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Reasons to Refer for Speech or Language Therapy

There are many reasons a child should be referred for speech or language therapy. Many families are surprised to find out their child needs speech or language therapy, as they often chalk up their child’s speech-related problems to not listening or just a cute “quirk.” It is also common for parents to be so focused on a child’s other medical conditions or therapy needs that they overlook those that require speech and language therapy. A child should be referred for a speech or language assessment if he or she has the following symptoms:

  • Struggles to imitate the sounds made by others.
  • The variety of sounds a child makes decreases instead of increases.
  • Makes only a few or poor quality sounds.
  • Has difficulties following commands.
  • Slow to show an understanding of new words.
  • Cognitive changes such as decreased memory or problem solving skills.
  • Has difficulties communicating basic needs.
  • Child not combining words by 18 months of age.
  • Child stops saying sounds or words he or she had previously mastered.
  • Has difficulty or is not responding to directions, questions or conversations with others.
  • Struggles to or is not able to start conversations with others.
  • Child has unintelligible speech after 24 months of age and cannot be understood by those who do not know the child well.
  • Not speaking in sentences by 36 months of age.
  • Child is not fluently speaking by 3 ½ years.
  • Child has changes in their communication or cognition following an injury or surgery.

Please refer to our speech and language milestones chart for more information on appropriate speech and language development. Caregivers who suspect that a child may need speech or language therapy should speak with the child’s physician about getting a referral for assessment. Learn more about the assessment process.