# When should I worry about speech and language delay at 18–24 months?

Canonical: https://pinnacleblooms.org/ask/when-should-i-worry-that-my-18-to-24-month-old-might-have-speech-and-language-delay
Publisher: Pinnacle Blooms Network / Bharath Healthcare Laboratories Private Limited

Between 18 and 24 months there's a wide normal range, but very few words, no pointing or gestures, not understanding simple instructions, or losing words are worth a gentle check. A single quiet phase often resolves; a persistent pattern is the real flag. A screen brings clarity — only a clinician can confirm anything.

*If the words you were waiting for haven't arrived yet, that worry is real — and it's a kind, wise reason to check.*

## In short
Between 18 and 24 months there's a wide, normal range — but a few patterns are worth a gentle look. By **18 months**, most toddlers use around 10–20 words and point to show you things. By **24 months**, many use 50+ words and are beginning to join two words ("more milk", "daddy go"). One quiet phase is common and often resolves; a *persistent* pattern is the real flag, and the kindest response is simply to check — not to panic.

## What to watch by this age
Consider a [speech and language](/speech-language-delay) screen if, by around 18–24 months, your child:

- uses **very few or no words**, or has stopped using words they once had
- **doesn't point** or use gestures to share interest or ask for things
- **doesn't seem to understand** simple instructions ("give me the cup")
- isn't combining **two words** by 24 months
- makes little eye contact or rarely tries to get your attention to communicate

Losing skills, or never responding to sound, deserves a prompt check — including a hearing review, since hearing is the first thing to rule out.

## The science, briefly
The WHO classifies developmental speech and language difficulties under **ICD-11 6A01**. The first three years are a period of rapid brain wiring for language, which is exactly why early support works so well — and why a brief screen now is far better than "wait and see". Many late talkers catch up; a screen simply tells you which children need a helping hand, and gives that hand early.

## The Pinnacle way
No diagnosis or clinical AbilityScore® is ever made from an online form — it is formed only at a Pinnacle Blooms Network centre, under qualified clinician care, as a structured clinician-administered assessment measuring your child against their *own* baseline. Our [speech therapy](https://www.pinnacleblooms.org/top-speech-therapy-center-india-proven-improvement-rate) team looks for other causes first, then gives you clarity and a plan — not a label. Learn how the [AbilityScore® is calculated](/ask/what-is-the-abilityscore-and-how-is-it-calculated).

## Trusted sources
WHO ICD-11 (6A01); CDC "Learn the Signs. Act Early." milestones; Indian Academy of Pediatrics; American Academy of Pediatrics (HealthyChildren.org); RBSK developmental screening.

**Next step —** The kindest thing you can do with worry is check. [Book a speech and language screen](https://www.pinnacleblooms.org/top-speech-therapy-center-india-proven-improvement-rate) with a Pinnacle speech-language pathologist.

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. (milestones): 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
- Concern: https://pinnacleblooms.org/ask/lens/intent/concern
- 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
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- When should I worry about few words at 18–24 months?: https://pinnacleblooms.org/ask/when-should-i-worry-that-my-18-to-24-month-old-might-have-non-verbal-minimally-verbal-presentation
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- When to worry about DLD at 18–24 months: https://pinnacleblooms.org/ask/when-should-i-worry-that-my-18-to-24-month-old-might-have-developmental-language-disorder
- 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
- When should I worry that my 2-year-old might have Speech and Language Delay?: https://pinnacleblooms.org/ask/when-should-i-worry-that-my-2-year-old-might-have-speech-and-language-delay
- Early Signs of Speech and Language Delay at 18–24 Months: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-speech-and-language-delay-in-a-18-to-24-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: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-speech-and-language-delay

### 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
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- 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