Young boy practising O sound with speech pathologist in speech therapy

Does My Child Need Speech Therapy? 5 Signs to Look Out For

Every child develops at their own pace especially when it comes to speech and language. Some children chatter away early, while others take their time forming their first words. But when should parents be concerned that their child isn’t talking as expected? And how do you know when it’s time to seek professional help?

Speech and language delays are more common than many parents realise, affecting up to 1 in 5 children during early development (Raising Children Network). While some delays are temporary and resolve on their own, others may require the support of a speech pathologist to help a child communicate clearly and confidently.

Here are five key signs to look out for, along with practical guidance and what to do next.

1. Delayed Speech Milestones

Children follow general developmental patterns when it comes to language, and while there’s a wide range of what’s considered “normal,” certain delays can raise concerns.

By 12 months, most babies should be babbling and responding to sounds around them. By 18 months, they usually have a small set of words typically around 10 to 20 and begin naming familiar objects or people. By the time a child reaches two years, they’re expected to say about 50 words and start forming two-word phrases like “want toy” or “go park.”

If your child isn’t reaching these speech milestones, it may be more than just “a late talker.” Delays in these early stages can be linked to a variety of underlying issues, such as hearing problems, developmental disorders like autism spectrum disorder, or specific speech and language impairments.

Early intervention is crucial. Research shows that children who receive therapy before the age of three often make more significant gains in communication than those who begin later. (National Library of Medicine)

2. Unclear or Difficult-to-Understand Speech

Some mispronunciations are completely normal for young children, especially when they’re still learning to form sounds. However, as they get older, their speech should become increasingly clear and intelligible.

By age three, your child’s speech should be understood by familiar adults most of the time. By age four, people outside the family should understand around 90 – 100% of what your child says. If you find that even you have trouble understanding your child or that they get frustrated when trying to communicate it may be time to investigate further.

Common red flags include:

  • Persistent sound substitutions past the expected age (e.g., “wabbit” instead of “rabbit” at age five)
  • Omitting sounds in words (e.g., “ca” for “cat”)
  • Avoiding speech or getting upset when misunderstood

These could point to articulation issues, apraxia of speech (a motor planning disorder), or phonological processing difficulties. A speech therapist can assess the specific sounds your child is struggling with and create targeted activities to improve clarity.

A young boy finding difficult listening to instructions requires speech therapy

3. Limited Vocabulary or Difficulty Expressing Thoughts

Communication isn’t just about how clearly a child speaks, but also about how well they express their ideas and needs. Some children understand everything being said but struggle to find the right words or form full sentences. This can be a sign of expressive language delay.

Children with expressive language issues might use vague terms (“that thing,” “this one”) or short, incomplete phrases that make it difficult for others to follow. They may leave out key words or mix up sentence structure, especially when telling a story or answering open-ended questions.

Expressive delays can make it harder for children to describe their experiences, express feelings, or participate in play. Over time, this can affect both academic learning and emotional development.

Speech therapy can help children build vocabulary, improve sentence structure, and become more confident in sharing their thoughts with others. Therapy often includes storytelling, role-playing and visual supports to help children form connections between words, actions, and ideas.

4. Trouble Understanding Language or Following Instructions

Sometimes, a child’s communication difficulty lies not in speaking but in understanding what’s being said. This is known as a receptive language delay.

Children with receptive difficulties may appear to “tune out” when spoken to, or may struggle to follow even simple instructions like “Put the toy in the box” or “Get your shoes from the bedroom.” They might also respond inappropriately to questions or rely on copying other children’s behaviour rather than understanding directions themselves.

These issues are often mistaken for behaviour problems or attention difficulties. In reality, they may stem from the child not fully understanding the words or concepts being used.

Speech therapy for children with receptive language delays focuses on improving listening, comprehension, and memory through age-appropriate language activities. The earlier the support is given, the better the outcomes particularly for children preparing to start school.

5. Social or Behavioural Issues Linked to Communication

Language is not just about speaking, it’s central to how we connect with others. That’s why communication delays can sometimes appear as social or behavioural problems.

