18-month-old not talking?

Q: Our son is 21 months old and not talking beyond the word “Mama.” Should we be concerned? His older sister was talking in sentences much earlier.

A: This is a great question and important issue to address with your pediatric clinician sooner rather than later. 

Optimal speech and language development in toddlers depend on a lot of factors — good hearing, normal muscle development of the mouth and facial structures and normal cognitive development, just to name a few. 

There are also inherited family factors that can cause both early as well as delays in speech development. 

Environmental factors can also influence how quickly a child is likely to start talking. 

An older sibling, for example, can delay a toddler’s language use. If the older sibling is always talking in place of his or her younger sibling, the younger brother or sister may not have much need to use actual words: Kids in this situation sometimes do little more than grunt and point.

The good news is that a lack of language development is more concerning for children older than 24 months. Your son may just suddenly start talking on a much larger scale, just like a switch has been turned on. 

On the other hand, you should bring it up the next time your son is at the doctor.