Speech Delay: Early Assessment Makes a Difference
Is your child using fewer words than others their age, or not talking yet? The right support at the right time helps their development. Plan an early assessment with our team, in person at our centre in Beykent, Büyükçekmece (Istanbul). Sessions are in English, and bilingual Turkish-English sessions are available too.
Speech delay in toddlers and young children means a child uses fewer words than their peers or does not start talking at the expected age. It is not a diagnosis on its own, but it is an important developmental sign to follow closely. Below you will find what to expect at each age, the possible causes and how our assessment works, including what is different for bilingual children.
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What Is Speech Delay?
Speech delay is when a child does not produce the words and sentences expected for their age. Parents often call these toddlers late talkers. In some children, understanding develops normally and only expressive speech falls behind. That is why our therapist looks at understanding and expression separately during the assessment.
Speech delay does not have a single cause. So noticing it early makes it easier to find the underlying reason and build the right therapy plan.
Specialists usually look at two areas: receptive language (understanding) and expressive language (producing words). In some children only expressive language falls behind, while in others both are affected. This difference shapes the therapy goals directly, so we always clarify it in the first assessment.
Parents often arrive with one observation, such as "he doesn't talk at all" or "she talks very little". Our therapist looks at the details behind it: which sounds the child makes, how they use gestures and whether they copy others. This builds a much clearer picture.
Signs of Speech Delay by Age
Between 12 and 18 months, a child is expected to use at least a few meaningful words. Saying no words at all, or using few gestures, is a warning sign at this age. Alongside simple words such as "mama" and "dada", children of this age usually wave and point to communicate.
Between 18 and 24 months, vocabulary should grow quickly and the child should start putting two words together. If they still use very few words or cannot combine them, we recommend an assessment. Many children go through a "word spurt" at this stage, and a delay in this spurt is an important sign.
Between 2 and 3 years, a child is expected to build simple sentences. People outside the family should understand most of what they say. If they cannot, early support becomes more important. Children of this age can usually answer simple questions such as "What's that?" and "Where is it?" too.
Signs are not limited to the number of words. A child's wish to communicate, eye contact, copying others and pretend play are also key signs of language development. If one or more of these is weak, our therapist widens the assessment. For more detail, read language milestones from 0 to 6. We also have guides for a 2-year-old who is not talking and a 3-year-old who talks very little.
What Are the Possible Causes?
Hearing loss is one of the most often missed causes of speech delay. So when needed, our therapist first refers you for a hearing assessment. Even mild hearing loss can clearly slow language development, because the child cannot hear sounds clearly. Enlarged adenoids and fluid in the ear can sometimes play a part.
Oral-motor difficulties, tongue-tie, general developmental delay or too little language input can also lead to speech delay. In some cases no clear cause is found, but this does not mean therapy is unnecessary.
Premature birth or low birth weight can also affect language development. Some of these children progress a little more slowly in other areas too. A family history of late talking is another risk factor.
Too much screen time can hold back language development, because it reduces back-and-forth talk. Passive watching cannot replace real interaction that asks a child to use language. Read more in how screen time affects language development.
In some families, a child's needs are met before they say a word, which can lower their motivation to talk. For example, if a child points and gets what they want straight away, they have less reason to use words. Our therapist goes over these everyday patterns with you during the assessment.
Simple Speech Delay or Something Else?
In simple speech delay, a child usually understands well, wants to interact and uses gestures actively. Children with this profile often progress quickly with early support.
If both understanding and expression are affected, or if social interaction is also clearly difficult, our therapist recommends a broader assessment. This helps clarify whether autism or a wider language disorder may be involved.
In some children, speech delay points to a broader picture called developmental language disorder. Here, sentence building and grammar are affected as well as the number of words. For details, see our Language Disorder page.
When Should You See a Specialist?
If your child says no words at 18 months, or cannot put two words together at 2 years, it is time for an assessment. Early support is also recommended if vocabulary grows much more slowly than expected after your child starts talking.
An early assessment lets you spot a possible delay before it grows. So if you have a concern, book a first meeting rather than wait.
Some families put things off with sayings such as "boys talk late" or "his grandfather talked late and was fine". These are sometimes right, but they cannot replace a specialist assessment. Every child's profile is different, and only an assessment shows what lies behind the delay.
Speech Delay and Autism
Speech delay is common in autistic children, but on its own it does not point to autism. To tell the difference, we look at social interaction, eye contact, joint attention and play skills together.
In simple speech delay, a child usually wants to interact, uses gestures and makes eye contact. In profiles linked to autism, these social communication skills may also be affected. Our therapist carries out a thorough assessment to clarify this. For details, see our Language Development in Autism page and our article autism or speech delay?
Speech Delay in Bilingual Children
Many children in Istanbul grow up with Turkish and English, or with English and another home language. Bilingualism on its own does not cause speech delay, although a slight slowdown can appear at the start. Our therapist tells this apart from a true delay.
To get a fair picture, count the words your child knows in both languages together. A child may know "dog" only in English and "water" only in Turkish. Each language may look small on its own, while the total tells a different story.
Mixing two languages in one sentence is normal for bilingual children. A child who starts nursery in a new language may also stay quiet for a while. When a child is clearly behind children of the same age in both languages, an assessment is worthwhile.
