Speech Delay in Toddlers: My Child Isn't Talking — What Should I Do? (Australia Guide)
If your baby or toddler isn't talking as much as you expected, it can be difficult to know what to do next.
Should you wait? See a speech pathologist? Get their hearing checked? Ask your GP for a paediatrician referral? And what if you're also noticing ear infections, hearing concerns, frustration or difficult behaviour?
Many Australian parents searching for answers aren't necessarily looking for a diagnosis. They're trying to work out: Who should I see about my child's speech delay — and what should I do while I'm waiting?
This guide explains how to navigate speech delay in babies and toddlers in Australia, including speech pathology, hearing tests, recurrent ear infections and when broader developmental assessment may become part of the pathway.
Important: This article provides general information about navigating health and developmental services in Australia. It does not diagnose speech or language delay or replace individual advice from your child's healthcare professionals.
Is my toddler's speech delayed?
There is a wide range of normal speech and language development in young children. Some children begin talking earlier than others, and some children who are initially 'late talkers' catch up.
But if you've found yourself Googling questions such as the following, you don't need to determine the answer yourself before asking for help.
My 18 month old isn't talking
My 2 year old isn't talking
How many words should a 2 year old say?
When should I worry about speech delay?
Does my toddler need speech therapy?
Can ear infections cause speech delay?
Should my child see a paediatrician for speech delay?
Speech delay vs language delay: what's the difference?
Parents often use speech delay as an umbrella term for several different communication concerns. But speech and language aren't exactly the same thing.
Speech relates to producing sounds and words. Expressive language is how a child communicates thoughts, needs and ideas. Receptive language relates to understanding communication.
You don't need to work out whether your child has a speech, expressive language or receptive language difficulty yourself. That's what assessment is for.
My 18-month-old isn't talking — should I be worried?
One of the most common questions parents have is whether an 18-month-old who isn't talking needs assessment or simply needs more time.
Development varies considerably between children. Rather than focusing on one number of words alone, it can be useful to consider your child's overall communication pattern.
Are they gaining new words or sounds?
Do they use gestures?
Do they point to communicate or show you things?
Do they appear to understand familiar words?
How do they tell you what they want?
Have they stopped using communication skills they previously had?
Are you noticing concerns in other areas of their development?
My 2-year-old isn't talking — what should I do?
Some children who begin talking later catch up, while others have ongoing communication difficulties. If your 2-year-old isn't talking, has very few words, isn't combining words or you are concerned about what they understand, there are several pathways you may want to investigate.
Importantly, you don't necessarily have to do them one at a time.
Who should I see about my toddler's speech delay in Australia?
There isn't one single Australian speech delay pathway. Depending on your child's circumstances, several professionals may become involved.
GP→ Speech Pathologist and/or Audiologist (hearing assessment) → if there are broader developmental concerns, Paediatrician / Developmental Paediatrician.
The important navigation point is that you may be able to investigate several pathways while you're waiting.
Does my toddler need a speech pathologist?
A speech pathologist can assess different aspects of your child's communication, including understanding language, using words and sentences, speech sounds, communicating wants and needs, social communication, and gestures or other forms of communication.
You generally don't need to wait until your child has a diagnosis before discussing whether a speech pathology assessment would be appropriate.
Should my child's hearing be checked for speech delay?
Hearing is an important part of the speech delay pathway. This can sometimes be overlooked because parents know their child can hear.
If there are speech or language concerns, your GP or other healthcare professional may discuss whether a formal hearing assessment with an audiologist is appropriate.
If a child is experiencing any of the following issues a hearing assessment may provide useful and relevant information:
Recurrent ear infections
Glue ear
Persistent middle-ear fluid
Concerns about hearing
Inconsistent responses when spoken to
Unclear speech
Delayed speech or language
Can recurrent ear infections cause speech delay?
Ear infections and hearing are particularly important pieces of this puzzle. Some children experience recurrent ear infections or persistent middle-ear fluid (glue ear). Persistent fluid can affect hearing, and hearing difficulties can potentially affect speech and language development.
If your child has speech delay + recurrent ear infections + possible hearing concerns, make sure you communicate the whole pattern when seeking assessment.
Can speech delay cause tantrums or behaviour problems?
Sometimes parents seek help for behaviour before realising communication might also be part of the picture. Communication difficulties may occur alongside screaming, crying, hitting, pushing, throwing, frequent tantrums or becoming extremely frustrated when misunderstood.
That doesn't mean speech delay is necessarily causing the behaviour. Behaviour in young children can have many different contributing factors.
Does speech delay mean autism or ADHD?
No. Speech delay alone does not tell you that a child has autism, ADHD or another developmental condition.
If communication concerns occur alongside broader developmental or social communication differences, discuss the complete pattern with your GP or other healthcare professional. You can discuss aspects of your child’s needs like:
Social communication
Interaction with other children
Play
Attention
Behaviour
Emotional regulation
Sensory responses
Feeding
Learning
Development in other areas
Does my child need a paediatrician for speech delay?
Not every child with a speech delay will need to see a paediatrician. For some children, speech pathology and/or hearing assessment may be the most relevant pathways. For others, a GP may consider paediatric assessment appropriate, particularly when there are additional medical or developmental concerns.
Tell your GP about the whole pattern: speech, understanding, hearing, behaviour, development and childcare observations.
It is also a possibility that if there are recurrent ear infections or glue ear that the engagement of an ENT may be required. Your GP can guide you here.