Children who struggle with communication might:

  • Avoid eye contact or become anxious in social situations
  • Exhibit tantrums or meltdowns due to frustration
  • Have difficulty forming friendships or participating in group play
  • Interrupt conversations or struggle to take turns speaking

These behaviours may be signs that a child feels isolated, misunderstood, or overwhelmed. They may be labelled as “shy,” “naughty,” or “distracted” when the real issue is an inability to communicate effectively.

Speech therapy can address both the language and social aspects of communication. Therapists often work on conversation skills, interpreting non-verbal cues, and building confidence to engage with peers. For children on the autism spectrum or with social communication disorder, these strategies can be especially valuable.

Young girl suffering hearing loss finding difficult to speak

What Causes Speech or Language Delays?

Speech and language delays can result from a range of factors, including:

  • Hearing loss or chronic ear infections
  • Neurodevelopmental conditions (e.g., autism, ADHD)
  • Premature birth or low birth weight
  • Family history of language disorders
  • Environmental factors like reduced verbal interaction at home

It’s important to note that a delay is not a reflection of parenting ability. Sometimes, children simply need extra support to get on track.

What Speech Therapy Involves

Speech therapy isn’t a one-size-fits-all approach. A qualified speech pathologist will first assess your child’s strengths and needs using standardised tools, observation, and interaction. Depending on the results, therapy may focus on articulation, language development, social communication, fluency (stuttering), or a combination of these.

Therapy is usually fun and interactive, involving games, stories, role-playing and repetition in a structured environment. Parental involvement is key, as practising strategies at home can reinforce what’s learned in therapy sessions.

Importantly, seeking help early leads to better long-term outcomes. The brain is highly adaptable in early childhood, and most children make excellent progress with the right support.

Speech therapy session with the kids

When to Seek Help

 If you’re unsure whether your child needs speech delay help, it’s best to trust your instincts. You know your child better than anyone, and if something doesn’t feel quite right, whether they’re late to talk, hard to understand, or struggling socially, it’s worth seeking professional advice.

Start by speaking with your GP or child health nurse. They can refer you to a speech pathologist for assessment and guidance. The earlier the concern is identified, the easier it is to support your child’s development.

At Medsana Medical Clinic in Brisbane, our team of doctors, specialists and allied health professionals work collaboratively to support children with speech and language challenges. Our allied health team offers practical, individualised care designed to empower your child and ease the journey for families.

Final Thoughts

Speech and language skills underpin so many areas of a child’s life from learning and literacy to social development and emotional wellbeing. If your child is experiencing any of the signs mentioned above, you don’t need to wait and see. Early speech therapy for children can make a world of difference, giving them the tools they need to thrive in their own time and way.

Whether your child is just starting to speak or preparing for school, getting support early can change their future.

Is Your Child Showing Signs of Speech Delay?

Contact Medsana Medical Clinic today to book an appointment with our team of experienced professionals. We’re here to help your child grow, connect and communicate with confidence.

References

Timely PCR Swab Service

Available between 8:30am – 9am

 

  1. Short Telephone Consult with the patient – bulk billed if Medicare eligible. Private fees with no Medicare rebates apply if the patient has not seen us in the last 12 months.
  2. The doctor will request a respiratory panel for viruses and bacteria (where clinically appropriate).  For example, Influenza, Covid, RSV, mycoplasma, pertussis and so forth.  Not all possible infections are on this panel.  The doctor may decline the request if it is not appropriate and direct the patient accordingly.
  3. Normal fees will apply if more than swabbing is requested.  Clinical examination and other requests requires a normal consultation at another time.
  4. Patient arrives at the car park next to Building 10 before 11am.  Or takes the pathology request to another 4Cyte collection centre.
  5. Patient calls reception to notify of their arrival so the 4Cyte Pathology Collector can gown up and go the patient’s car to swab the patient.
  6. PCR swab gets sent to 4Cyte.  The processing times varies according to workflows.
  7. 4Cyte will SMS the patient with the Covid results.  Positive PCR test results for other respiratory viruses or bacteria are not named.  A negative PCR result doesn’t mean the patient is infection free.  These swabs narrow down the possibilities and guide appropriate treatments.
  8. An appropriate appointment needs to be made for results in person, via video or via phone.  Normal fees applies for these consult.  Normal fees applies if the doctor calls the patient for further clinical advice and management.