Why doesn't my 18-month-old talk?

Lack of speech in an 18-month-old could stem from several different reasons, and evaluation at this age is important.

Expected developmental milestones at this age: The child can typically use 5-20 words, point to or identify objects or people, understand simple commands (like "get the ball"), and communicate through gestures and expressions. If none of these skills are present or the child isn't making any sounds, closer evaluation is needed.

Possible causes include:

• Hearing problems (often overlooked — even repeated ear infections can cause temporary hearing loss)
• Late talker (child understands everything, follows instructions, but isn't talking yet; this usually opens up by ages 2-3)
• Oral-motor difficulties (tongue, lip, jaw muscle coordination issues)
• Receptive language delay (struggling to understand what's being said as well)
• Autism spectrum (if there are also signs like poor eye contact, limited imitation, preoccupation with spinning objects)
• Environmental factors (excessive screen time, insufficient language input)

Pediatric guidance: If no words by 18 months or fewer than 50 words by age 2, evaluation by a pediatrician and child development specialist is recommended. Early intervention is always more effective.

General recommendations: Talk face-to-face with simple sentences and lots of repetition, eliminate screens completely, read books together, and make speech/modeling fun during play. However, for comprehensive evaluation at 18 months, seeing a specialist is the right step.