(Please) Use Your Words

By Terrah Tillman, MFT

Q: My son is 20 months old and his vocabulary only consists of about a dozen words. He is not interested in communicating and only uses gestures if he wants something. Should I be concerned? Do you have any advice on how I can improve his speech and language skills?

A: All children develop differently, and some are just “late bloomers.” But it is important to identify speech delays early on and seek treatment. Typically, by 24 months, children use 50-100 words and are beginning to string two words together.

It is important to determine if your child understands speech and to have his hearing checked. Children who have had many ear infections are more likely to be behind in language. You will want to rule out hearing problems or get treatment for your little guy before beginning speech therapy.

Take everyday interactions as opportunities to connect and use language. Talk to your child as much as possible. For example, at the grocery store you can describe items’ sizes, shapes, colors, and textures. Singing songs, counting, reading books, and playing with your child all promote speech development.

You can also teach your child to communicate with simple gestures such as those used in the book Baby Signs by Acredolo and Goodwyn. Children who use hand gestures learn language more quickly and feel less frustrated and more successful.

To encourage using words when a child points, describe what it is that he wants. For example, “You are pointing at the cup. You want more juice.” You can move onto the next step by saying, “Say: ‘more juice, please.’” Once your child makes an utterance, reward him with the juice. Gradually encourage him to use more and more language.

If you are still concerned about your son’s language skills, seek help. Alta California Regional Center provides assessment and treatment services for children ages birth to 36 months in Sacramento. Once a child is 36 months and older, your school district provides services, even if the child is not enrolled in school. During this phase of development, children’s brains are wired to learn language. Speech therapy early on can make learning easier and prevent problems from developing later.

Terrah Tillman, MFT, has a private practice in downtown Sacramento. She specializes in treating families with young children. You can contact her at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .