How do I know if my child needs speech therapy?

Book an assessment if your child has lost words they used to use, has fewer than about 50 words at two, is still on single words at two and a half, is hard for strangers to understand at four, does not respond to their name, or is getting frustrated and avoiding talking. A single mispronounced sound at the age it normally settles is not a reason on its own.

Is it worth getting a speech assessment if I am not sure?

Yes. An assessment either reassures you or starts help early, and early is when this work is most effective. Speech-language pathologists see uncertain parents constantly and a discharge with reassurance is a normal, useful outcome — not a wasted appointment.

At what age is speech delay a concern?

The clearest early marker is around age two: fewer than about 50 words, or no two-word combinations, is worth an appointment. Before that, no babbling by 12 months or no pointing by 18 months are the signals. At any age, losing words a child previously used should be seen promptly.

Will my child grow out of it?

Many children do, which is exactly why the advice to wait is so common — and why it is unreliable. Nobody can tell in advance which children are the ones who will not, and the children who need help do better the earlier it starts. An assessment answers the question rather than gambling on it.

Does being bilingual cause speech delay?

No. Growing up with two languages does not cause speech or language delay. Count your child's words across both languages together rather than in one, and treat any advice to drop a language with scepticism — a delay in a bilingual child needs assessing on its own merits, not blaming on the second language.

How much does a speech assessment cost?

In the US, Early Intervention under age three and school district services from three are free, and both take parent referrals. Private assessment is typically a few hundred dollars, with sessions commonly around $100 to $250 an hour. In the UK, NHS therapy is free and most areas accept parent self-referral. See [what speech therapy costs](/guides/how-much-does-speech-therapy-cost) for the detail.

Can an app tell me if my child needs speech therapy?

No, and any app claiming to screen or diagnose should be treated with suspicion. Help Me Talk is a practice app — it does not assess, diagnose or flag anything. Its job is the daily repetition between sessions, or while you are on a waiting list, not deciding whether you need one.

Guide

Does my child need speech therapy?

Most parents asking this have been told to wait and see by somebody, and are not sure whether that was reassurance or a brush-off. This page gives you the same rough sorting a speech-language pathologist does at a first appointment: which signs mean book now, which are ordinary for the age, and what an assessment actually involves so it is less daunting to arrange.

The short answer

Book an appointment now if your child has lost words they used to say, does not respond to their name, has fewer than about 50 words at age two, is still using single words at two and a half, is hard for strangers to understand at four, or is becoming frustrated and avoiding talking. A single mispronounced sound at the age it normally settles is not a reason on its own — R and TH often are not solid until six or seven.

The signs that mean book an appointment

Any one of these on its own is enough. You do not need several, and you do not need to wait for the next check-up.

They have lost words they used to say. At any age, this is the one that should be seen promptly rather than watched.
They do not respond to their name, or seem not to hear you. Hearing is checked first in any speech assessment for a reason — it is a common and very fixable cause.
Fewer than about 50 words at two years old, or no two-word combinations by around two and a half.
Strangers cannot understand them at four. A rough guide many clinicians use: about half understandable at two, three-quarters at three, and nearly all at four.
They are frustrated, giving up, or avoiding talking. The emotional signal matters as much as the speech one, and it is the one parents notice first.
They repeat or block on sounds and are becoming aware of it. Some dysfluency is normal between two and five; struggle, tension or avoidance is worth an early opinion.
Something feels wrong to you and you cannot name it. Parents are usually right about this, and no clinician will think you wasted their time.

The things that worry parents but are usually fine

These come up constantly, and most of them resolve without any treatment at all.

"Wabbit" for rabbit at four. R is one of the last sounds to arrive and often is not settled until six or seven.
A lisp at three or four. An interdental lisp — the tongue between the teeth — is common and frequently outgrown. A lateral lisp, where the sound goes slushy at the sides, is the one that rarely resolves alone and deserves an opinion.
Dropping the ends of words at two. "Ca" for cat is an ordinary pattern at that age.
Being quieter than a cousin the same age. The spread between typical children is enormous. Compare against milestones, not against other children.
Talking late in a bilingual home. Growing up with two languages does not cause speech delay. Count words across both languages together, and be sceptical of anyone who blames the second language.

A rough check by age

Age	Most children can	Worth an appointment if
12 months	Babble, use one or two words, respond to their name	No babbling, no response to sound or name
18 months	Use around 20 words, follow a simple instruction	Fewer than about 10 words, no pointing
2 years	Around 50 words, joining two together	Under 50 words, no two-word combinations
2½ years	Short phrases; about half understandable to strangers	Still single words only
3 years	Three- to four-word sentences; about 75% understandable	Under 50% understandable, or no sentences
4 years	Full sentences; nearly all understandable	Strangers regularly cannot understand them
5 years	Tells a story; most sounds correct except R, TH, and some blends	Several sounds still wrong, or people ask them to repeat

What actually happens at an assessment

The unfamiliarity puts people off booking, so here is the shape of it. It is a conversation and some play, not a test your child can fail.

