top of page

Recognizing Speech and Language Development Red Flags in Children: A Collaborative Approach

A historical street in a town in Switzerland
Estavayer-le-Lac, Switzerland


Not long ago, while on a two month trip to Switzerland, I was invited by Little Dove Counseling to present a webinar to a group of psychologists, social workers, and other mental health professionals on how to recognize speech and language development red flags in children. I discussed how we as allied professionals can collaborate to provide optimal care by identifying and addressing communication challenges in young clients. There is an interconnected relationship between communication and mental health, which inspired me a few months ago to reach out to this community.

The Role of Speech Therapists in Mental Health

As a speech therapist, I work with clients who live with speech and language impairments that affect their ability to effectively communicate. These impairments can range from articulation disorders, where sounds are pronounced incorrectly, to more complex language disorders that impact the ability to understand or produce speech.

Teaching advocacy skills often becomes a crucial part of intervention. Empowering clients and their families with these skills enables them to understand their strengths, gain independence, and navigate disability-related challenges that may arise. Advocacy is not just about understanding one’s rights but also about effectively communicating needs and seeking appropriate support.

The Interconnection Between Communication and Mental Health

There is a profound connection between communication abilities and mental health. Communication disorders can lead to frustration, social isolation, and behavioral issues, which in turn can exacerbate mental health conditions. Conversely, mental health issues such as anxiety and depression can negatively impact communication skills. By addressing both aspects in tandem, we can improve overall outcomes for our clients.

Understanding this nuanced relationship is vital. For instance, a child who stutters might develop social anxiety due to fear of speaking in front of peers. Early intervention can help mitigate these effects by providing the child with tools and strategies to manage their stutter and build confidence.

Early Signs and Symptoms of Communication Disorders

My main goal during this webinar was to help my mental health professional peers better identify speech and language development red flags indicating possible communication disabilities among their pediatric clients. Early identification and intervention are key to mitigating long-term impacts on a child's social, academic, and emotional development.

Red Flags that May Indicate a Speech-Language Delay in Young Children

Below are some common speech and language red flags that may indicate your child, client, or student has a speech-language delay.

No Babbling by 9 Months Babbling is an important developmental milestone that typically starts around 4-6 months. If a child is not babbling by 9 months, it could indicate a delay in the development of speech and language skills. Parents and caregivers should observe whether the child is making varied sounds (e.g., “ma-ba-ga”) and experimenting with vocalizations (e.g., “mamama”).

Not Imitating Sounds/Gestures by 12 Months Imitation is a key learning mechanism for young children. By 12 months, children should begin imitating sounds and gestures. This skill is crucial for the development of language and communication skills.

No First Words by 15 Months By 15 months, most children should have started to say their first words. If a child has not started speaking by this age, it may be a sign of a language delay.

No Joint Attention by 18 Months Joint attention refers to the shared focus of two individuals on an object. It is an important social communication skill that typically develops around 9-18 months. A lack of joint attention by 18 months can be a red flag for autism spectrum disorder or other developmental delays.

Not Responding to Simple Questions by 24 Months By 24 months, children should be able to understand and respond to simple questions. Difficulty in doing so can indicate a receptive language delay.

Difficulty Understanding 50% of the Child’s Speech by 24 Months By the age of 2, parents and caregivers should be able to understand about half of what a child says. If they struggle to understand the child’s speech, it might indicate a speech sound disorder.

No Word Combinations by 24 Months By 24 months, children should start combining two words to form simple phrases, such as "more juice" or "big truck". Failure to do so could signal a delay in expressive language development.

Red Flags that May Indicate a Communication Disorder in Older Children and Adolescents

Difficulty Answering WH Questions Older children and adolescents should be able to answer "who," "what," "where," "when," and "why" questions. Struggling with these questions can indicate language comprehension issues.

Challenges with Grammar Consistent grammatical errors that are not age- or culturally-appropriate may signal a language disorder. This includes incorrect use of verb tenses, plurals, and sentence structure.

Speech Sound Errors Persistent speech sound errors beyond the typical age of resolution can indicate a phonological disorder. For example, a child who continues to substitute "w" for "r" (saying "wabbit" instead of "rabbit") past the age of 6 may need intervention.

Following Directions Challenging Difficulty following multi-step directions can be a sign of auditory processing disorders or receptive language issues. This can impact a child's ability to perform well in school and follow routines at home.

Abnormal Voice Quality A voice that is consistently hoarse, nasal, or breathy may indicate a voice disorder. This could be due to vocal abuse, neurological issues, or structural abnormalities of the vocal cords.

Stuttering Repetitions, prolongations, and blocks in speech can indicate stuttering. Stuttering often starts in early childhood and can persist into adulthood if not addressed.

Difficulty Retelling a Story in Order with Appropriate Details Being unable to retell a story in a logical order with sufficient details may point to narrative skill deficits, which are important for both academic success and social interactions.

Social Skills Challenges Difficulties understanding social cues, facial expressions, and figurative language can be indicative of pragmatic language disorders. These challenges often impact a child’s ability to form and maintain friendships.


Early identification and intervention for speech and language disorders are crucial for the overall development of children. By recognizing the signs and collaborating with speech therapists, mental health professionals can play a pivotal role in supporting the communication and mental health needs of their young clients. If you notice any of these red flags in a child, consider referring them to a speech language pathologist for a comprehensive evaluation.

Schedule an Appointment

If you need more information or have any concerns about your child's speech and language development, don't hesitate to reach out to E-Speech Cafe. Additionally, if you're a business looking to host an insightful webinar covering topics like speech therapy, voice training, or effective communication skills, please get in touch using the contact details provided below. We're here to support you!


10 views0 comments


bottom of page