You Know Something Is Off. Here's Exactly What to Do Next
Step-by-step guidance on evaluations, finding the right SLP, early intervention services, and what it all costs — from a certified speech-language pathologist.
Getting from “I think something might be off” to “my child is in therapy” feels harder than it should be. There’s no single clear door to walk through — just a maze of pediatrician referrals, waitlists, insurance questions, and acronyms like EI and IEP that nobody explains.
This section exists to clear that path. Whether your child is 14 months old and not babbling, or 4 years old and still hard to understand, the steps are largely the same — and they’re more straightforward than the system makes them appear.
You’ll find guidance here on how to request an evaluation, what that evaluation actually involves, how to find an SLP who’s right for your child, and how to navigate cost and insurance. For children under 3, there’s an entire free system most parents never hear about — we cover that too.
Everything here is written by John Burke, a certified speech-language pathologist with decades of experience helping families move from concern to confident action.
This section exists to clear that path. Whether your child is 14 months old and not babbling, or 4 years old and still hard to understand, the steps are largely the same — and they’re more straightforward than the system makes them appear.
You’ll find guidance here on how to request an evaluation, what that evaluation actually involves, how to find an SLP who’s right for your child, and how to navigate cost and insurance. For children under 3, there’s an entire free system most parents never hear about — we cover that too.
Everything here is written by John Burke, a certified speech-language pathologist with decades of experience helping families move from concern to confident action.
Four Steps From Concern to Care
Most families move through these stages in order. Click any step to jump to that section.
Understanding what you’re seeing is the first step. Know which signs warrant action — and which fall within the range of normal.
A speech-language evaluation is where the process officially begins. Know what to expect, how to ask for one, and what happens next.
Not all speech therapists specialize in young children. Know what to look for, what questions to ask, and where to search.
Speech therapy is often covered — partially or fully — by insurance or state programs. Know your options before you assume it’s out of reach.
First Steps
The hardest part for most parents isn’t finding a therapist — it’s knowing whether to act at all, and how to start the conversation. These five pages cover exactly that ground: how to evaluate your concern, how to talk to your pediatrician, and what an evaluation actually looks like once you’ve scheduled one.
Helpful Resources
- Should I wait and see or get an evaluation now?
- How to talk to your pediatrician about speech concerns
- What happens at a speech and language evaluation?
- My pediatrician said to wait — but I'm still worried
- How to request an early intervention evaluation (ages 0–3)
- What to Do While You Wait for Speech Therapy
Finding the Right Help
Choosing an SLP for a young child isn’t like finding a general practitioner. Experience with toddlers, therapy approach, and setting all matter. These five pages help you understand what you’re looking for — and how to find it — before you make a single call.
Helpful Resources
Cost of Speech Therapy
Speech therapy costs can vary depending on the setting, location, length of each session, and whether insurance or early intervention services help cover care. These resources explain what families may expect to pay and where lower-cost options may be available.
FOR CHILDREN UNDER 3
Early Intervention — The Free Program Most Parents Never Hear About
If your child is under 3 years old, there is a federally mandated program in every U.S. state that provides free speech therapy evaluations and services. It’s called Early Intervention — and you don’t need a doctor’s referral, a diagnosis, or insurance to access it. You just need to call.
Most families who qualify never find out about it until their child has already aged out at age 3. These four pages make sure you’re not one of them.
Most families who qualify never find out about it until their child has already aged out at age 3. These four pages make sure you’re not one of them.
Key Facts
- Ages 0-3 only
- Free, any income
- No referral needed
- All 50 states
- In your home
What Sounds Should My Child Be Making — and When?
Not all speech sounds develop at the same time — and that’s completely normal. Children master sounds in a predictable sequence.
Here’s a simplified guide:
By Age 2
p, b, m, h, w, and n sounds. These are early sounds — easy to see on the mouth and produced naturally in babbling.
By Age 3
k, g, f, t, d, and ng sounds are added. Some errors on harder sounds are still completely normal at this stage.
By Age 4–5
l, sh, ch, j, s, and z sounds develop. Many children are still refining s and r through early elementary school — this is typical.
By Age 6–7
r, th, and blends like “str” and “spl” are fully established. Errors before age 7 on these sounds are expected and normal.
A speech sound error only becomes a clinical concern when it persists beyond the expected age range. An SLP can assess exactly which sounds your child uses — and whether therapy is appropriate.
→ Full chart: What Sounds Should My Child Be Making?
→ Full chart: What Sounds Should My Child Be Making?
"Is This Normal?" — Common Parent Concerns
You’ve noticed something — a missing word, a sound that doesn’t seem right, a sudden silence. These pages are written for exactly that moment: clear, specific answers from an SLP, not a generic checklist.
- My 12-month-old isn't babbling — should I be worried?
- My 18-month-old isn't talking yet
- My 2-year-old isn't talking but understands everything
- My 3-year-old is hard to understand
- When should a child start talking?
- My toddler stopped talking — speech regression
- Speech & language milestones: birth to age 5
- How many words should my child have at each age?
Not Sure Where Your Child Falls?
Our free speech screener takes less than 3 minutes.
Answer a few questions and we’ll tell you whether their development
looks on track — or whether it’s worth talking to an SLP.
Answer a few questions and we’ll tell you whether their development
looks on track — or whether it’s worth talking to an SLP.
No sign-up required. Takes about 3 minutes.
Frequently Asked Questions
How do I know if my child has a speech delay or is just a late bloomer?
This is one of the hardest calls to make on your own — which is exactly why a speech-language pathologist evaluation is so valuable. A true “late bloomer” typically has strong comprehension and social engagement but is slower to produce words. A speech delay usually involves gaps in multiple areas. Our free screener is a useful starting point, but a professional assessment is the only way to know for certain.
Can screen time cause a speech delay?
Research links excessive passive screen time — especially before age 2 — to slower language development. The mechanism isn’t the screen itself, but the interaction time it replaces: face-to-face conversation, responsive play, and shared reading. Limited, co-viewed, interactive use is far less concerning than hours of solo passive viewing.
My child has a lot of words but I still can't understand them. Is that a problem?
It depends on age. At 2 years, parents understanding about 50% of a child’s speech is typical. By age 3, most of what your child says should be clear to you. By age 4, strangers should understand the majority. If clarity is significantly behind these benchmarks, it’s worth scheduling an evaluation with an SLP.
My pediatrician said to "wait and see." Should I?
Sometimes waiting is reasonable — language develops in spurts. But if you have a persistent concern, you don’t need a referral to see a private SLP. For children under 3, early intervention through your state is free and doesn’t require a physician referral. Trust your instincts as a parent.
Is bilingualism causing my child's speech delay?
No — bilingual children are not at higher risk for speech delays. They spread their vocabulary across two languages, so a word count in one language may look lower than monolingual peers. Total vocabulary across both languages is typically comparable. If you have concerns, seek an SLP experienced in bilingual development.
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