Expect a first appointment of roughly 45 to 60 minutes. Your child will not be aware of being assessed.

1They ask you a lot of questions — pregnancy and birth, ear infections, when words started, what your child does at home, what worries you. Your account is the largest part of the evidence.
2Hearing gets checked or referred. Glue ear after repeated infections is a common, treatable cause of speech delay, and it gets ruled out before anything else.
3They play with your child and record how sounds are produced, how words are combined, and how much is understood. Usually with toys and pictures rather than anything clinical.
4They score it against norms and tell you whether this is within the typical range, a delay, or a disorder — and those three mean genuinely different things.
5You get a plan. That might be a block of sessions, a home programme with a review, or an honest "come back in six months". A discharge with reassurance is a good outcome, not a wasted appointment.

How to get seen, and what it costs

In the US, children under three go through your state's Early Intervention programme, which is free and takes self-referrals — you do not need a doctor to agree with you. From three, the route is your local school district, also free. Private assessment typically runs a few hundred dollars, and private sessions commonly land somewhere around $100 to $250 an hour. We go through the numbers in detail in what speech therapy costs.

In the UK, NHS speech and language therapy accepts parent self-referral in most areas — you can refer your own child without going through the GP. Waiting lists are long in many places, so it is worth joining one while you decide what else to do.

Wherever you are: join the waiting list first and think afterwards. Coming off a list is easy. Waiting six months to join one is six months lost.

What to do while you wait

Waiting lists are long almost everywhere, and the months in between are not wasted time. What helps most depends on which problem you have.

If your child has few words, the job is building vocabulary — say back what they say plus one word, and wait longer than feels natural for a reply. This guide covers it. If your child talks plenty but is hard to understand, the job is sounds: pick one, and work up from the sound alone to words, phrases and sentences. The exercises are here, and every sound has a free page with word lists, phrases and games.

Our app is built for exactly this gap — it listens to your child say each word, scores the attempt and tracks the sound over weeks, which is the part that is genuinely hard to judge by ear. It is practice, not assessment: it does not screen, diagnose or flag anything, and it is not a reason to skip the appointment.

Practice these sounds

Free word lists, mouth-position guides and games — no app needed.

R Sound S Sound L Sound K Sound TH Sound

Help Me Talk is a practice app, not a diagnosis or a replacement for a licensed speech-language pathologist. If you are worried about your child’s speech, talk to your doctor or an SLP — this app is for the practice in between.

Questions parents ask

How do I know if my child needs speech therapy?: Book an assessment if your child has lost words they used to use, has fewer than about 50 words at two, is still on single words at two and a half, is hard for strangers to understand at four, does not respond to their name, or is getting frustrated and avoiding talking. A single mispronounced sound at the age it normally settles is not a reason on its own.
Is it worth getting a speech assessment if I am not sure?: Yes. An assessment either reassures you or starts help early, and early is when this work is most effective. Speech-language pathologists see uncertain parents constantly and a discharge with reassurance is a normal, useful outcome — not a wasted appointment.
At what age is speech delay a concern?: The clearest early marker is around age two: fewer than about 50 words, or no two-word combinations, is worth an appointment. Before that, no babbling by 12 months or no pointing by 18 months are the signals. At any age, losing words a child previously used should be seen promptly.
Will my child grow out of it?: Many children do, which is exactly why the advice to wait is so common — and why it is unreliable. Nobody can tell in advance which children are the ones who will not, and the children who need help do better the earlier it starts. An assessment answers the question rather than gambling on it.
Does being bilingual cause speech delay?: No. Growing up with two languages does not cause speech or language delay. Count your child's words across both languages together rather than in one, and treat any advice to drop a language with scepticism — a delay in a bilingual child needs assessing on its own merits, not blaming on the second language.
How much does a speech assessment cost?: In the US, Early Intervention under age three and school district services from three are free, and both take parent referrals. Private assessment is typically a few hundred dollars, with sessions commonly around $100 to $250 an hour. In the UK, NHS therapy is free and most areas accept parent self-referral. See [what speech therapy costs](/guides/how-much-does-speech-therapy-cost) for the detail.
Can an app tell me if my child needs speech therapy?: No, and any app claiming to screen or diagnose should be treated with suspicion. Help Me Talk is a practice app — it does not assess, diagnose or flag anything. Its job is the daily repetition between sessions, or while you are on a waiting list, not deciding whether you need one.

Keep reading

Last updated 6 August 2026.