|

Expert Iconexpert advice MORE

Two-Year-Old Still Not Speaking

Pediatrics Expert Advice from Henry Bernstein, M.D.

Q: My sister's boy is now two years and four months old and has yet to peep one single word. When he tries, all that comes out is a googeley sound. She refuses to take him in to get checked, as she is afraid to hear something is wrong with him. He's very smart and seems to be able to hear you when you speak to him. Is this normal or could he have a birth defect?

A: Assuming your nephew is a healthy pre-schooler, has not had any significant past medical history, and is otherwise developmentally normal, I feel there is cause for concern. I agree with you that he should be saying more words by this age. In fact, we would expect him to already have a better than 50-word vocabulary and be able to put two words together. A normal child's speech also has progressively improved clarity--roughly half intelligible by two years of age, moving toward fully intelligible by four years.

It would be very worthwhile having your sister speak with his physician, so an appropriate referral for evaluation can be made. Your nephew may just have some difficulty in producing or expressing speech. Although this type of problem can occasionally be traced to a specific underlying factor, it is much less common to identify a "birth defect." I am glad that you think he hears well and is able to follow directions, but I generally would still confirm normal hearing. Help your sister to understand that the earlier something can be identified and treated, the less likelihood for any life-long problem and the brighter the future should be for your nephew.

More on: Expert Advice

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 FamilyEducation.com 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.

stay connected

Sign up for our free email newsletters and receive the latest advice and information on all things parenting.

Enter your email address to sign up or manage your account.

Facebook icon Twitter icon Follow Us on Pinterest

editor’s picks

highlights

Join BIC on our mission to save handwriting and Fight For Your Write! Writing helps kids become better readers, boosts their confidence and sparks their creativity. Visit BICFightForYourWrite.com to sign our petition to save handwriting!

7 Fun Driveway and Sidewalk Games for Kids
Looking for classic outdoor games kids can play in the driveway or on the sidewalk, just like the good ol' days? From hopscotch to bubble-blowing contests, there's something for all ages!

Kindergarten Readiness App Wins Gold
Our Kindergarten Readiness app won the Gold Award of Excellence in the educational category at the 2014 Communicator Awards. This valuable checklist comes with games and activities to help your child practice the essential skills she needs for kindergarten. Download the Kindergarten Readiness app today!

Best Sun Safety Practices for Babies
Follow these sun safety practices for babies to ensure your little one stays safe on the beach and on sunny days all year long.