How to tell if your child needs a speech evaluation

Start with milestones, not worry

Most parents sense something is off before they can name it. The practical question is whether your child's communication is outside the range most children reach at that age. The American Speech-Language-Hearing Association (ASHA) publishes expected age ranges for speech, language, and hearing skills, and notes that a child who takes longer to learn a skill may have a problem (ASHA).

Milestones are benchmarks, not deadlines. Missing one marker is not automatically a red flag. A pattern of delay across several markers is what should prompt a conversation.

Red flags by age

Use this checklist as a starting point. It draws on published milestone guidance from ASHA and pediatric sources.

• Birth–3 months: Not smiling or playing with others.
• 4–7 months: Not babbling.
• 7–12 months: Making only a few sounds; not using gestures like pointing or waving.
• 12–15 months: Only a few sounds, no gestures, no first words.
• 18–24 months: Grunting and pointing instead of communicating; not using two-word combinations frequently; leaving ends off words.
• 2–4 years: Not putting two- and three-word combinations together; saying fewer than 50 words; speech that is mostly unintelligible.
• 4–5 years: Repeating the first sounds of words; unable to follow classroom directions; repeating sounds or words most of the time.

These signs are described in Hackensack Meridian Health's overview and align with ASHA's early identification guidance.

Any age: Loss of speech or language skills your child previously had is a reason to seek an evaluation promptly.

Speech delay vs. language delay

These are different problems and they need different support.

• Speech is the physical production of sounds — articulation, fluency, and voice. A child with a speech delay may understand language well but struggle to pronounce words clearly.
• Language is understanding and using words and sentences — vocabulary, grammar, and social communication. A child with a language delay may speak clearly but have limited vocabulary or difficulty forming sentences.

Some children have both. A speech-language pathologist can evaluate which areas need support.

What happens during an evaluation

The first step is usually an evaluation with a speech-language pathologist to determine what challenges your child is facing. The SLP works with you and your child to build a plan that addresses the specific issues found.

An evaluation is not a test your child can fail. It is a structured way to describe your child's strengths and needs so the right support can be chosen.

How to request an evaluation through your school

If your child is school-aged and you suspect a disability, you have the right under the Individuals with Disabilities Education Act (IDEA) to ask the school to evaluate your child. This is called an initial evaluation, and it is free of charge.

Follow these steps:

1. Put your request in writing. Send a letter or email to your child's principal or the district's special education coordinator. A written request documents your ask and starts the timeline.
2. State what you suspect. Name your specific concerns about speech, language, or communication.
3. Include your child's full name, your address, and a daytime phone number.
4. Ask for a comprehensive evaluation in all areas of suspected disability.
5. Send it in a way that proves receipt — certified mail or email — and keep a copy.
6. Give consent for the evaluation once the school agrees, so testing can begin.

The Center for Parent Information and Resources provides a model letter you can adapt, and Disability Rights Ohio outlines the consent and timeline steps.

If you are not sure, ask anyway

Getting an evaluation "just in case" is not wrong. If everything is fine, you have confirmation. If something is going on, starting therapy early — before habits deepen or gaps widen — can make a meaningful difference in communication and confidence.

How the Featured Expert Can Help

Domino Therapy offers speech therapy services for families, schools, and therapists, with both in-person and virtual support based in Philadelphia, PA. The practice focuses on enhancing communication skills and professional growth. You can learn more at domonotherapies.com.

Quick quiz

Test your understanding of when a speech evaluation is warranted.