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Speech Problems in Two-Year-Old

Pediatrics Expert Advice from Henry Bernstein, M.D.

Q: Should I be concerned about my two-year-old's speech? He's not talking much. Don't get me wrong -- he's always babbling about something, and tries very hard to say words, but does not have very much success. Blue comes out "buuue," yellow is "eeooww," water is "I," truck is "uck," etc. He always points to things and strives to say them, which I think is very good that he is trying - -and I try to pronounce the words as clearly as possible for him. I don't use his version of the word. I know what he's trying to say, but I always say it in the proper way. Someone told me their child did the same thing and he had plugged-up ears and couldn't hear certain sounds. My son did have a lot of ear infections. Is there something I should be concerned about, or is it just normal growth?

A: Lots of parents raise concerns about their child's speech because there is a wide range of speech. Most kids at 2 years of age have close to a 50 word vocabulary and are already putting 2 words together. Some are more advanced; others are less. We do like to know that children are hearing normally. If they can't appreciate the sound coming in, they may not learn to pronounce the sound when it comes out.

You'd probably know whether your child had a hearing problem or not. If he's watching a television show or you're speaking with him--does the volume need to be louder than normal? If you ask your child to do something, will he do it, look quizzically, or seemingly not even pay attention to what you're saying? His pediatrician can look at his ears to see if there is any fluid accumulation. If there is, it can often be managed medically.

If hearing is normal, I would just continue what you're doing and not push him. The improvement in quality and quantity of speech can be quite dramatic, but it does take time and patience on your part. Follow his speech with his pediatrician over time--not daily, but over months and from year to year. Certainly, if there is improved clarity with his speech, an increase in the number of vocabulary words, and in putting more words together, there would be no further reason for concern.

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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.

Please note: This "Expert Advice" area of should be used for general information purposes only. Advice given here is not intended to provide a basis for action in particular circumstances without consideration by a competent professional. Before using this Expert Advice area, please review our General and Medical Disclaimers.


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