When to Worry if a Child Has Too Few Words

There is nothing simple about speech, and there is nothing simple about speech delay – starting with the challenge of diagnosing it.

Every pediatrician knows the frustration of trying to quantify the speech and language skills of a screaming toddler. How many words can he say? Can she put two or more words together into a sentence? Can people besides you understand him when he talks? Questions like these, put to the parents, are the quick and somewhat crude yardsticks we often use.

Crude or not, the assessment is crucial: the earlier it is made, the earlier the speech-delayed child can get some help, and the earlier the help, the better the prospects.

“The physician who understands delayed speech understands child development,” said Dr. James Coplan, a neurodevelopmental pediatrician in Rosemont, Pa., who created the Early Language Milestone Scale to measure children’s language from birth to age 3.  

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