Child Not Talking — When to See a Doctor in Hyderabad
By age 2, most children say 50+ words. If your child is not speaking yet — or has stopped speaking — early assessment makes an enormous difference.
"My child is 2 years old and still not talking properly" is one of the most common concerns parents bring to Sri Anand Child and Neuro Center. Speech delay is among the most treatable developmental problems — but the window for early intervention is narrow. Dr. Sushma B (DNB Paediatrics, Fellowship PICU) and Dr. Anand Karnam evaluate the full picture: language development, hearing, social communication, and underlying neurological causes — to identify why the child is not speaking and what to do next.
Key Points
- Hearing loss is the most commonly missed cause of speech delay — a hearing test must be the first investigation.
- Speech delay red flags: no babbling by 12 months, no single words by 16 months, no 2-word sentences by 24 months.
- Any loss of previously acquired words at any age is a neurological emergency requiring same-day assessment.
- Early speech therapy (before age 3) gives the best outcomes — the brain is most adaptable in this window.
- Expressive language delay (understands well, speaks little) has an excellent prognosis with early speech therapy.
1 in 7
children has some form of communication disorder
Source: ASHA / WHO
Before age 3
is the optimal intervention window for speech delay
Source: WHO / CDC
90%
of hearing-related speech delay improves with early intervention
Source: NICE / CDC
"The most important thing I tell parents is: earlier is always better. Every month of untreated speech delay is a month of lost brain plasticity. If your child is not meeting language milestones, see a paediatrician — do not wait and see."
Seek Emergency Care Immediately If You Have:
- 1No babbling by 12 months
- 2No single words by 16 months
- 3No 2-word phrases by 24 months
- 4Loss of previously acquired words at any age
- 5No eye contact, no pointing, no social smile by 12 months
- 6Cannot follow simple 1-step instructions by 18 months
Possible Causes of This Symptom
Hearing Loss
The most commonly missed cause of speech delay. If a child cannot hear clearly, they cannot learn to speak. A simple hearing test (BERA or OAE) can rule this out in 30 minutes. Every child with speech delay must have hearing assessed first.
Global Developmental Delay
When a child is delayed across multiple areas — speech, walking, understanding, and social skills — the cause may be a global developmental delay, which requires full neurological and paediatric evaluation.
Autism Spectrum Disorder
Children with autism often have speech delay alongside reduced eye contact, limited social smile, and repetitive behaviours. Early autism assessment (from 18 months) leads to earlier intervention and better outcomes.
Expressive Language Delay
Some children understand well but are slow to speak — this is expressive language delay. Understanding is preserved; output is delayed. Usually has a good prognosis with speech therapy.
Neurological Causes
Conditions such as cerebral palsy, rare metabolic disorders, or epileptic encephalopathy can affect speech development. A neurologist review is important when speech delay is accompanied by other motor or cognitive delays.
How We Diagnose the Cause
Developmental History
Detailed account of when the child sat, walked, first babbled, first said words, and current language level. We also assess understanding, play, social interaction, and behaviour.
Hearing Screening
We arrange BERA or OAE hearing testing when indicated — essential before attributing speech delay to any other cause.
Neurological and Paediatric Examination
Assessment of tone, reflexes, coordination, and cognitive level. Autism screening tools (M-CHAT-R) are applied where appropriate.
Your Treating Specialist
Sri Anand Child and Neuro Center, Chanda Nagar, Hyderabad
In-house EEG and NCS — same-visit diagnosis, no referral delays
Frequently Asked Questions
Related Pages
Book Your Consultation Today
Sri Anand Child & Neuro Hospital · Open 24/7 · Chanda Nagar, Hyderabad