“Wait and See” OR “Need to See”???
Raise your hand if you have ever asked yourself (or your pediatrician, mother, friend, etc.) these questions:
- “My child is not talking yet, but he is only 15 months. Should I see someone about this?”
- “I can understand my child, but no one else can. Does she just need to grow up some?”
- “He throws tantrums instead of asking for the things he wants. Will he grow out of this?”
As you ask these questions, people with good intentions may have responded with, “just wait and see.” While 
this is may be an appropriate recommendation, this phrase makes many speech-language pathologists cringe. “Waiting” and “seeing” may not be the best recommendation for every child, and it could have lasting, long-term effects on a child’s development.
Just like with any behavior, the longer it is allowed to persist, the harder it is to “break.” Consider this example: Little Johnny (age 1) wants milk, so he simply reaches his hand forward without making a sound. His mother gives him the desired milk. Two hours later, he does the same behavior: reaches for milk + doesn’t make a sound = gets milk. The more this pattern is repeated, the more this behavior is reinforced. Fast-forward to Johnny (age 3), he continues to request for desired objects by solely reaching for them. When the parent (or teacher) does not give Johnny the wanted item, he is confused because this has worked so well in the past! What happens next? You guessed it, probably a meltdown.
Ok. Now that we have established that “just wait and see” is not an appropriate response for EVERY child, how in the world do you know if this mindset is appropriate for YOUR child?
First, look at the listed “red flags” below. Although this is not an all-inclusive list, it may relieve or confirm your concerns. Yes, all children develop at different rates. However, a lack of some of these milestones may indicate that further evaluation by a speech-language pathologist is needed.
What happens if you have read the “red flags” below and your child shows several of them. Now what do you do?
…Keep reading.
Second, express your concerns to your child’s pediatrician. Be specific with your concerns, and bring outside resources (such as the list below) to confirm your suspicions. Ask the doctor for their advice and request a referral to a local speech-language pathologist for an evaluation.
Third, have your child screened or fully evaluated by a speech-language pathologist (SLP). The SLP will be able to offer professional advice as to whether or not your child needs “more time” to develop these milestones (AKA: “wait and see”) or if your child needs follow-up therapy to aid in meeting milestones and closing gaps.
Bottom Line: Go with your instinct. If you feel like your child needs to be evaluated, please contact your pediatrician and seek out your local SLP. After all, a speech and language evaluation never hurt anyone. 
Red Flags
12 Months and Younger:
- No babble or vocalizations that contain several different consonants and vowels
- Minimal engagement with others, including eye contact, smiling, pointing, etc.
- Does not gain the attention of others
- Does not recognize or respond to the name of common objects
- No response seen when his/her name is spoken
By Age 18 Months:
- Does not use several words (at least 10-15) consistently
- Unable to point to common body parts
- Has difficulty following simple directions such as “go get it”, “come here”, etc.
- No greetings/farewells (“bye bye”) seen
- No back-and-forth interaction with others, such as smiling, laughing, or playing
By Age 2:
- No use of 2-word phrases (e.g., “Daddy gone”)
- Does not play with other children
- Difficulty following 2-step commands (e.g., “Give me the ball and give Daddy the car.”)
- Not understood in at least 50% of the time
- Does not point to named objects or pictures
By Age 3:
- Does not understand simple colors and sizes (“big/little”)
- Does not respond to simple “who, what, where” questions
- Does not use 2-, 3-, and 4- word phrases/sentences
- No turn-taking or playing with others
- Not understood in at least 75% of the time
- Not saying the beginning or ending of words (“hou” for “house”)
By Age 4:
- Does not use sentences consistently
- Not yet asking questions
- Not naming letters or numbers
- Unable to tell a short story
- Not at least 90% understandable when speaking. Some sound errors may still be present such as “R, L, CH, SH, J, or TH”.
- Does not follow multi-step directions without the use of gestures or pointing
Red Flags for ALL Ages:
- Repetitive movements with objects, arms, hands, etc.
- Does not respond to people or sounds
- Stops saying or learning words
- Echoes (repeats) words or phrases over and over
- No imitation of sounds, words, or gestures
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