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My two-year-old still can’t talk. Is there a problem?

The question: My two-year-old son babbles, but he doesn't say a word. He understands everything we say to him and is otherwise a very active, social, happy child. Is there speech therapy for a baby that doesn't talk?

The answer: Absolutely! I would be quite concerned about a two-year-old who isn't saying any words.

By a child's second birthday, we would expect him to have dozens of words in his vocabulary and that he would be starting to put two or three words together into short sentences. The fact that he understands everything, is social and otherwise healthy is somewhat reassuring, however, I would not recommend procrastination, as early intervention is key to addressing delays.

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I would recommend you seek a referral to a pediatrician, a speech pathologist and an audiologist who will perform a hearing test. Expect the pediatrician to review your child's general health, assess your child's overall developmental status, and exclude medical conditions that are associated with speech delays, including autism.

Next, make inquiries into what early-childhood intervention programs are available in your community. Consider having your child attend daycare or a play group, as young children often learn best from interacting with their peers.

Finally, don't be lured into complacency by well-meaning family and friends who will tell you stories about an uncle or cousin who didn't say a word until they were three-years-old and is now performing neurosurgery! Unfortunately, I do have families that come to my office with their four- or five-year-old children who have delays and have not been receiving therapy. Although therapy can be initiated at any age, I always lament that a critical window of opportunity for providing therapy and stimulating development has been missed. This is a potentially serious problem, and rapid access to diagnostic services and therapy can only help promote your child's speech and development.

Dr. Michael Dickinson is the head of pediatrics and chief of staff at the Miramichi Regional Hospital in New Brunswick. He's a staunch advocate for children's health in Atlantic Canada through his involvement with the Canadian Paediatric Society.

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