# Early Signs of Speech and Language Delay at 18–24 Months

Canonical: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-speech-and-language-delay-in-a-18-to-24-month-old
Publisher: Pinnacle Blooms Network / Bharath Healthcare Laboratories Private Limited

By 18–24 months most toddlers understand a lot, gain new words steadily, and begin joining two words. Early signs of speech and language delay include very few words, little gesture, not following simple instructions, or losing words once used — reasons for a friendly developmental check, not alarm, since early support works very well at this age.

*Between 18 and 24 months, words usually start arriving in a rush — so when they don't, many parents quietly wonder if they should wait or act.*

## In short
By 18–24 months most toddlers understand far more than they say, are picking up new words steadily, and are beginning to join two words together. Gentle early signs of a speech and language delay include very few spoken words, little gesture, not following simple instructions, or seeming not to understand everyday talk. These are reasons for a friendly developmental check — not alarm — because early support works beautifully at this age.

## Signs worth watching
**Understanding (receptive language)**
- Doesn't follow simple one-step instructions like "give me the ball" by around 18 months
- Rarely points to familiar things when named ("Where's the doggy?")
- Seems not to respond to their name or to everyday words

**Talking (expressive language)**
- Fewer than around 10–20 words by 18 months, or fewer than 50 by 24 months
- Not combining two words ("more milk", "daddy gone") by 24 months
- Loses words or babble they once used — this always deserves a prompt check

**Social communication**
- Little use of gestures — waving, pointing, showing
- Limited back-and-forth babble or eye contact during play

A simple first step alongside this is a hearing check, since glue ear and hearing dips are a common, very treatable cause.

## The science, briefly
The 18–24 month window is when toddlers typically move from single words into a fast vocabulary "burst" and early word combinations. WHO ICD-11 groups these patterns under 6A01 (developmental speech or language disorders). A delay does not predict a child's intelligence or future — many late talkers catch up, and those who need support respond best when it begins early.

## The Pinnacle way
A clinical [AbilityScore®](/ask/what-is-the-abilityscore-and-how-is-it-calculated) and any diagnosis are formed only at a Pinnacle Blooms Network centre, under the care of a qualified clinician — never from an online list. Our team uses a warm, structured assessment to map your child's communication strengths and next steps, then shapes a plan through [speech therapy](https://www.pinnacleblooms.org/top-speech-therapy-center-india-proven-improvement-rate) built around play. You can read more about [speech and language delay](/speech-language-delay) and what helps.

## Trusted sources
Aligned with WHO ICD-11 (6A01), the CDC's "Learn the Signs. Act Early." milestones, the Indian Academy of Pediatrics, the American Academy of Pediatrics, and RBSK developmental screening guidance.

**Next step —** if any of these signs feel familiar, book a developmental check with the Pinnacle team on WhatsApp: +91 91001 81181.

This is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.

## Sources
- WHO ICD-11 · Developmental speech or language disorders: https://icd.who.int/browse11
- CDC — Learn the Signs. Act Early.: https://www.cdc.gov/child-development
- American Academy of Pediatrics (HealthyChildren.org): https://www.healthychildren.org

## Connected topics and perspectives
- Conditions: https://pinnacleblooms.org/ask/conditions
- Parent / Family: https://pinnacleblooms.org/ask/lens/stakeholder/parent
- Toddler-18-24: https://pinnacleblooms.org/ask/lens/age/toddler-18-24
- Communication: https://pinnacleblooms.org/ask/lens/domain/communication
- Early Signs: https://pinnacleblooms.org/ask/lens/intent/early_signs
- Screen: https://pinnacleblooms.org/ask/lens/lifecycle/screen
- Speech Therapy: https://pinnacleblooms.org/ask/lens/route/speech-therapy
- Early Clarity: https://pinnacleblooms.org/ask/lens/empowerment/early_clarity
- Speech and Language Delay: https://pinnacleblooms.org/ask/lens/condition/speech-delay
- 6A01 · Developmental speech or language disorders: https://pinnacleblooms.org/ask/lens/icd11/6A01
- English: https://pinnacleblooms.org/ask/lens/language/en
- SDG 10: Reduced Inequalities: https://pinnacleblooms.org/ask/lens/sdg/10
- SDG 3: Good Health and Well-being: https://pinnacleblooms.org/ask/lens/sdg/3
- ASHA / PHC / Frontline: https://pinnacleblooms.org/ask/lens/stakeholder/asha_phc
- Doctor / Pediatrician: https://pinnacleblooms.org/ask/lens/stakeholder/doctor

## Related question paths

### Understand the subject
- How Speech and Language Delay Affects Daily Life: https://pinnacleblooms.org/ask/how-does-speech-and-language-delay-affect-a-child-s-daily-life
- Is Speech and Language Delay considered a disability?: https://pinnacleblooms.org/ask/is-speech-and-language-delay-considered-a-disability
- Is Speech and Language Delay Genetic or Hereditary?: https://pinnacleblooms.org/ask/is-speech-and-language-delay-genetic-or-hereditary
- What are common myths about Speech and Language Delay?: https://pinnacleblooms.org/ask/what-are-common-myths-about-speech-and-language-delay
- What are the types or levels of Speech and Language Delay?: https://pinnacleblooms.org/ask/what-are-the-types-or-levels-of-speech-and-language-delay
- What causes speech and language delay in children?: https://pinnacleblooms.org/ask/what-causes-speech-and-language-delay-in-children
- What is Speech and Language Delay?: https://pinnacleblooms.org/ask/what-is-speech-and-language-delay
- What Often Occurs Alongside Speech and Language Delay?: https://pinnacleblooms.org/ask/what-other-conditions-often-occur-alongside-speech-and-language-delay
- Early intervention outcomes for speech and language delay under 7: https://pinnacleblooms.org/ask/what-does-current-research-show-about-early-intervention-outcomes-for-speech-and-language-delay-in-children-under-7
- Speech and Language Delay (ICD-11 6A01) Defined: https://pinnacleblooms.org/ask/what-is-speech-and-language-delay-and-what-are-its-icd-11-features-in-early-childhood
- ICD-11 Classification for Speech and Language Delay: https://pinnacleblooms.org/ask/what-is-the-icd-11-classification-for-speech-and-language-delay
- What is the SNOMED CT concept for Speech and Language Delay?: https://pinnacleblooms.org/ask/what-is-the-snomed-ct-concept-for-speech-and-language-delay

### Recognise signs & concerns
- Early Signs of Speech & Language Delay (12–18 Months): https://pinnacleblooms.org/ask/what-are-the-early-signs-of-speech-and-language-delay-in-a-12-to-18-month-old
- Early Signs of Speech and Language Delay: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-speech-and-language-delay
- Signs of communication delay in an 18-to-24-month-old: https://pinnacleblooms.org/ask/what-are-the-signs-of-communication-delay-in-a-18-to-24-month-old
- Early Signs of Speech and Language Delay in a 2-Year-Old: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-speech-and-language-delay-in-a-2-year-old
- When should I worry about speech and language delay at 18–24 months?: https://pinnacleblooms.org/ask/when-should-i-worry-that-my-18-to-24-month-old-might-have-speech-and-language-delay
- Signs of communication delay in a 12-to-18-month-old: https://pinnacleblooms.org/ask/what-are-the-signs-of-communication-delay-in-a-12-to-18-month-old
- Can Speech and Language Delay Be Cured?: https://pinnacleblooms.org/ask/can-speech-and-language-delay-be-cured
- Can speech and language delay be prevented?: https://pinnacleblooms.org/ask/can-speech-and-language-delay-be-prevented
- Do boys show Speech and Language Delay differently?: https://pinnacleblooms.org/ask/do-boys-show-speech-and-language-delay-differently
- Do girls show speech and language delay differently?: https://pinnacleblooms.org/ask/do-girls-show-speech-and-language-delay-differently
- Early Signs of Speech and Language Delay in a 1-Year-Old Boy: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-speech-and-language-delay-in-a-1-year-old-boy
- Early Signs of Speech & Language Delay in a 1-Year-Old Girl: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-speech-and-language-delay-in-a-1-year-old-girl

### Explore causes & influences
- Are boys more likely to have speech and language delay?: https://pinnacleblooms.org/ask/are-boys-more-likely-to-have-speech-and-language-delay
- Are girls more likely to have a speech and language delay?: https://pinnacleblooms.org/ask/are-girls-more-likely-to-have-speech-and-language-delay
- What causes speech and language delay in young children?: https://pinnacleblooms.org/ask/what-causes-speech-and-language-delay-in-young-children
- How Early Speech-Language Intervention Advances UNCRPD and the SDGs: https://pinnacleblooms.org/ask/how-does-early-intervention-for-speech-and-language-delay-advance-un-child-rights-uncrpd-and-the-sdgs
- Contributing Factors for Speech and Language Delay: https://pinnacleblooms.org/ask/what-are-the-known-contributing-factors-for-speech-and-language-delay-in-early-childhood
- Cost-effectiveness of early therapy for speech and language delay: https://pinnacleblooms.org/ask/what-is-the-cost-effectiveness-of-early-therapy-for-speech-and-language-delay-in-young-children
- Prevalence and Public-Health Burden of Speech and Language Delay in India: https://pinnacleblooms.org/ask/what-is-the-prevalence-and-public-health-burden-of-speech-and-language-delay-among-young-children-in-india

