When Should My Toddler Get a Developmental Assessment?
The short answer
The AAP recommends developmental screening at 9, 18, and 30 months of age, with autism-specific screening at 18 and 24 months. If you have concerns about your toddler's development at any point, you do not need to wait for a scheduled screening — you can request an evaluation at any time. Early intervention services are free through your state's early intervention program for children under age 3, and early identification leads to better outcomes.
Parents everywhere have the same worry. You are doing the right thing by looking into it.
By Age
What to expect by age
9-18 months
By 9 months, your pediatrician should administer a standardized developmental screening tool. If your baby is not meeting motor milestones like sitting independently, not babbling, not responding to their name, or not making eye contact, bring these concerns to your pediatrician. You do not need a referral to contact your state's early intervention program — any parent can self-refer. Early intervention services evaluate children at no cost and provide therapy if delays are identified.
18-24 months
This is a critical screening window. The AAP recommends formal developmental screening at 18 months and autism-specific screening at both 18 and 24 months using validated tools like the ASQ-3 and M-CHAT-R. If your toddler is not using any words by 18 months, has lost previously acquired skills, does not point or gesture, or seems disconnected from others, request a formal evaluation. Trust your instincts — parents often notice subtle concerns before screening tools catch them.
24-36 months
The AAP recommends another developmental screening at 30 months. By age 2, your toddler should be using at least 50 words and beginning to combine two-word phrases. By age 3, speech should be mostly understandable to unfamiliar adults. If your child is significantly behind in any area — speech, motor skills, social interaction, or play skills — request a comprehensive developmental evaluation. For children approaching age 3, contact your local school district, which is required to evaluate and provide services through the Individuals with Disabilities Education Act (IDEA).
What Should You Do?
When to take action
- Your toddler is meeting most milestones within the expected timeframe, even if some come slightly later
- Your pediatrician has screened your toddler at recommended intervals and is not concerned
- Your toddler is progressing steadily, even if at their own pace, and is not losing skills
- Your toddler is consistently behind in one or more developmental areas compared to age expectations
- Your toddler has lost skills they previously demonstrated, such as words they used to say or social behaviors they used to show
- You have a gut feeling that something is not right, even if you cannot pinpoint exactly what
- Your toddler has had a sudden regression in multiple developmental areas, which requires urgent medical evaluation
- Your toddler is not walking by 18 months or has no words by 18 months — request early intervention evaluation immediately
- Your toddler shows signs of hearing or vision loss that could be affecting development
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Medical Concerns
Signs of Speech Delay in Toddlers
Speech delay is one of the most common developmental concerns in toddlers, affecting about 10-15% of children under age 3. Key signs include no babbling by 12 months, no words by 16-18 months, fewer than 50 words by age 2, no two-word combinations by age 2, and speech that is difficult for familiar adults to understand by age 2-3. Early identification and intervention through speech therapy leads to significantly better outcomes than a "wait and see" approach.
When Should I Actually Worry About My Toddler's Speech?
While some toddlers are genuinely "late bloomers" who catch up on their own, research shows that earlier evaluation leads to better outcomes when a true delay exists. The key is not to panic but to act. You should be concerned if your toddler has no words by 18 months, fewer than 50 words by age 2, or is not combining two words by age 2. A speech evaluation does not mean something is wrong — it either gives you peace of mind or gets your child the help they need.
My Baby Isn't Standing Independently
Independent standing - letting go and balancing without holding anything - typically happens between 9 and 14 months, with many babies not mastering it until around 12 months. Standing independently requires tremendous balance and confidence, and it's one of those skills that often clicks suddenly after weeks of almost-but-not-quite moments.
Toddler Has a Limited Vocabulary
Vocabulary size varies widely among toddlers, but general benchmarks are about 5-20 words by 18 months and around 50 words by 24 months. Many "late talkers" catch up beautifully, especially when they show strong understanding of language and use gestures to communicate.
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.