YOUR QUESTION. A CLEARER NEXT STEP.
When to refer a child with possible DLD
Refer when language difficulty persists past age markers — or immediately for red flags like loss of words, no response to sound, or no babble/gesture by 12 months. Always pair the referral with a hearing check. When in doubt, refer; early checking never harms a child, and only a clinician diagnoses DLD.
In this answer 5 sections
You can be the one who catches a language difficulty early — knowing exactly when to refer turns a worried family into an empowered one.
In short
Refer a child for specialist speech-language assessment when language difficulties persist rather than pass — and refer immediately, without waiting, for any red flag below. As a frontline worker, you are not diagnosing Developmental Language Disorder (DLD, ICD-11 6A01.2); you are opening the door to clarity. When in doubt, refer — early checking never harms a child.
When to refer
Use these age-based markers at every contact (immunisation, growth, ANC follow-up):
- By 18 months — no clear words; not pointing or gesturing to share interest
- By 2 years — fewer than ~50 words; not combining two words
- By 3 years — strangers cannot understand most of the child's speech; not following simple instructions
- By 4–5 years — sentences stay short or jumbled; trouble telling a simple story or answering simple questions
Refer urgently, at any age, if the child:
- loses words or skills once present (regression)
- shows no response to sound or you suspect hearing loss
- has no babble or gesture by 12 months
- shows marked frustration or withdrawal when trying to communicate
Always arrange a hearing check alongside the referral — undetected hearing loss mimics DLD.
The science, briefly
DLD affects around 7% of children yet is widely missed, because these children are often bright and sociable. International expert consensus (CATALISE) defined it so frontline systems would stop overlooking it. Identified early, language outcomes improve markedly; left unaddressed, it quietly affects reading, learning and confidence at school.
The Pinnacle way
Developmental measurement supports care planning; diagnosis requires an appropriately qualified healthcare professional., under qualified clinician care — never from a screening form or a checklist. Your referral connects the family to a speech-language pathologist who compares the child against their own AbilityScore baseline, rules out other causes, and returns a plan — not a label.
Trusted sources
WHO ICD-11 (6A01.2); CATALISE international consensus on language disorders; American Speech-Language-Hearing Association (ASHA); CDC developmental milestones.
Next step — When a marker is missed or a flag appears, don't wait and watch alone. Refer the family for a language assessment with a Pinnacle speech-language pathologist.
This is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.
CONNECT THE ANSWER TO YOUR CHILD’S DAY
Something to notice. Something to discuss.
What to notice
Refer without delay if a child loses words once used, shows no response to sound, has no babble or gesture by 12 months, or grows visibly frustrated trying to communicate. Always arrange a hearing check alongside.
In everyday life
Coach families in 'serve and return': narrate the day, pause, and warmly celebrate any sound, word or gesture the child offers. Ten minutes of back-and-forth daily is gentle, powerful language practice between visits.
Bring your observations and questions to your child’s professional. Choose activities that suit your child’s comfort, abilities and agreed plan.
Bring your questions to a first visitQuestions families ask
Should I wait to see if the child catches up before referring?
One late-talking phase is common and often resolves. But refer when a difficulty persists past the age markers, and refer immediately for any red flag such as loss of words or no response to sound. Early assessment never harms a child.
Do I need to confirm DLD before referring?
No. Frontline workers screen and refer; they do not diagnose. A qualified speech-language pathologist confirms whether it is DLD, a passing phase or another cause, and forms any AbilityScore® only at a Pinnacle centre.
Why arrange a hearing check with the referral?
Undetected hearing loss produces language delays that closely mimic DLD. Pairing a hearing check with the speech-language referral ensures the real cause is identified and the child gets the right support.
FOLLOW THE SOURCE
References behind this answer.
- Organisation website · further readingWHO ICD-11: Developmental language disorder
- Organisation website · further readingASHA: Spoken Language Disorders
- Organisation website · further readingCDC: Developmental Milestones
References are supplied with this answer. An organisation homepage offers further reading; it does not establish an independent review of this page.
Content attribution: SETU Consortium · Pinnacle Blooms Network.
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General information supports a conversation with an appropriately qualified professional. Advice, goals and support depend on the individual child.