Speech and Language Concerns: When to Seek Help

An independent educational resource prepared by Mark M. Simonian, MD, FAAP

Sources checked: August 10, 2026     |     Medical review completed: August 10, 2026

This page is for general education only and does not replace individualized medical advice. This resource does not establish a doctor-patient relationship. For questions about your own child, contact your child's current healthcare professional.

Magnolia Pediatrics, Valley Children's Healthcare

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Children develop communication skills at different rates. A concern about speech, understanding, hearing, social communication, or a loss of skills deserves attention. Early evaluation can identify strengths, guide support, and connect families with services when needed.

Urgent Warning Signs - Check This First

Most speech and language concerns are not emergencies. Seek prompt medical care when a communication change occurs with breathing, swallowing, weakness, head injury, severe illness, or a sudden loss of function.

CALL 911 NOW

  • A sudden inability to speak, understand, smile normally, move one side of the body, or stay awake, especially after injury or with other neurologic symptoms

  • Trouble breathing, choking, severe drooling with inability to swallow, blue or gray color, or another life-threatening emergency

GET EMERGENCY MEDICAL CARE NOW

  • Sudden speech or language change with severe headache, confusion, seizure, fever and stiff neck, new weakness, facial droop, or a head injury

  • A child who cannot swallow saliva, has a muffled voice with breathing difficulty, or has sudden voice change after choking or a suspected inhaled foreign object

CONTACT YOUR CHILD'S HEALTHCARE PROFESSIONAL TODAY

  • Loss of words, communication skills, social skills, or understanding that the child previously had

  • Concern that a child does not hear normally, does not respond consistently to sound or name, needs frequent repetition, or has a sudden hearing change

  • Speech, language, or social-communication concerns that interfere with daily life, child care, school, friendships, or behavior

  • A child who is not making expected progress, stops adding new skills, or seems frustrated because they cannot understand or be understood

  • Speech changes after repeated ear infections, a severe illness, head injury, or a new neurologic symptom

What Families May Notice

  • Speech: how a child makes sounds and how understandable their words are to familiar and unfamiliar listeners

  • Language: how a child understands words, gestures, questions, and directions, and how they use words, signs, pictures, or other methods to express ideas

  • ·Social communication: shared attention, gestures, eye contact in the child's own comfortable way, back-and-forth interaction, play, and using communication with other people

  • Hearing: response to sound and name, following directions, listening at ordinary volume, and changes after congestion, ear infections, or loud-noise exposure

Milestones Are Guides, Not a Diagnosis

Milestones help families notice progress over time, but one missed skill does not diagnose a condition. Consider the whole child, including hearing, understanding, gestures, play, social interaction, movement, feeding, family history, and the languages used at home. Share concerns at every well visit and whenever you notice a change.

  • Use CDC developmental checklists and ASHA communication milestones as conversation tools, not as pass-or-fail tests.

  • A child learning more than one language may distribute words across languages. Bilingual or multilingual exposure does not cause a language disorder.

  • Describe what the child does well as well as what concerns you. Avoid comparing siblings or using labels before an evaluation.

Why Hearing Matters

Hearing changes can affect speech and language at any age, including after a normal newborn or school screening. Middle-ear fluid from colds or ear infections can temporarily affect hearing. A formal hearing evaluation is appropriate whenever a parent, caregiver, teacher, or clinician is concerned.

How Families Can Support Communication

  • Talk, read, sing, play, and respond to the child's attempts to communicate in the language or languages most comfortable for your family.

  • Follow the child's interests, pause to give time for a response, and add words to what the child communicates through sounds, gestures, signs, pictures, or words.

  • Reduce competing noise when possible, limit background television, and create regular opportunities for back-and-forth conversation and shared play.

  • Do not pressure or shame a child for speech errors. Model the word or sound naturally and praise communication attempts.

Getting an Evaluation and Services

  • Start with the child's primary-care clinician, who may recommend developmental screening, hearing testing, speech-language evaluation, or other assessment.

  • For children younger than 3 years, families may contact their state early-intervention program directly for an evaluation; a doctor's referral is not required.

  • For children age 3 and older, families may request an evaluation through the local public school district, even if the child does not attend that school.

  • A speech-language pathologist and audiologist can evaluate different parts of communication and hearing. Services may be available through early intervention, schools, health systems, or private practice.

Call Preparation

  • Examples of what the child understands, says, signs, gestures, or communicates; when concerns began; and whether skills were lost or are progressing slowly

  • The languages used at home and child care, hearing or ear-infection history, family history of communication or learning differences, and any prior screening or therapy

  • Teacher, child-care, or family observations; effects on play, behavior, friendships, learning, or daily routines

  • A short video of typical communication if safely obtained and acceptable to the family; do not share private information publicly

Related Guides

  • Developmental Concerns: When to Seek Help

  • Ear Pain and Sore Throat: When to Seek Care

  • Swollen Lymph Nodes and Neck Lumps in Children: When to Seek Care

  • Feeding Concerns and Poor Weight Gain: When to Seek Care

Sources and Medical Review

  • HealthyChildren.org (AAP), Language Delays in Toddlers: Information for Parents https://www.healthychildren.org/English/ages-stages/toddler/Pages/Language-Delay.aspx

  • Centers for Disease Control and Prevention (CDC), Developmental Monitoring and Screening https://www.cdc.gov/act-early/about/developmental-monitoring-and-screening.html

  • Centers for Disease Control and Prevention (CDC), Early Intervention https://www.cdc.gov/findei

  • American Speech-Language-Hearing Association (ASHA), Developmental Milestones https://www.asha.org/public/developmental-milestones/

  • HealthyChildren.org (AAP), Hearing Loss in Children https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/Hearing-Loss.aspx