Speech delay: what to do

If your child is not speaking as much as you would expect, the worst thing to do is wait. The second worst thing is to do everything at once. Here is the order Australian speech pathologists actually recommend.

Step 1 — Rule out hearing

Every speech concern begins with a hearing check. Not because hearing loss is likely — most speech-delayed children have normal hearing — but because undetected hearing loss is the single most treatable cause of speech delay.

Australian newborns have a universal hearing screen. That screen catches profound hearing loss. It does not catch milder or fluctuating hearing loss, or hearing loss caused by glue ear (middle-ear fluid from recurrent ear infections). If your child has had more than one or two ear infections, glue ear is a very common, very treatable cause of speech delay.

How: see your GP and ask for a referral to an audiologist or ENT. In most states, public audiology is free for under-26 year olds through Hearing Australia. Private audiology is also available. The test takes about an hour.

Step 2 — See a speech pathologist

You do not need a GP referral to see a speech pathologist in Australia. You can self-refer to a private speech pathologist — most take children from 18 months. You do need a referral to access public community speech services, which vary by state.

The first speech pathology appointment is an assessment. The speech pathologist will play with your child, talk to you about what you are seeing, and give you a picture of whether this is developmentally appropriate, mildly delayed, or significantly delayed. That picture will tell you what comes next.

What speech pathology actually is

It is not a child being made to repeat sounds. It is structured play that targets specific language skills — vocabulary, sentence length, articulation, comprehension, social language. Sessions typically run 30–45 minutes. The most effective speech therapy is coached-parent therapy: the speech pathologist teaches you, so that the 167 hours a week you have with your child can do more of the work than the one hour a week of formal therapy.

Step 3 — Consider a paediatrician

Some speech delays live inside a broader pattern. If your child is delayed in speech and in other domains — social, motor, play — a developmental paediatrician can assess whether what you are looking at is isolated speech delay or part of something bigger (such as Developmental Language Disorder, or an emerging autism or ADHD profile).

A GP will make this referral. In most Australian states, public paediatric waitlists are 6–18 months. Private paediatricians are often available in weeks with a partial Medicare rebate. This is the point where many families face a real cost question.

Step 4 — The NDIS Early Childhood Approach (under 9s)

If your child is under 9 and has significant developmental concerns, the NDIS Early Childhood Approach is the pathway. You can self-refer through an NDIS Early Childhood Partner — you do not need a diagnosis first. An NDIS EC Partner will meet with you, help you document the concerns, and support the application.

Changes are underway in 2026 around which supports sit inside individual NDIS plans and which sit in a new Foundational Supports layer. Both routes remain open to families of children with speech concerns.

What parents can do this week

1. 1Narrate what you are doing together. 'Up the stairs. Slowly. Hand on the rail. Good work.' Language bath.
2. 2Get face-to-face and down to their level. Speech is a face-reading exercise for a young child.
3. 3Leave pauses. Count to five in your head between a question and filling the silence yourself.
4. 4Read the same books over and over. Repetition is how language goes in.
5. 5Reduce background input — television and passive video reduce active vocabulary more than they add to it.