Which child should be referred to a speech-language pathologist?

Which child should be referred to a speech-language pathologist?

• A. A 18-month-old female with no expressive vocabulary
• B. A 2-month-old male with no expressive vocabulary
• C. A 24-month-old male who is starting to put words together in sentences
• D. A 24-month-old female who is starting to put words together in sentences

Answer: (A)

Expressive language development should be evident by around 18 months. By this age, many children have started saying a few words and using them to communicate, even if their speech isn’t perfectly clear. When a child shows no expressive vocabulary at 18 months, it can signal a potential speech-language delay or related issue that benefits from professional assessment. A speech-language pathologist can determine whether this is a typical variation or a need for targeted therapy. In infancy, such as at 2 months, language milestones aren’t expected yet—babies are developing prelinguistic skills like listening, cooing, and early social communication, so absence of spoken words isn’t a concern at this stage. By 24 months, many children are starting to combine words into short phrases; this is generally a sign of progress, provided those milestones are developing alongside increasing vocabulary and intelligibility. The child who is just beginning to put words together at 24 months can still be on track, especially if other language skills are emerging normally. Therefore, the 18‑month‑old with no expressive vocabulary is the one most clearly indicated for referral.

Expressive language development should be evident by around 18 months. By this age, many children have started saying a few words and using them to communicate, even if their speech isn’t perfectly clear. When a child shows no expressive vocabulary at 18 months, it can signal a potential speech-language delay or related issue that benefits from professional assessment. A speech-language pathologist can determine whether this is a typical variation or a need for targeted therapy.

In infancy, such as at 2 months, language milestones aren’t expected yet—babies are developing prelinguistic skills like listening, cooing, and early social communication, so absence of spoken words isn’t a concern at this stage. By 24 months, many children are starting to combine words into short phrases; this is generally a sign of progress, provided those milestones are developing alongside increasing vocabulary and intelligibility. The child who is just beginning to put words together at 24 months can still be on track, especially if other language skills are emerging normally. Therefore, the 18‑month‑old with no expressive vocabulary is the one most clearly indicated for referral.