18 Month Old Not Talking? 5 Action Steps for Speech Delays

What do you do when your 18-month-old or 2-year-old says nothing—no “mama,” no “up”—and they’re also not pointing, not really babbling, and not making any word approximations that look like they’re heading toward real words? It can feel confusing, overwhelming, and honestly, a little scary. But today, I’m going to make it easier. In this episode, we’re breaking down five simple, science-backed steps you can take right now if your toddler, or a toddler you know, isn’t talking yet. These are the exact five steps I wish I had known decades ago when my firstborn son Lucas started showing signs of speech delay and then of autism. And these steps can make a huge difference whether your child is simply delayed, showing early signs of autism or ADHD, or just needs some strategies to nudge them in the right direction. So let’s jump into the five steps to take when your toddler isn’t talking yet.

As you may know, children around the age of one should start to develop expressive language—saying “mama” to their actual mom or “dada,” or “baba” for bottle. These aren’t necessarily real, full words, but they should be the beginning of functional communication. This typically begins around one year old and definitely by 15 months. Today, we’re talking specifically about 18-month-olds, and by 18 months, they should be adding a few more words in addition to “mama,” “dada,” and “baba.” So what do you do if your child, client, or neighbor’s child is not developing spoken language? What do you do?

My most popular video blog by far is “Is It Speech Delay or Autism?” (which we’ll link below). There are some ways to tell the difference, but in the end, it doesn’t matter for today because the strategies I’m going to share work regardless of whether a child has an autism diagnosis, is speech-delayed, or even typically developing but just a bit behind. As a parent of a son with autism—now in his late 20s—Lucas was a toddler with a speech delay. His language looked different, and I didn’t recognize it. He went on to be diagnosed with moderate-to-severe autism one day before he turned three. I truly believe that if I had the information I have now, his life and trajectory would look very different.

I’m on a mission to get this information to parents and early-intervention professionals so they can start turning things around—patching up language as much as possible, teaching imitation and self-care skills, reducing problem behaviors so they don’t overwhelm the situation. So we’re going to cover five things you can do today, whether the toddler is your own or one you’re simply concerned about.

The first step is: don’t panic, don’t stick your head in the sand, and don’t overinflate your child’s abilities. I did all three. I didn’t panic, but I did tell my husband—when he first mentioned autism at 21 months—that Lucas didn’t have autism and that I never wanted to hear the word again. Then I went into deep denial. And I also overinflated his language. Back in the late 1990s, Lucas did have some words, but they were inconsistent. When the doctor said he should have 25 words, I stretched the truth. For example, Lucas used delayed echolalia—like repeating “Please do not feed the ducks. Quack-quack.” Even though “quack-quack” was the only part remotely functional, I counted all eight words as eight separate words. That’s what I mean by overinflating abilities. Step one is simply: don’t panic, don’t deny, and be realistic. The next four steps will not diagnose your child but will help you see how delayed they are and what else to look at besides expressive speech.

Step two is to check what typically developing children should be doing at this age. The CDC’s “Act Early” website is an excellent resource (and we will link it in the show notes at marybarbera.com/238). They list milestones at 4 months, 6 months, 1 year, 15 months, 18 months, 2 years, and beyond. For 18-month-olds, there’s even a printable handout. One of the most important milestones is pointing with the index finger. Lack of pointing by 18 months is a concern. Children should point often—with their index finger, not their whole hand—to request things and to show you things, like an airplane in the sky.

Other 18-month milestones include cooperating when turning pages in a book, helping you put on their coat, and participating in self-care without major resistance. Many children with speech delays or early signs of autism develop problem behaviors if we don’t teach positive, child-friendly strategies. In terms of expressive language, 18-month-olds should have at least three words besides “mama” and “dada.” They should follow one-step directions without gestures (like “give it to me” without you reaching your hand out), begin identifying body parts, and imitate sounds, actions, chores, and simple pretend play. Motor-wise, they should be walking independently, drinking from an open cup with assistance, attempting spoon use, and feeding themselves with fingers.

Notice that only one of these milestones relates to expressive talking. That’s why it’s so important to look at the whole child—not just whether they are saying words.

Step three is to learn the early signs of possible autism. If the milestones reveal a significant discrepancy, it’s wise to learn what some early red flags look like. One tool is the M-CHAT (Modified Checklist for Autism in Toddlers). Pediatricians should be giving the M-CHAT at 18 months and again at 24 months, but parents can take it for free anytime. Chapter 2 of my book Turn Autism Around also covers ten possible signs of autism.

These signs include: lack of pointing, speech or language delays, difficulty understanding or following directions, not responding to their name, excessive tantrums, limited joint attention, delayed play and social skills, repetitive behaviors (like lining up toys), hyperfocus on letters or numbers (hyperlexia), insistence on sameness (like needing the same cup or the same routine), excessive sensory issues, motor delays (including toe walking), and lack of imitation. None of these signs alone means autism, but several together may indicate the need for more support. Remember step one: don’t panic.

Step four is to take my free 10-minute digital assessment. Over 20,000 parents and professionals have taken it. You’ll get scores across three areas—self-care, language and learning, and problem behaviors. These scores can guide your next steps.

Step five is to continue learning and consider reaching out for help. Calling your pediatrician or Early Intervention may be appropriate, but I’ve learned that parents who are willing to learn how to assess and implement strategies themselves often make the most rapid progress. You can also read Turn Autism Around or join my online toddler–preschooler course, where half the parents start without any diagnosis at all. The techniques are the same: child-friendly, step-by-step, and proven to work. You can find everything at marybarbera.com/238.

In summary, I’ve been in the autism world for over 25 years—first as a confused, overwhelmed parent of a speech-delayed toddler, and then as a professional. And I truly believe that if I had this information earlier, Lucas’s life and my own would look very different. My mission is to change the way autism is detected and treated around the world and to help children—even those with speech delays or sensory issues—make progress by increasing talking, improving self-care skills like eating, sleeping, and potty training, and decreasing tantrums in a step-by-step way.

Thank you so much for listening. I hope today’s episode gave you the confidence and next steps to help your toddler, or the toddler you’re concerned about, make measurable progress. If you want to continue learning the most effective child-friendly strategies for increasing talking, teaching cooperation, and reducing tantrums, you can join our online toddler course and community. You can attend a free workshop at marybarbera.com/workshop to learn more and see if the course is a good fit. And if this episode resonated with you, please leave a review and share it with someone who could benefit. Together, we can start turning things around for kids as early as possible. Thanks again, and I’ll see you next time.