Therapy guides

Speech Therapy for Developmental and Language Delays

  • Editorially Reviewed
  • Evidence Based
  • Patient Focused

Written and reviewed by the DrSensory editorial team against cited evidence and national clinical guidelines · How we write and who reviews it · Last updated October 29, 2026

Full guidesSpeech therapySpeech delay

Speech therapy for developmental delays addresses understanding language, using it, and the pre-verbal skills that come first — gestures, joint attention, and early sounds. A child is generally described as a late talker when by 24 months they use fewer than 50 words and aren't combining two words, while being age-appropriate in every other area. Many late talkers catch up; some don't, and research has found late language emergence at 24 months to be a risk indicator for language impairment at seven. Nobody can reliably predict which group a child is in, which is why waiting is harder to justify than it sounds — particularly when, for children under three, a parent can refer to early intervention directly and the evaluation is free everywhere.⁠3

Key takeaways

  • Speech therapy for developmental delays addresses understanding language, using it, and the pre-verbal skills that come first.
  • Pre-verbal skills are pointing, joint attention, imitation and gestures, and they come before words.
  • A child is generally described as a late talker when by 24 months they use fewer than 50 words and are not combining two words.
  • AAC is used where speech is significantly delayed, rather than held back until other approaches fail.
  • Parent coaching is a large part of the work, because the hours that matter are at home.
  • Goals are small and countable: uses ten new words in daily routines, points to request, combines two words to ask for something.

This page covers what speech and language therapy does for speech and language difficulties. For the range of conditions and how each is assessed, see Speech and language difficulties.

What does speech delay therapy work on?

Pre-verbal skills — pointing, joint attention, imitation, gestures · understanding language · expressive language · speech sound development · AAC where speech is significantly delayed · feeding where relevant · parent coaching

Should you wait and see, and does being bilingual cause delay?

"Wait and see" is the weakest of three options. Watching with review, or early support, are both defensible. Doing nothing while free assessment is available isn't.

Being bilingual doesn't cause delay. ASHA holds that learning two or more languages doesn't inhibit language development or worsen outcomes, and late language emergence occurs at similar rates in bilingual and monolingual children. Don't drop your home language on that advice. → Speech and language

Speech therapy goals for a child with a speech or language delay

Uses ten new words in daily routines · Points to request · Combines two words to ask for something

Frequently Asked Questions

When should I worry about late talking?
Fewer than 50 words and no two-word combinations by 24 months is the usual screening marker.⁠1 It marks a child worth assessing, not a typical two-year-old: the CDC lists about 50 words at 30 months.⁠4 You can self-refer to early intervention under three; the evaluation is free everywhere, and some states charge sliding fees for services.⁠3
Will he catch up on his own?
Many late talkers do; some don't, and it isn't reliably predictable. That uncertainty is the argument for assessment rather than waiting.
Does being bilingual cause delay?
No. Don't drop your home language.
Should we consider AAC for a young child?
Where speech is significantly delayed, yes — it doesn't delay speech and gives a child a way to communicate now.

RelatedSpeech therapySpeech delay

Sources

  1. American Speech-Language-Hearing Association. Late Language Emergence. ASHA Practice Portal. www.asha.org/practice-portal/clinical-topics/late-language-emergence/ Checked August 24, 2026.
  2. National Institute on Deafness and Other Communication Disorders. Speech and Language Developmental Milestones. NIH. www.nidcd.nih.gov/health/speech-and-language Checked August 24, 2026.
  3. Individuals with Disabilities Education Act, Part C regulations, 34 CFR Part 303 (eCFR). Parents are primary referral sources: §303.303(c). Checked October 6, 2026.
    Show the passageHide the passage
    Evaluation and assessment, service coordination and the IFSP “must be carried out at public expense, and for which no fees may be charged to parents”; a State may set a “schedule of sliding or cost participation fees that may be charged to the parent for early intervention services,” and a family the State finds unable to pay receives all Part C services at no cost: §303.521.
  4. Centers for Disease Control and Prevention. Learn the Signs. Act Early. Milestones by 30 months (“Says about 50 words”) and milestones by 2 years (“Says at least two words together”). Checked October 29, 2026.

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your child.