Speech Therapy for Toddlers

Speech therapy is a treatment led by a speech and language pathologist (SLP) or speech therapist. It helps a person communicate and speak more clearly. Toddlers may develop language or speech impairments due to illness, hearing problems, or brain disorders.

This article covers speech and language milestones, causes of speech disorders, diagnosis, what happens in speech therapy, and how parents can help their toddlers. 

What Is Speech Therapy?

Speech therapy is a treatment that helps a person speak or communicate more effectively. It is performed by specially trained speech and language pathologists (SLPs) or speech therapists. They help their patients better understand others, pronounce words clearly, or put words together. 

There are different types of speech therapy and their use will depend on the age of the child and what they are experiencing. For example, therapy practices vary for children with apraxia (difficulty pronouncing different syllables), stuttering, aphasia (difficulty speaking due to damage to the brain), and difficulty swallowing, and for late talkers.

Language Development (Newborn to Toddler)

While delay does not always mean there’s a problem, it’s important to recognize when a toddler misses a developmental milestone. The following are general guidelines of speech and language development for babies and toddlers:

0–6 Months

Newborns communicate through crying. Their cries may sound the same at first but start to vary as they grow. They also cry to express emotions, and parents begin to understand what different cries mean.

Newborns pick up on rhythms of speech and their parents' voices within the first few weeks of life. Between 1 and 4 months old, they become more alert to sounds and may startle more easily or turn to look for the source of the noise. 

Around 2 to 3 months old, infants start smiling and cooing, which often sounds like "ah" or "eh." Babies begin laughing by 3 to 4 months old. 

By 5 or 6 months old, infants imitate adult sounds produced by babbling or shrieking. Babbling involves repeating sounds such as "ba," "ma," or "ga." 

7–12 Months

Seven-month-old infants hear words as distinct sounds and try to repeat them. By 9 months old, they start to understand expressions and simple commands like "no," recognize words for objects, and respond to their names.

Ten- to 12-month-olds follow simple commands such as "give mommy your cup." They also begin to say simple words such as "dada" or "bye-bye."

13–18 Months

By 18 months, a toddler puts two words together and says phrases such as "push it." They often communicate in gestures that get more complex over time.

Toddlers this age start recognizing objects, body parts, pictures, or people. For example, if you ask, "Where is your nose?," they will be able to point to it. 

19–24 Months

By 24 months old, toddlers know and say 50 or more words. They start to form two- to three-word sentences. Two-year-olds can usually communicate their needs, such as “I want more milk,” and follow two-step commands.

Signs of Speech or Language Delay in Toddlers

The following are general guidelines to help parents know if they should have their young child evaluated for speech or language problems:

• A baby who does not vocalize or respond to sound
• A 1-year-old who does not use gestures, such as pointing
• An 18-month-old who would rather use gestures than sounds
• An 18-month-old who has difficulty imitating sounds or understanding simple requests
• A 2-year-old who imitates speech but doesn’t talk spontaneously
• A 2-year-old who can say words but not communicate more than their immediate needs or follow simple directions
• A 2-year-old who has a raspy or nasal-sounding voice

Causes

Speech or language delays can occur due to problems with the structures of the mouth, head injuries, chronic illnesses, or brain disorders. 

If the cause is a brain disorder, it can be difficult to coordinate their tongue, lips, and mouth to make sounds or words. 

Hearing problems can make it difficult to imitate or understand language. This is not always a problem that is apparent at birth. Chronic ear infections can cause hearing damage in one or both ears.

Diagnosis

A speech therapist will perform tests with your toddler to check the following:

• What your child understands
• What your child can say 
• Clarity of speech
• How the structures in their mouth work together to form words and eat

The following are diagnostic tests or scales a speech therapist may perform with your toddler:

• Bayley Scales of Infant and Toddler Development (Bayley-III): Bayley-III is used worldwide to measure all aspects of development from birth to 42 months. A speech therapist administers the language portion by watching the child follow instructions and identify people and objects. It helps them know if the child is on track or needs further evaluation. 
• Preschool Language Scales–Fifth Edition (PLS)-5 English: The PLS-5 is an interactive screening tool designed for infants and young children. Speech therapists measure all areas of language through a play-based approach. 
• Differential Ability Scales Assessment–Second Edition (DAS-II): The DAS-II provides a scale to help speech therapists better understand how a child processes information. This allows them to develop appropriate activities for therapy.
• Goldman-Fristoe Test of Articulation 3 (GFTA-3): The GFTA-3 involves asking a child to identify colorful drawings and measures their ability to pronounce consonants.
• The Rossetti Infant-Toddler Language Scales: This test is specifically designed for children from birth to 36 months old. It involves a parent interview, as well as observation of the child performing tasks.
  

What Happens During Speech Therapy?

The speech therapist will plan and perform activities to help your toddler with skills based on their specific needs. Therapy may occur in small groups or individually. 

Language building activities include using picture books, repetition, talking, and playing. If a toddler has difficulty pronouncing certain words, the therapist will teach them how to make the sound or say specific words. 

Sometimes speech therapists help toddlers with speech mechanics. This involves teaching them how to move their mouth or tongue to pronounce a word. They may also prescribe lip, tongue, or jaw exercises to continue at home.

How Can Parents Help?

It helps to talk and read to your child frequently. Use correct names and speak in a slow and clear voice. When giving direction, keep things simple. Kneeling to their level can them focus on what you are saying.

If your child points at a glass of water, help them connect the gesture and language by asking, “Do you want water?” When they don’t pronounce words accurately, emphasize the correct pronunciation when responding.

Summary

Chronic illnesses, brain disorders, and hearing problems can cause a toddler to have delayed speech or language development. Speech therapy can help them learn to communicate more effectively. 

Parents can help by talking to their children often, speaking clearly, and emphasizing correct pronunciation. If your child is in speech therapy, it’s helpful to perform exercises prescribed by your speech therapist at home.

A Word From Verywell

Not all children follow a typical timeline for speech and language development. Sometimes they are focused on learning a new task, such as walking, and put language development on the back burner. They often catch up later. 

If your toddler is experiencing a language or speech delay, talk with your child’s healthcare provider. If there is a problem, getting help early can make a difference.