Does My Child Need Speech Therapy? 10 Signs Utah Parents Should Know
By Megan Williamson, MS, CCC-SLP | Licensed Speech-Language Pathologist
As a parent, you watch your child grow and hit milestones—first steps, first words, first day of school. But what happens when something feels... off? Maybe your 3-year-old is hard to understand. Maybe your kindergartener struggles to follow directions. Maybe your fourth-grader avoids speaking in class.
You wonder: Is this normal? Will they outgrow it? Or do they need speech therapy?
As a speech-language pathologist who works with Utah families every day, I hear these questions constantly. Here's the truth: If you're concerned, trust your gut. You know your child better than anyone.
This article breaks down the 10 most common signs that a child may benefit from speech therapy—organized by age so you can see what's typical and what's not. I've also included a simple checklist you can save and share.
Quick Reminder: What Speech Therapy Actually Treats
Before we dive in, let's clarify what speech-language pathologists (SLPs) do. We don't just work on "speech sounds." We address:
- Articulation: How clearly a child produces sounds and words
- Expressive language: How a child uses words to express thoughts and ideas
- Receptive language: How a child understands language
- Fluency: Stuttering or rhythm of speech
- Voice: Quality, pitch, volume
- Social communication: Using language appropriately in conversations and social situations
- Feeding/swallowing: Oral motor skills for eating and drinking
Now let's look at the signs.
Ages 18 Months – 2 Years: Early Language Development
Sign #1: Your Child Isn't Using Words Yet
What's typical at this age:
- By 18 months: Using 10-20 words (e.g., "mama," "dada," "more," "bye")
- By 24 months: Using 50+ words and combining two words together ("more juice," "daddy go")
Red flags:
- No words by 18 months
- Fewer than 50 words by age 2
- Not combining two words by 24 months
- Relying on gestures and grunts instead of attempting words
What to do: Don't wait. Early intervention is most effective during this critical language development window. Contact an SLP for a screening or evaluation. In Utah, children under age 3 can also access free services through the Baby Watch Early Intervention Program.
Sign #2: Your Child Doesn't Respond to Their Name or Follow Simple Directions
What's typical:
- By 18 months: Responds to their name, follows one-step directions like "come here" or "give me the ball"
- By 24 months: Follows two-step related directions like "Get your shoes and bring them to me"
Red flags:
- Doesn't look up when you call their name
- Doesn't respond to simple requests
- Seems to "tune out" when you talk
Note: This can also be a sign of hearing loss or autism spectrum disorder. An SLP can help screen for these concerns and refer to specialists if needed.
Ages 2-3 Years: The Language Explosion
Sign #3: Strangers Can't Understand Your Child
What's typical:
- Age 2: About 50% of speech is understandable to unfamiliar listeners
- Age 3: About 75% of speech is understandable to unfamiliar listeners
Red flags:
- Family members struggle to understand your child
- Your child leaves off most beginning or ending sounds ("a" for "cat," "boo" for "blue")
- Your child gets frustrated when people don't understand them
- You find yourself "translating" for your child constantly
Why it matters: Intelligibility affects social development. If peers can't understand your child, they may avoid playing with them. Speech therapy can dramatically improve clarity in just a few months.
Sign #4: Your Child Isn't Putting Sentences Together
What's typical:
- Age 2: Using 2-word combinations ("more milk," "doggie bark")
- Age 2.5: Using 3-word sentences ("I want cookie")
- Age 3: Using 4+ word sentences with some grammar ("Mommy is going to store")
Red flags:
- Still using mostly single words at age 2.5+
- Limited vocabulary (fewer than 200 words by age 3)
- Not using action words (verbs) or describing words (adjectives)
- Speech sounds "telegraphic" (e.g., "Me go park" instead of "I want to go to the park")
Ages 3-5 Years: Preschool Communication
Sign #5: Your Child Still Can't Produce Certain Sounds
What's typical: Children gradually master speech sounds in a predictable order. Here's a general timeline:
- By age 3: p, b, m, h, n, w, d, t, k, g, f
- By age 4: y, ng, l, s, z, sh, ch, j
- By age 5-6: r, v, th (voiced and voiceless)
- By age 7-8: consistent use of all sounds in conversation
Red flags:
- Your child substitutes easy sounds for hard ones beyond the expected age ("tat" for "cat" at age 4+)
- Consistent omission of sounds ("_og" for "dog" at age 3+)
- Distorted sounds (a slushy /s/ that sounds like a lisp)
Why it matters: Articulation errors can impact reading and spelling later. Kids who can't hear the difference between sounds often struggle to decode words when learning to read.
