at a year of age, older infants begin to usually utter single words like “ma-ma” to mom and “da-da” to dad.

¯ Between one and two years of age, toddlers will point to objects of interest such as body parts, and follow simple commands with gestures like waving bye-bye.

¯ At age two, they’ll usually be using a number of words and even two or three-word phrases or sentences with half of their speech being understandable.

¯ Most toddlers will have 20 words by 18 months and 50 words by two years.

When do we worry?

We worry if your baby or toddler doesn’t want to cuddle, return a smile, notice noises in the room, acts as if they are in their own world, and has interests in objects other young children are using rather than the other children themselves.

If these concerns are present, please let your child’s health care professional know.

Hearing and other developmental tests can then be done to identify a speech or language delay.

If a delay is identified, early intervention treatments can get started to help remedy this problem.

Sometimes increasing the time you spend reading and talking with your infant and toddler (if you have not been doing that a lot) will remedy the situation.

Other times, your child’s health care professional may recommend a hearing or speech and language therapist to help your child learn to speak and understand what is being said.

Reading to your child in early infancy is a great way to start getting your young child used to sounds and voice tones and may enable you to identify a potential problem in hearing or understanding sooner rather than later.

Hopefully, tips like these will speak for themselves, or at least help you know when to speak up, if you are concerned that your young child may have a speech or hearing problem.

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Lewis First, MD, is Chief of Pediatrics at The University of Vermont Children’s Hospital and Chair of the Department of Pediatrics at the University of Vermont’s Larner College of Medicine. You can also catch “First with Kids” weekly on WOKO 98.9FM and NBC5.