Speech Delay
You’re doing the right thing
Catching a speech delay early is a gift, not an alarm
Trusting your instinct and looking early is one of the kindest things you can do for your child. A delay is not a diagnosis, and noticing one does not mean something is wrong. It simply means a gentle check can bring answers or reassurance, and where support helps, starting early makes a real difference.
What to look for
What a speech delay can look like
Speech and language show up differently in every child. These are areas parents often notice. Seeing one or two is common and frequently nothing to worry about.
Babbling and sounds
Slow to babble or coo, with little vocal play and few speech sounds in the first year.
First words
Late to first words, or a much smaller vocabulary than other children the same age.
Understanding
Does not seem to follow simple instructions, or to understand everyday words and names.
Putting words together
Not joining two words by around two years, such as “more milk” or “daddy go”.
Being understood
Speech that family or other people struggle to understand when it should be getting clearer.
Hearing and ears
Frequent ear infections or glue ear, or little reaction to sounds, voices and their name.
Is it a concern?
Normal, or worth a closer look?
Much of the variation in how children talk is completely normal. Here is how everyday difference tends to differ from what deserves a check.
Talking and words
Usually normal
Late talkers who understand you well, use gestures, and connect socially often catch up with time.
Worth a look
Little babble or very few words, not responding to their name, or losing words they once used.
Understanding
Usually normal
A child who follows simple instructions and clearly understands you, even if not talking much yet.
Worth a look
Does not follow simple instructions, or does not seem to understand familiar everyday words.
Being understood
Usually normal
Toddlers whose speech is a little unclear but improving, and who are understood by close family.
Worth a look
Speech that stays hard to understand, or that other people cannot follow at all.
Hearing
Usually normal
A child who hears well, turns to voices and sounds, and passed their newborn hearing screening.
Worth a look
Frequent ear infections or glue ear, or not reliably reacting to sounds, at any age.
Guidance only, not a diagnosis. When something feels off, a check brings clarity.
When to seek a check
Signs that deserve a prompt check
Most children with one or two of the earlier signs are developing typically. A few, though, are worth acting on sooner. Consider a speech and developmental check if your child shows any of these:
No babbling by 12 months of age
No pointing, waving or other gestures by 12 months
No single words by 16 months
No two-word phrases by 24 months, or fewer than 50 words
Any loss of words, babbling or social skills, at any age
Speech that you, or other people, largely cannot understand
Frequent ear infections or glue ear alongside slow speech
A strong feeling that your child is not hearing, or not understanding, well
Any loss of skills, or a strong feeling that something is not quite right, is reason enough to come in. Early support changes outcomes.
Milestones
The speech milestones that guide a check
You should not have to track these alone. Speech and language follow a broad but recognised pattern. If your child has not reached these, it is worth a check.
By 12 months
Babbles with a range of sounds, responds to their name, and uses gestures like pointing and waving.
By 18 months
Uses several single words, understands simple instructions, and points to show you things.
By 24 months
Has around 50 words or more, and starts joining two words together, such as “more milk”.
In Malaysia
Ministry of Health child health clinics check speech and language as part of developmental screening at the 18-month and 36-month visits. If your child has not been checked, you can ask for it.
Any age, if you are worried
Milestones are a guide, not a deadline. A parent’s concern at any age is a reason to check, and losing words at any age is a reason to check now.
What a delay means
That a closer look is worthwhile, not that something is wrong. Many late talkers catch up, and the ones who need help do best when it starts early.
The assessment pathway
What a speech and developmental assessment involves
A speech delay is not sorted out with one test. A good assessment works through a few clear steps, and knowing them tells you exactly what to expect.
1
A full history
Dr Nisa asks about pregnancy and birth, ear infections, family history, and exactly what your child understands and says at home, and in which languages.
2
Watching your child
She watches how your child plays, points, makes eye contact and connects, because communication is far more than words, then checks understanding and talking against what is expected for the age.
3
Hearing and medical checks
A hearing test comes first when speech is delayed, because hearing loss and glue ear are common and very treatable causes. Ears, growth and other medical causes are considered before anything is concluded.
4
Speech, language and the wider picture
She separates speech, language and understanding, and screens for the things that sometimes travel with a speech delay, including social communication differences, so nothing is missed.
5
Support starts early
You do not wait for a label to start help. Where support is needed, it begins as soon as the delay is identified, because what is being helped is the delay itself.
6
A written plan, and the next step
You leave with the findings in writing: what was seen, what it means, and what to do next, whether that is review at home, a hearing test, or referral to a speech-language therapist.
What happens in this clinic: Dr Nisa takes the history, checks hearing and medical causes, assesses understanding and talking, gives you practical things to try at home, writes the plan, and refers to a speech-language therapist or audiologist when one is needed. She will tell you plainly which step your child is at.
Important
A delay is not a diagnosis
Many children with a slow start to talking are simply on their own timeline. Only a proper assessment can tell. And whatever the outcome, understanding your child early is never a bad thing: it opens the door to the right support, and to seeing your child clearly, exactly as they are.
About Dr Nisa
A paediatrician who takes your worries seriously
Dr Nisa Khalil is a Consultant Paediatrician at ParkCity Medical Centre, Kuala Lumpur, with a special interest in child development, including speech and language delay. She holds an MBBS from the International Islamic University Malaysia and a Master of Paediatrics from Universiti Malaya, and has over 18 years in paediatrics. She has guided many families through speech and developmental worries, and knows how much reassurance, or the right early support, can mean. Her approach is calm, careful and free of judgement.
MBBS (IIUM) · MPaeds (Universiti Malaya) · MMC 49282 · ParkCity Medical Centre, Kuala Lumpur · English & Bahasa Malaysia
Questions parents ask
Speech delay, common questions
At what age should my child be talking?
Every child is different, but as a broad guide: babbling and gestures by 12 months, several single words by 18 months, and around 50 words with some two-word phrases by 24 months. If your child is behind these, or you are worried at any age, it is worth a check.
Who can assess a speech delay in Kuala Lumpur?
My child understands everything but does not talk much. Should I still come?
We speak two or three languages at home. Is that why my child is late to talk?
Isn't it better to just wait and see? Won't he catch up?
Could it be a hearing problem?
What happens after the assessment?
Do I need a referral to see Dr Nisa?
Clarity brings peace of mind.
Whether it turns out to be nothing, or the start of helpful support, you will leave understanding your child better. Book a speech and developmental assessment with Dr Nisa.
Evidence
The guidance this page follows
The milestones, early signs and assessment steps described on this page follow published paediatric guidance, not opinion. Where countries differ, both positions are given.
Centers for Disease Control and Prevention. Learn the Signs. Act Early.: communication milestones.
American Speech-Language-Hearing Association. Late Language Emergence.
Ministry of Health Malaysia. Developmental screening in child health clinics.
World Health Organization. Improving early childhood development: WHO guideline, 2020.
Medically reviewed by Dr Nisa Khalil, Consultant Paediatrician
This page is general information for parents and does not replace a personal assessment. If you are worried about your child’s speech or development, please see a doctor.