For bilingual children we offer bilingual Turkish-English sessions. We plan them around your child's language profile: home languages, nursery or school language and how your child uses each one. Read more on our bilingual children page and in does bilingualism delay speech?
How Does the Assessment Work?
In the first meeting, our therapist looks at how your child understands and uses language. This is based on observation, play and a detailed conversation with you about your child's development, not on standardised tests. When needed, we refer you for a hearing assessment.
Play skills are part of the assessment too, because pretend play, such as using a box as a car, is closely linked to language. Our therapist combines what they see in play with what you share about everyday life. This gives a fuller picture.
For bilingual children, we also ask which languages your child hears, from whom and how often. Then we look at their skills in each language and in both together.
Based on the results, we prepare an individual therapy plan. At our centre each session lasts 40 minutes, and our therapist usually suggests one or two sessions a week. For the full process, see our main speech and language therapy page.
Expected Speech Development by Age
The table below sums up the rough number of words expected at each age and the signs that call for attention.
| Age | Rough Expected Development | When to Be Concerned |
|---|---|---|
| 12 to 18 months | A few meaningful words | No words, and few gestures |
| 18 to 24 months | 50+ words, two-word phrases | Very few words, no combining |
| 2 to 3 years | Simple sentences, about 70 to 80% understandable | People outside the family cannot understand |
| 3 to 4 years | Fluent sentences, first steps in telling stories | Clear difficulty building sentences |
These figures are a general guide, not a strict rule. Every child develops at a slightly different pace. But delays across more than one age band make a specialist assessment even more important. Our therapist considers your child's whole developmental history and never decides on one milestone alone.
How Can You Support Speech at Home?
Talk to your child face to face with eye contact, and repeat what they say in a slightly longer form. For example, when your child says "ball", you can say "Yes, a red ball". This is called expansion. It offers a model without correcting the child, so it does not put pressure on them.
Reading lots of books and putting daily routines into words also help. Limiting screen time gives your child more time for back-and-forth communication. Ask questions and give your child enough time to answer, because rushing can stop them from speaking at their own pace.
Songs, nursery rhymes and simple rhythm games support language in a fun way too. In a bilingual home, use the language you feel most at ease with. After the assessment, our therapist suggests home exercises for your child and reviews progress with you regularly. For more ideas, see language development activities at home.
Speech Delay Therapy in English at Our Istanbul Centre
All our therapy is available in English, so you do not need to speak Turkish to support your child's speech. Sessions, family meetings and progress updates can all be in English. For bilingual children, we also offer bilingual Turkish-English sessions.
Therapy takes place in person at our only centre: Cumhuriyet Mah. Yıldıray Çınar Sk. No:21 D:1, Beykent, 34520 Büyükçekmece, Istanbul, Türkiye. We are open Monday to Saturday, 09:00 to 18:00.
Families come to us from Beylikdüzü, Bahçeşehir, Avcılar, Esenyurt, Büyükçekmece, Silivri and Çatalca. Learn more about our centre or see how to book an appointment.
Frequently Asked Questions About Speech Delay
Does speech delay go away on its own?
In some children a mild delay closes over time. Even so, an early assessment matters, because it shows how serious the delay is and what lies behind it.
Is speech delay a sign of autism?
Not on its own, but it is common in autistic children. Our therapist clarifies the difference through a thorough assessment. For details, see our Language Development in Autism page.
Is speech delay more common in boys?
Yes, research shows that speech delay is more common in boys than in girls. But this does not mean every boy will have a delay.
Does my child need a hearing test?
A hearing assessment is recommended for every child with speech delay, because hearing loss is a common but often missed cause.
How long should I wait before starting therapy?
If you have a concern, we suggest an early assessment rather than waiting. Early support stops the delay from growing and speeds up results.
Does a bilingual home cause speech delay?
Bilingualism on its own does not cause delay, although a slight slowdown can appear at the start. Our therapist tells this apart from a true delay. For details, see our Bilingual Children page.
Should we stop speaking one language at home?
Usually not. Dropping a language rarely speeds up speech, and it can weaken your child's bond with family members who speak it. Richer, more regular exposure to both languages helps more.
Can my child have sessions in English?
Yes. All our therapies are available in English, and family meetings and progress updates are in English too.
Do you offer bilingual Turkish-English sessions?
Yes. We plan bilingual sessions around your child's language profile: home languages, nursery or school language and how your child uses each one.
My child's sibling also talked late. Is it hereditary?
A family history can raise the risk, but every child develops in their own way. A sibling's past delay does not mean this child will follow the same path, so a separate assessment is important.
Do you share information with my child's nursery teacher?
With your permission, our therapist can contact the nursery or school and share suggestions, so classroom communication supports the therapy goals.
Do I need a doctor's referral for an assessment?
Usually not. You can book an assessment directly, and if you have a concern, we suggest you contact us without waiting.
At what age can therapy start?
Speech delay therapy can usually start from 18 months. An assessment is possible at any age, and our therapist chooses an approach that suits your child's age.
Where are you located?
Our only centre is in Beykent, Büyükçekmece (Istanbul), right on the Beylikdüzü border. Families come to us from Büyükçekmece, Beylikdüzü, Bahçeşehir, Avcılar, Silivri, Esenyurt and Çatalca. All sessions take place in person at the centre.