Speech Therapy for Nonverbal Toddlers: A Parent’s Guide

If your toddler has reached 18 months without speaking, you're not alone—and there's real hope. Speech therapy offers proven ways to help your child communicate, even if they never say a single word. Every gesture, every picture touched, every attempt to connect is meaningful progress.

At Coral Care, we connect parents with licensed pediatric speech therapists who come right to your home, so your child can learn and practice communication skills in the environment where they feel most comfortable. We also offer free parent-friendly guides to help you understand what’s expected at each developmental stage and what support might look like.

How Speech Therapy Helps

Speech therapy isn't just about teaching kids to talk—it's about helping them communicate in whatever way works best for them. Speech-language pathologists (SLPs) understand that communication happens through gestures, pictures, signs, devices, and yes, sometimes words too.

The best news? Studies show that 70-85% of nonverbal toddlers who receive early, intensive therapy develop functional communication within their first year of treatment. Communication might look different for each child, but progress is absolutely possible.

What therapy provides:

• Immediate tools like picture boards and simple apps that let your child "speak" within 2-4 weeks
• Sign language and gestures they can use right away
• Devices that give them a voice when words won't come
• Strategies to reduce frustration and increase connection

The earlier you start—especially between 18-36 months—the better. Your child's brain is incredibly adaptable during these years, making this the perfect window for building communication skills.

Understanding Why Some Toddlers Don't Speak

About 20-30% of toddlers with autism remain nonverbal by age 3, but this doesn't predict their future. "Nonverbal" includes children who make sounds or use limited gestures but haven't developed functional spoken language yet.

Common causes include:

• Autism spectrum disorder
• Childhood apraxia of speech (difficulty with the motor planning needed for speech)
• Hearing loss
• Developmental delays
• Selective mutism (speaking at home but not in other settings)

Warning signs by 18 months:

• No single words
• Limited gestures like pointing or waving
• Doesn't respond to their name
• No babbling or vocal play

By 24 months:

• Fewer than 50 words
• No two-word phrases like "more juice"
• Lost words they previously used
• Limited interest in social interaction

If you're seeing these signs, trust your gut and seek evaluation. You're not overreacting—you're being a thoughtful parent.

When to Start Therapy

The short answer: Now.

Therapy can begin as early as 12 months if delays are significant. The American Academy of Pediatrics recommends evaluation by 18 months if your child has no words, especially with limited gestures or poor eye contact.

Good news about access: Early intervention programs through your state provide free assessments for children under 3. No family should delay getting help because of cost concerns.

Get immediate evaluation if:

• Your child lost words they previously had
• No babbling by 12 months
• No gestures by 16 months
• Doesn't respond to their name

Core Therapy Techniques That Work

Picture Exchange Communication System (PECS)

PECS teaches your child to hand you a picture to get what they want. Start with pictures of favorite snacks, toys, or activities—things they really care about.

Most toddlers master basic picture exchanges within 4-6 weeks. You'll create a communication book with 10-20 essential words for daily life, giving your child a portable way to "talk" wherever they go.

Sign Language

Essential first signs address immediate needs: "more," "help," "all done," "please," and "thank you." These signs are easier for many toddlers than speaking because hand coordination often develops before the mouth coordination needed for words.

Many children who start with signs eventually transition to spoken language, while others continue using signs alongside speech. The goal isn't to replace speech—it's to open communication now while supporting whatever develops naturally.

Communication Devices (AAC)

Simple voice-output devices with 4-8 buttons work beautifully for toddlers ages 2-3. Your child presses a button and hears a word or phrase, making clear connections between their actions and communication.

Popular apps include Proloquo2Go, LAMP Words for Life, and TouchChat. Low-tech options like communication boards with velcro pictures work great too and don't require batteries or tablets.

Important to know: Research proves that using devices actually supports speech development rather than preventing it. AAC gives your child a bridge while speech develops naturally—or becomes their primary voice if speech doesn't develop.

Daily Activities That Build Communication

You don't need special equipment—just consistency and creativity during everyday moments:

Mealtimes: Practice "more," "finished," and food names using pictures or signs. Hunger creates natural motivation!