Sign #6: Your Child Struggles with Back-and-Forth Conversation
What's typical at ages 3-5:
- Asks and answers "who," "what," and "where" questions
- Tells simple stories with a beginning, middle, and end
- Stays on topic during conversations
- Takes turns talking and listening
Red flags:
- Talks "at" people instead of "with" them (monologues, not conversations)
- Doesn't respond appropriately to questions
- Changes topics abruptly or randomly
- Doesn't make eye contact or read social cues
- Repeats phrases from TV/movies out of context (echolalia)
Why it matters: Social communication (pragmatics) is essential for friendships, classroom participation, and later workplace success. These skills can be taught through speech therapy.
Ages 5-8 Years: Early Elementary
Sign #7: Your Child Stutters—And It's Not Going Away
What's typical: Many kids go through a phase of "normal disfluency" between ages 2-5 as their brains work faster than their mouths. They might repeat whole words ("I-I-I want that") or use filler words ("um," "uh").
Red flags (stuttering that needs therapy):
- Sound or syllable repetitions: "C-c-c-cat" or "ba-ba-ba-ball"
- Prolongations: "Sssssssnake"
- Blocks: Getting stuck with no sound coming out
- Physical tension: Facial grimacing, eye blinking, head nodding while trying to speak
- Awareness and frustration: Your child notices their stuttering and seems upset or avoids talking
- Duration: Stuttering has lasted more than 6 months
- Family history: A parent or sibling who stuttered (genetic component)
Why early intervention matters: Research shows that treating stuttering early (before age 7) has a much higher success rate. If you wait until middle school, stuttering becomes more ingrained and harder to modify.
Sign #8: Your Child Struggles with Reading or Writing
What's typical:
- Kindergarten: Recognizes some letters, rhymes, segments words into syllables
- 1st grade: Decodes simple words, writes simple sentences
- 2nd-3rd grade: Reads grade-level books with fluency, writes multi-sentence paragraphs
Red flags:
- Difficulty with phonics (can't sound out words)
- Can't rhyme or identify beginning/ending sounds
- Avoids reading aloud
- Writes sentences that don't make sense grammatically
- Trouble organizing thoughts in writing
Why speech therapy can help: Reading and writing are language-based skills. Many children with language delays in preschool go on to have reading difficulties. An SLP can address underlying language foundations like phonological awareness, vocabulary, and grammar—skills that directly support literacy.
Ages 8-12 Years: Upper Elementary & Middle School
Sign #9: Your Child Misunderstands Complex Instructions or Struggles in School
What's typical: By this age, children should follow multi-step directions, understand abstract language (idioms, sarcasm), and organize their thoughts for school assignments.
Red flags:
- Frequently asks "What?" or "Huh?" even with good hearing
- Takes everything literally (doesn't understand idioms like "break a leg")
- Needs directions repeated multiple times
- Struggles with inferencing (reading between the lines)
- Loses track during class discussions or lectures
- Grades are dropping due to language-based challenges
Why it matters: Upper elementary and middle school place heavy demands on language processing—complex vocabulary, abstract concepts, multi-step assignments. Language therapy can teach compensatory strategies and strengthen these skills.
Sign #10: Your Child Avoids Speaking Situations or Has Social Struggles
What's typical: Preteens and teens should be able to participate in group conversations, present in front of the class, and adapt their communication style to different situations (casual with friends, respectful with teachers).
Red flags:
- Refuses to speak in class (even when they know the answer)
- Avoids social situations with peers
- Struggles to "read the room" or pick up on social cues
- Gets teased or excluded due to communication differences
- Has residual articulation errors that affect confidence (lisp, /r/ distortion)
Why it matters: Communication challenges affect self-esteem, academic performance, and social development. Speech therapy isn't just about fixing sounds—it's about building confidence and equipping kids with skills for life.
📋 Printable Checklist: Does My Child Need Speech Therapy?
If you checked 2+ boxes in your child's age range, consider getting a speech-language evaluation.
