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  • Writer's pictureStaci Henderson

To Wait and See ? Or Not ?

Often parents come to their child's well visit with a concern regarding their child's language skills. Pediatricians often ask questions about the speech, language and social skills of their child. Often the statistics that are used for reporting typical vocabulary size in young children actually represents the very bottom range of normal. This means if vocabulary size is less than the range on the chart then there is a cause for concern. These statistics often look similar to this chart:

  • by 16 months: at least one word

  • by 18 months: at least 15-20 words

  • by 24 months: at least 50 words

Many well visit appointments will look like this: Parents and pediatricians will note that their 18 month old has 15 words and the discussion will be to not worry , and to wait 6 months to see how he progresses. This is known as a 'wait and see' approach. For some children, this approach is appropriate as occasionally children who are late talkers do seem to 'outgrow' it, but oftentimes children do not outgrow their delays. For these children, the 'wait and see' approach might not be best.

It is important to note that expressive language development occurs at a prolific rate in typically developing children. Here is a list of what this looks like for children. (Data taken from LinguiSystems Guide to Communication Milestones)

  • 12 months: 2-6 words other than Mama and Dada

  • 15 months: 10 words

  • 18 months: 50 words

  • 24 months: 200-300 words

  • 30 months: 450 words

  • 36 months: 1,000 words

  • 4 years: 1,600 words

Quite a difference between the two charts, right? So for example, if a pediatrician notes your 18 month old is on the bottom range of normal and wants to wait 6 months, then should you wait that 6 months and see if his speech increases on it's own? Remember, in 6 months time, the average developing toddler can gain 150-200 or more words over that 6 month period. For a child who is a late talker, this gap between their peers will only get larger and often leads to extreme frustration for the child and parents.

I often tell concerned parents whose pediatrician uses a 'wait and see' approach to go ahead and ask for a referral for a speech/language evaluation. In my experience, if a parent is worried enough to mention their concerns,then there is usually a good reason. Getting a specialist to assess language skills often can pinpoint what the difficulty is and help the family create a plan to increase their child's communication skills sooner rather than later. This can ease frustration for the child and enable you as the parent to provide your child with a jump start to becoming a great communicator!

If you have any questions about your child's communication skills or want to schedule an evaluation, contact me at or through my website:


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