Many parents find themselves comparing notes at the park or birthday parties: “My child was already saying everything at 18 months,” or “Mine was forming complex sentences at two years old.” It’s a common experience that can leave parents feeling concerned, especially when their own child is still using only a few sounds or the classic “mama” and “papa.” Knowing when to seek expert advice can be challenging.
To address these concerns, we spoke with Dr. Claudia Costabile, a speech-language pathologist at the University of Campania Luigi Vanvitelli. Her first message is reassuring: every child develops at their own pace. “The developmental milestones we typically refer to are statistical norms, not deadlines,” Dr. Costabile explained. “Small variations can fall within normal development.”
Recognizing Warning Signs
It’s not necessary to meticulously track every syllable, but it’s important to pay attention to key developments. By 12 months, for example, babbling should be present – the practice ground for language. Another important indicator is gesturing: pointing to an object to request it or waving hello are fundamental prerequisites. “We shouldn’t just count the words a child says, but rather consider language development within a communicative context,” Costabile emphasized. “Communication isn’t just verbal; we need to look at communicative intent, reciprocity, and understanding.” The often-cited benchmark of 50 words by age two is a useful reference point, but should be interpreted with flexibility. As the expert reminds us, a word doesn’t have to be perfect to be counted: “A child who consistently uses the same label to refer to the same thing, even if the pronunciation isn’t correct, is still using a word.” However, it’s important to pay attention if, around the age of two, a child hasn’t yet begun to combine two words to form short phrases, such as “mama juice” or “baby sleep.”
Comprehension is likewise crucial. A child who follows simple instructions but speaks little may be a “late talker,” a variation in development that often resolves on its own by age three. “They often catch up independently,” the expert explained, but stressed that only a specialist can distinguish a temporary delay from a persistent disorder.
Families with bilingual children can also be reassured: exposing a child to two languages does not cause delays. “In fact, it offers a cognitive advantage, improving attention and stimulation,” Dr. Costabile clarified. The key in these cases is contextualization: speaking one language with the mother and another with the father helps the child orient themselves without losing this valuable opportunity.
If you suspect a problem, a multidisciplinary approach is best. The first point of contact is the pediatrician, who can then refer you to specialists such as an audiologist to rule out hearing loss or organic causes, and a child neuropsychiatrist to assess whether language development is part of overall healthy development.
How Therapy Works
For parents, the idea of taking a two- or three-year-old to “therapy” can be daunting. How do you convince a child who can barely sit still to cooperate with a stranger? Dr. Costabile dispels the image of a sterile office, describing an environment that resembles a playroom more than a medical clinic: “The session isn’t a lesson, but a meeting lasting between 30 and 45 minutes, depending on the child’s needs, and based on sensorimotor and symbolic play.” Real objects, drawings, and flashcards are used, but the goal isn’t to memorize words, but to stimulate abstract thinking. A key component of the session is practicing conversation, even if it happens without words: “We do many small activities where we take turns, which is also a fundamental element of conversational skills,” Costabile emphasized. Work is also done on joint attention: the child and therapist focus on the same object (a car, a doll, a bubble), creating the necessary connection for language to emerge as a natural need to share an emotion.
“Parent Training”
The session doesn’t conclude when you leave the office. In fact, the real work begins there. The speech-language pathologist transforms the parent into a “therapist of daily life” through parent training. “It’s unrealistic to solve the problem with one or two hours of speech therapy per week,” Dr. Costabile warned. Parents are given small “assignments”: not tedious exercises, but practical tips. They are taught to verbalize every action (“Now mommy is putting the pasta on the plate”), to read books together, and to create situations where the child is encouraged to ask for things without the adult anticipating their needs. A golden rule for parents concerns correction. If the child says “tatto” instead of “cat,” the instinctive reaction is to ask them to repeat it correctly. Wrong. “Asking the child to repeat the same word, forcing correct repetitions, can certainly cause frustration,” the doctor warned. The winning strategy is so-called “indirect modeling”: parents become a correct mirror. If the child says “tatto,” we respond with a smile: “Yes, it’s a cat, look, a red cat sleeping.” This provides the correct sound within a sentence, without making the child experience inadequate.
Mistakes to Avoid at Home
During this process, the family environment plays a key role, and some “false myths” need to be debunked. First and foremost: laziness. “Language emerges from neurobiological factors and social interaction. Communicative laziness doesn’t exist,” the expert warned. Another common mistake is responding for the child or not respecting their processing time: “It’s counterproductive, because it inhibits the child. We need to grant them time to speak.”
Practically speaking, the doctor is categorical about the use of technology: screens should be avoided altogether before the age of one. “Prolonged exposure to TV, smartphones, and tablets causes a loss of face-to-face interactions, symbolic play, conversational language, and even imitation, which are fundamental to learning,” she warned. Attention should also be paid to oral habits. Prolonged use of a pacifier or bottle beyond two or three years of age can alter tongue posture. “It establishes a swallowing pattern we call infantile swallowing, in which the child pushes the tongue forward to direct the flow of milk,” Costabile explained. Bottles with spouts or straws, if used constantly as often happens at school, can also hinder the transition to adult and physiological swallowing: the advice is to switch to a cup as soon as possible.
How to Determine When Therapy is Complete
One of the questions parents worry about most is duration: how long will it take for my child to speak “well”? Dr. Costabile clarifies that there is no one-size-fits-all timer: “The time depends on the severity of the disorder, the speed of intervention, and, above all, the family’s adherence to the treatment.” But the criterion for completion is clear: “Treatment ends when the functional goals are achieved, that is, when the child is finally autonomous in communication.” But the speech-language pathologist doesn’t act alone: “There’s always a check-up after three or six months with the medical specialist, whether it’s the otolaryngologist or the child neuropsychiatrist,” the expert explained. It’s only through this constant collaboration between therapist and doctor that a decision can be made on whether the treatment has been successfully completed.
The Importance of Early Intervention
Many parents, reassured by relatives or friends, tend to wait for language to “unlock” on its own. But an untreated disorder can leave deep scars, starting with social skills. “It can cause a disorder in interaction with peers,” Dr. Costabile warned. “It can happen that the parent understands, but the peer doesn’t, and this can cause relational problems.” The most insidious risk, however, appears with the start of school. Language is, in fact, the building block on which reading and writing are built. “A child who hasn’t resolved their language difficulties before entering primary school will have a much higher probability of encountering obstacles in learning to read and write.” Intervening promptly doesn’t mean labeling the child, but respecting their right to communicate. Because, as the doctor concludes, “children teach us that, sometimes, we just need to gradual down to meet them where they are.”
Last updated: Wednesday, March 4, 2026, 09:49
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