Ages 18 months – 2 years:
- ☐ No words by 18 months or fewer than 50 words by age 2
- ☐ Not combining two words by 24 months
- ☐ Doesn't respond to name or follow simple directions
Ages 2-3 years:
- ☐ Strangers (or even family) can't understand my child
- ☐ Still using mostly single words or very short phrases
- ☐ Gets frustrated when trying to communicate
Ages 3-5 years:
- ☐ Speech is unclear (less than 75% intelligible by age 3)
- ☐ Leaves out or substitutes sounds beyond typical development
- ☐ Struggles with back-and-forth conversation or answering questions
- ☐ Limited vocabulary or grammar compared to peers
Ages 5-8 years:
- ☐ Stutters with tension, repetitions, or blocks
- ☐ Still has articulation errors that should be mastered
- ☐ Struggles with reading or writing
- ☐ Trouble following directions or understanding stories
Ages 8-12 years:
- ☐ Misunderstands complex instructions or abstract language
- ☐ Grades dropping due to language-based challenges
- ☐ Avoids speaking in class or social situations
- ☐ Peers have difficulty understanding them
What to Do If You Checked Multiple Boxes
Step 1: Trust Your Gut
If something feels off, it's worth investigating. You're not overreacting. Early identification and intervention lead to better outcomes.
Step 2: Get a Professional Evaluation
Contact a licensed speech-language pathologist (SLP) for a comprehensive evaluation. This typically takes 60-90 minutes and includes:
- Parent interview about developmental history and concerns
- Standardized testing to measure specific skills
- Observation of communication in play or conversation
- Written report with findings and recommendations
Step 3: Explore Your Options
Depending on your child's age and needs, you have several paths:
- Ages 0-3: Utah Baby Watch Early Intervention (free services)
- School-age: Request evaluation through your school district's special education department (free if they qualify)
- Private therapy: Contact a private practice SLP for flexible, personalized services
Step 4: Start Therapy
Consistency is key. Most children benefit from 1-2 sessions per week, with home practice between sessions. Celebrate progress and trust the process.
Common Parent Questions
Q: Should I wait to see if my child "grows out of it"?
A: Some children do catch up on their own, but research shows that early intervention is more effective than waiting. A speech evaluation provides clarity—if your child doesn't need therapy, you'll have peace of mind. If they do, starting early leads to faster progress.
Q: Will speech therapy make my child feel "different" or embarrassed?
A: Kids who receive therapy early (preschool/early elementary) rarely feel stigmatized—therapy is often play-based and fun. For older children, we frame it positively: "We're going to work together to make it easier for people to understand you" or "Let's practice strategies to help you feel more confident speaking in class."
Q: My pediatrician said my child is "fine." Should I still get a second opinion?
A: Pediatricians are wonderful, but they aren't speech-language specialists. If your gut says something is off, consult an SLP. Many parents tell me, "I wish I'd trusted my instincts sooner."
Q: How long will my child need therapy?
A: It depends on the severity, your child's learning pace, and consistency of practice. Some kids reach their goals in 3-6 months; others need 1-2 years. Your SLP will give you a realistic estimate after the evaluation.
You Know Your Child Best
Here's the bottom line: If you're worried, get an evaluation. You don't need permission. You don't need to wait for a teacher or doctor to tell you it's okay to be concerned.
Speech therapy isn't just about fixing problems—it's about unlocking your child's potential to communicate confidently, make friends, succeed in school, and navigate the world.
The earlier you start, the easier it is. And the best time to start? Right now.
Ready to Take the Next Step?
At Clear Sky Speech Therapy, we provide comprehensive speech and language evaluations for children ages 18 months through high school—plus adult services for stroke recovery, voice therapy, and more.
Serving families in Park City, Heber City, Midway, Kamas, Oakley, and surrounding areas.
📞 Call or text: (435) 572-8873
✉️ Email: info@clearskyspeechutah.com
🌐 Schedule a free consultation: clearskyspeechutah.com/schedule-consult
Let's help your child find their voice.
About the Author: Megan Williamson, MS, CCC-SLP, is a licensed speech-language pathologist based in Kamas, Utah. She has helped hundreds of Utah families navigate speech and language challenges with compassion, expertise, and personalized care.