How do I get a paediatrician referral for speech delay in Australia?
If your GP thinks paediatric assessment is appropriate, they can discuss referral options with you. Depending on the circumstances and services available in your area, this might involve a public paediatric service, private paediatrician, developmental paediatrician or another developmental service.
What if the developmental paediatrician waitlist is months long?
This is where many Australian families become stuck. The important question becomes: What can we do while we're waiting?
Depending on your child's circumstances, discuss whether it is appropriate to arrange hearing assessment, investigate speech pathology, collect childcare observations, document communication and behaviour patterns, follow up referrals, and investigate public and private options.
What should I track if my child has a speech delay?
Instead of trying to remember several months of development during a short appointment, consider keeping a simple record.
Words your child uses spontaneously and new words
Examples of what they understand
Gestures and non-verbal communication
What happens when they can't communicate what they want
Ear infections, hearing concerns and audiology/ENT reviews
Childcare or kindergarten observations
Short videos that demonstrate real-life communication
What if I've been told to 'wait and see'?
Sometimes monitoring development is an appropriate part of the plan. But if you're leaving an appointment with a 'wait and see' approach, make sure you understand what you're waiting to see, when your child should be reviewed again, what changes to monitor, whether hearing should be assessed and when broader assessment would be considered.
Speech delay + hearing + behaviour: look at the whole picture
Different concerns can end up being managed separately: the GP hears about speech, another clinician hears about the ears, childcare mentions behaviour, and the parent notices something else entirely. These pieces sometimes need to be considered together.
Think about three pathways: speech and language (Speech Pathology), hearing (Audiology → ENT where appropriate), and broader development (GP → Paediatrician / Developmental assessment where appropriate).
What should I do if my toddler isn't talking? A simple Australian pathway
1. Write down what you're noticing — including speech, understanding, gestures, hearing, behaviour and other developmental concerns.
2. Discuss the concerns with an appropriate health professional.
3. Ask whether hearing should be assessed, particularly with recurrent ear infections, glue ear or hearing concerns.
4. Ask what can happen while you wait; don't assume every assessment needs to happen sequentially.
5. If there are broader developmental concerns, discuss those too.
6. Keep records while you're waiting.
Frequently Asked Questions About Speech Delay in Toddlers
When should I worry if my toddler isn't talking?
There is considerable variation in early communication development. If you're concerned that your toddler isn't talking, isn't gaining communication skills, doesn't appear to understand language as expected, or you have other developmental concerns, discuss the pattern with an appropriate healthcare professional.
My 18-month-old isn't talking. Who should I see?
Depending on your circumstances, you might discuss your concerns with your GP. They can help you to assess who will be required to support your child through their assessment process. Hearing assessment may also form part of the pathway.
My 2-year-old isn't talking. Should I wait?
Some late-talking children catch up, while others have ongoing communication difficulties. If you're concerned, seeking professional assessment can give you a clearer plan rather than relying on waiting alone.
Can ear infections cause speech delay?
Recurrent ear infections and persistent middle-ear fluid can be associated with hearing difficulties. Because hearing is important for speech and language development, hearing assessment may be considered when speech concerns and recurrent ear problems occur together.
Should a toddler with speech delay have a hearing test?
Hearing assessment is commonly considered when investigating communication concerns, particularly when there are recurrent ear infections, glue ear or suspected hearing difficulties.
Does speech delay mean my child has autism?
No. Speech delay alone does not establish a diagnosis of autism. If communication concerns occur alongside broader developmental or social communication differences, discuss the complete pattern with your GP or other healthcare professional.
Can speech delay cause tantrums?
Communication difficulties can contribute to frustration for some children, but behaviour can have many causes. If significant behavioural concerns occur alongside speech delay, mention both when seeking professional assessment.
Do I need a referral to see a speech pathologist in Australia?
Access pathways vary depending on the service and how you plan to fund the appointment. If you're unsure, contact the speech pathology service directly or discuss your options with your GP.
Do I need a referral to see a paediatrician in Australia?
A GP referral is generally required to access specialist paediatric care and relevant Medicare rebates.
Where should I go next?
Speech delay + recurrent ear infections or hearing concerns: Recurrent Ear Infections in Toddlers: When to Consider Grommets, Adenoids & What It Means for Hearing and Speech
Considering a paediatrician: Do You Need a Referral to See a Paediatrician in Australia? (And How to Get One Faster)
Facing a long paediatrician wait: How to Get a Paediatrician Appointment Faster in Australia
Speech isn't the only developmental concern: How to Get a Developmental Paediatrician Appointment in Australia
Deciding between public and private: Public vs Private Paediatric Care in Australia: What Parents Need to Know
Considering both pathways: Can Your GP Refer to Public AND Private Specialists at the Same Time?
Final thoughts
If your child isn't talking as much as you expected, the hardest part can be knowing where to start. You don't need to diagnose the cause yourself.
Instead, think about the three pathways that may need to be considered: speech and language, hearing, and broader development. Then ask: Which of these can we start investigating now?
Understanding the system won't give you an instant answer about your child's development. But it can help you work out who to see next, what information to collect and what you can do while you're waiting.
The information on Kids Health Navigator is general in nature and is designed to help Australian families understand and navigate healthcare services. It does not provide individual medical advice, diagnosis or treatment. Speak with an appropriately qualified healthcare professional about concerns regarding your child's development.
