With a 2‑year‑old who has a speech delay but normal motor and cognitive skills and a normal hearing test, what is the next step?

With a 2‑year‑old who has a speech delay but normal motor and cognitive skills and a normal hearing test, what is the next step?

• A. Ask the child's parents whether they read to the child.
• B. Give parents educational materials to encourage speech.
• C. Refer the child to an early intervention program.
• D. Suggest that they purchase age‑appropriate music videos.

Answer: (A)

The key idea here is that the first step in addressing a toddler’s speech delay, when hearing and overall development are normal, is to evaluate the language environment and opportunities for language learning at home. Asking the parents whether they read to the child is the best next move because shared reading is one of the most powerful, practical ways to boost a toddler’s language exposure, vocabulary, and syntax in everyday life. It directly informs whether the child is getting rich language input, and it provides a clear starting point for anticipatory guidance: if reading isn’t regular, you can coach the family to read aloud daily, talk about the pictures, describe events, and ask open-ended questions to stimulate conversation. If reading is already common and the delay persists, you would then pursue further steps such as a formal language evaluation or referral to early intervention or speech-language pathology. Giving educational materials or music videos doesn’t immediately assess or change the interactive language environment and is less likely to produce a meaningful, targeted impact on early speech development. Referring to early intervention is important when delays persist or other concerns are present, but the best immediate step is to explore and optimize the child’s language exposure at home.

The key idea here is that the first step in addressing a toddler’s speech delay, when hearing and overall development are normal, is to evaluate the language environment and opportunities for language learning at home. Asking the parents whether they read to the child is the best next move because shared reading is one of the most powerful, practical ways to boost a toddler’s language exposure, vocabulary, and syntax in everyday life. It directly informs whether the child is getting rich language input, and it provides a clear starting point for anticipatory guidance: if reading isn’t regular, you can coach the family to read aloud daily, talk about the pictures, describe events, and ask open-ended questions to stimulate conversation. If reading is already common and the delay persists, you would then pursue further steps such as a formal language evaluation or referral to early intervention or speech-language pathology.

Giving educational materials or music videos doesn’t immediately assess or change the interactive language environment and is less likely to produce a meaningful, targeted impact on early speech development. Referring to early intervention is important when delays persist or other concerns are present, but the best immediate step is to explore and optimize the child’s language exposure at home.