Toddler Has No Words at 18 Months
This is a CDC red flag — here is what to do, what it might mean, and how to get help.
Key takeaways
- The CDC expects at least 6 words by 18 months; no words at all is a clear red flag
- A hearing test should be the first step for any child with no words at 18 months
- Possible causes include hearing loss, autism, developmental language disorder, or apraxia of speech
- Good comprehension and gestures are positive prognostic signs — but evaluation is still needed
- Early speech therapy (before age 2) produces significantly better outcomes
- Contact your state's early intervention program for a free evaluation — no referral needed
Content reviewed against published CDC, AAP, ASHA guidelines
Last reviewed: July 2026 · Editorial policy
Last reviewed:
What is normal at 18 months?
By 18 months, most toddlers can:
- Say at least 6-10 recognizable words
- Attempt to say new words they hear
- Point to several body parts when asked
- Follow simple one-step directions (“Give me the cup”)
- Point to things they want or find interesting
- Use gestures like nodding, shaking head, waving
The CDC's 2022 milestone checklist identifies fewer than 6 words at 18 months as an “act early” warning sign. Having zero words at 18 months is a more significant concern that requires prompt evaluation.
When to worry
No words at 18 months itself warrants evaluation. Seek evaluation more urgently if your toddler also:
- Does not point to things or use gestures
- Does not seem to understand what you say
- Does not respond to their name consistently
- Does not make eye contact or share attention with you
- Has lost words or sounds they previously had
- Does not imitate actions or sounds
- Shows limited interest in other people
These additional signs may indicate a broader developmental concern such as autism spectrum disorder and should be evaluated promptly.
Possible causes
- Hearing loss: Even mild loss can prevent speech development; always test hearing first
- Chronic ear infections (otitis media): Fluctuating hearing from fluid buildup delays speech
- Autism spectrum disorder: Usually accompanied by differences in social communication and behavior
- Childhood apraxia of speech: The brain has difficulty planning the motor movements for speech
- Developmental language disorder: Difficulty learning language despite normal hearing and intelligence
- Intellectual disability: Global developmental delay affecting all areas
- Selective mutism (rare at this age): Speaking in some settings but not others
- Environmental factors: Severe neglect or minimal language exposure (rare)
What you can do now
- Schedule a hearing test — this is the essential first step
- Contact early intervention — request a speech-language evaluation
- Talk to your pediatrician — discuss your concerns and request screening
- Continue talking, reading, and singing to your child throughout the day
- Narrate daily activities in simple, clear language
- Respond to all communication attempts (gestures, sounds, eye gaze)
- Reduce background noise during interaction time
- Follow your child's lead in play and comment on what they are doing
- Avoid pressuring your child to talk — create opportunities, not demands
What the evaluation involves
A comprehensive evaluation for an 18-month-old with no words typically includes:
- Audiological evaluation: Testing hearing across different frequencies
- Speech-language assessment: Evaluating both receptive (understanding) and expressive (speaking) language
- Developmental screening: Assessing all areas of development (motor, cognitive, social)
- Autism screening: M-CHAT-R/F or similar tool to screen for autism
- Oral-motor exam: Checking the structures used for speech (tongue, palate, lips)
This evaluation is available free through your state's early intervention program for children under 3.
Reassurance
While no words at 18 months is a serious concern that needs evaluation, many children who start speech therapy at this age make excellent progress. The brain is remarkably plastic at this age, and early intervention takes advantage of this window.
If your child understands what you say, uses gestures, makes eye contact, and is socially engaged, these are positive signs. Many children with isolated expressive language delays respond well to therapy and catch up to peers.
Frequently asked questions
How many words should an 18-month-old say?
Is my toddler a "late talker" or is something wrong?
Should I get a hearing test for my 18-month-old with no words?
Will my child need speech therapy?
Bottom line
No words at 18 months is a CDC red flag that requires prompt evaluation. Start with a hearing test, then get a speech-language evaluation through your pediatrician or early intervention program. Early therapy (before age 2) produces the best outcomes. Good comprehension and gestures are positive signs, but evaluation is still essential to identify the cause and start appropriate support.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources