A 2-year-old child is evaluated for language development. Which finding would indicate a language delay?

A 2-year-old child is evaluated for language development. Which finding would indicate a language delay?

• A. The child can name two pictures
• B. The child has a vocabulary of 20 words
• C. The child can put two words together
• D. The child’s speech is halfway understandable

Answer: (C)

At age 2, children are expected to start combining words into short phrases and have a vocabulary typically around 50 words or more, with speech becoming increasingly intelligible. A two-word combination is a normal milestone for this age, so it does not indicate a delay. Naming two pictures shows some expressive labeling and can be within normal variation. Being about halfway understandable to others is also commonly seen at this age and not, by itself, a clear delay. The finding that would indicate a language delay is having only about 20 words in the vocabulary, which is well below expectations for a 2-year-old and suggests a need for further evaluation and possible early intervention.

At age 2, children are expected to start combining words into short phrases and have a vocabulary typically around 50 words or more, with speech becoming increasingly intelligible. A two-word combination is a normal milestone for this age, so it does not indicate a delay. Naming two pictures shows some expressive labeling and can be within normal variation. Being about halfway understandable to others is also commonly seen at this age and not, by itself, a clear delay. The finding that would indicate a language delay is having only about 20 words in the vocabulary, which is well below expectations for a 2-year-old and suggests a need for further evaluation and possible early intervention.