### Understand assessment
- How AbilityScore Tracks Progress in Speech and Language Delay: https://pinnacleblooms.org/ask/how-does-abilityscore-track-progress-in-a-child-with-speech-and-language-delay
- How Speech and Language Delay Is Assessed in a Young Child: https://pinnacleblooms.org/ask/how-is-speech-and-language-delay-assessed-in-a-young-child
- What does an AbilityScore of 0–100 mean for a child with Speech and Language Delay?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-0-100-mean-for-a-child-with-speech-and-language-delay
- What does an AbilityScore of 100–200 mean for a child with Speech and Language Delay?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-100-200-mean-for-a-child-with-speech-and-language-delay
- What does an AbilityScore of 200–300 mean for a child with Speech and Language Delay?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-200-300-mean-for-a-child-with-speech-and-language-delay
- What an AbilityScore of 300–400 means for speech and language delay: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-300-400-mean-for-a-child-with-speech-and-language-delay
- What does an AbilityScore of 400–500 mean for a child with Speech and Language Delay?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-400-500-mean-for-a-child-with-speech-and-language-delay
- What an AbilityScore® of 500–600 Means for Speech and Language Delay: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-500-600-mean-for-a-child-with-speech-and-language-delay
- What does an AbilityScore of 600–700 mean for a child with Speech and Language Delay?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-600-700-mean-for-a-child-with-speech-and-language-delay
- What an AbilityScore of 700–800 Means for Speech and Language Delay: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-700-800-mean-for-a-child-with-speech-and-language-delay
- AbilityScore 800–900 for Speech and Language Delay: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-800-900-mean-for-a-child-with-speech-and-language-delay
- What an AbilityScore of 900–1000 Means for Speech and Language Delay: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-900-1000-mean-for-a-child-with-speech-and-language-delay

### Explore therapy & support
- Speech and Language Delay and Mainstream School: https://pinnacleblooms.org/ask/can-a-child-with-speech-and-language-delay-attend-a-mainstream-school
- Can a child with speech and language delay attend a regular school?: https://pinnacleblooms.org/ask/can-a-child-with-speech-and-language-delay-attend-a-regular-school
- Can a Child With Speech and Language Delay Live Independently?: https://pinnacleblooms.org/ask/can-a-child-with-speech-and-language-delay-grow-up-to-live-independently
- How to Support Communication in Speech and Language Delay: https://pinnacleblooms.org/ask/how-can-we-support-communication-development-in-a-child-with-speech-and-language-delay
- How Is Speech and Language Delay Diagnosed in a Child?: https://pinnacleblooms.org/ask/how-is-speech-and-language-delay-diagnosed-in-a-child
- How is Speech and Language Delay supported through therapy?: https://pinnacleblooms.org/ask/how-is-speech-and-language-delay-supported-through-therapy
- AbilityScore for Speech and Language Delay — what to do next: https://pinnacleblooms.org/ask/my-child-with-speech-and-language-delay-has-an-abilityscore-of-0-100-what-should-we-do-next
- AbilityScore 100–200 in Speech & Language Delay: next steps: https://pinnacleblooms.org/ask/my-child-with-speech-and-language-delay-has-an-abilityscore-of-100-200-what-should-we-do-next
- AbilityScore 200–300 for Speech and Language Delay: https://pinnacleblooms.org/ask/my-child-with-speech-and-language-delay-has-an-abilityscore-of-200-300-what-should-we-do-next
- AbilityScore 300–400 for Speech and Language Delay — next steps: https://pinnacleblooms.org/ask/my-child-with-speech-and-language-delay-has-an-abilityscore-of-300-400-what-should-we-do-next
- AbilityScore 400–500 for Speech Delay: What to Do Next: https://pinnacleblooms.org/ask/my-child-with-speech-and-language-delay-has-an-abilityscore-of-400-500-what-should-we-do-next
- AbilityScore 500–600 for Speech and Language Delay — next steps: https://pinnacleblooms.org/ask/my-child-with-speech-and-language-delay-has-an-abilityscore-of-500-600-what-should-we-do-next