Bath time: Practice body parts, "wash," "bubbles," and "splash" with gestures during this relaxed, playful time

Playground: Request "swing," "slide," "up," and "down" using signs or pictures during exciting play

Bedtime stories: Point to pictures together, make animal noises, practice "good night" routines

Sensory play: Playdough, water, and bubbles naturally encourage vocalizations and requests

These 15-20 minute activities fit easily into routines you're already doing. The key is following your child's interests and staying consistent.

Making Play Work for You

The best therapy happens during play because kids are naturally motivated and engaged:

• Cause-and-effect toys (pop-ups, musical instruments) encourage vocalizations
• Turn-taking games (blocks, balls, simple puzzles) teach social communication
• Peek-a-boo and tickle games elicit laughter and verbal attempts
• Pretend play (dolls, cars, kitchen sets) creates opportunities for new words
• Bubble play encourages requests for "more" and "pop"

When your child is having fun, they're more likely to attempt communication and practice new skills repeatedly.

Working with Your Speech Therapist

What to expect:

• Initial evaluation: 60-90 minutes assessing comprehension, expression, motor skills, play, and social communication
• Regular sessions: 30-45 minutes, 1-2 times per week
• Individualized plan with 3-5 specific goals based on your child's needs and your family priorities
• Parent training so you can practice techniques at home
• Monthly progress checks to celebrate growth and adjust strategies

Your therapist will teach you specific techniques to use throughout the day. You're your child's most important communication partner—the consistency you provide at home makes all the difference.

Supporting Your Child at Home

Create structure:

• Use picture schedules for daily routines so your child knows what's coming
• Establish consistent communication expectations during meals, play, and bedtime
• Use 5-10 second wait times after making requests—give your child time to respond

Build language naturally:

• Narrate your activities in simple language: "Mommy's washing the dishes"
• Model communication through signs, pictures, or words
• Celebrate ALL communication attempts—gestures, sounds, picture touches, everything

Most important: Accept whatever communication methods work for your child. Some kids will speak eventually, others will use alternative methods beautifully. Both are valuable, and both give your child a voice.

What to Expect: Timeline and Progress

First 4-8 weeks: You'll likely notice initial improvements in communication attempts

3-6 months: Meaningful functional communication typically develops

First year: Most children show significant progress in their ability to express needs and connect with others

Long-term: Research shows 60-70% of nonverbal 2-year-olds develop some functional speech by school age with appropriate intervention. Others become skilled users of alternative communication.

Progress depends on several factors: the underlying cause, therapy intensity, and family involvement. But with consistency and the right support, virtually all children can develop ways to communicate effectively.

Common Questions Parents Ask

Will using pictures or devices stop my child from learning to talk? No! Research consistently shows AAC supports speech development. It reduces frustration and gives your child communication success, which motivates them to keep trying.

How long until we see results? Most families notice changes within 4-8 weeks, though meaningful communication often takes 3-6 months.

Should I wait until age 3? No—start as soon as you notice delays. The 18-36 month period is prime time for brain development. Starting early gives your child the best chance for progress.

What about cost? Early intervention services for children under 3 are typically free through state programs. Private therapy ranges from $100-200 per session, and many insurance plans cover medically necessary services.

What if my child has autism? Many children with autism benefit tremendously from speech therapy. The techniques are tailored to your child's specific needs, and progress is absolutely possible.

Next Steps

Speech therapy opens doors that might otherwise stay closed. It gives children tools to express themselves, reduces frustration, and builds connections with family and friends.

If you’re noticing signs of a speech or developmental delay, or even if you just have a gut feeling that something’s not clicking, don’t be afraid to reach out for support. Coral Care makes it easy for families to get started with in-home pediatric developmental therapy, with experienced clinicians and openings available in as little as 7–14 days. You can explore our online resources, learn more about what therapy looks like, or connect with a Coral Care Concierge member who will walk you through the next steps with care and clarity.

Your child’s communication journey deserves a team that celebrates their strengths and meets them right where they are. Book an evaluation today! www.joincoralcare.com