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Is It Time to Talk? If your 2-year-old can’t express herself, she may need some help As you watch the 2-year-olds romp in the park, you notice a difference between the other toddlers and your daughter: They’re talking. She’s not. In fact, you realize, you’ve never heard your girl go beyond single words like “mama” and “da-da.” “I would be concerned about that,” says Jeffrey Okamoto, M.D., Kapi‘olani pediatrician and developmental specialist. In general, expect a 2-year-old to put together words to express a thought. “Throw ball, mommy up, push car — that’s the kind of two-word utterances you’d expect of a 2-year-old,” says Dr. Okamoto. Children master some sounds before others, he adds. “I would expect a 2-yearold to clearly use the sounds b, p, m, t, d and n.” Your 2-year-old also should understand simple requests, like “put the ball on the table.” “There are individual differences, so there are some children who are not producing two-word utterances at age 2 who will end up developing normally,” he says. “But we don’t know that without checking, and the sooner we find out the better.” Speech and language problems — which affect 8 to 10 percent of preschoolers — can delay development. If you suspect a problem, Dr. Okamoto recommends you talk to your child’s pediatrician. If necessary, your child’s doctor can make a referral to a speech-language pathologist. That specialist would test your child’s hearing, speech and language skills and watch your child interact with others. The root of problems can vary, ranging from the mechanics of speech to the process of putting words together. A speech-language pathologist can suggest ways to stimulate development. Your words help shape your child’s language skills. “You can follow the child’s lead and talk about what the child is doing,” Dr. Okamoto suggests. If your daughter is playing with trucks as you cook, talk about the trucks — not cooking. To serve as a model, use language slightly more complex than your toddler’s. Don’t dazzle children with complex language — or bore them with baby talk. For further information or assistance finding a doctor, phone Kapi‘olani Call-a-Nurse at 535-7000. TYPICAL DEVELOPMENT 0–3 months — Your child repeats the same sounds a lot and makes cooing sounds. 4–6 months — Your child’s babbling sounds more like speech. 7 months–1 year — Your child imitates different speech sounds. 1–2 years — Your child begins to use single words, beginning with many different consonant sounds. 2–3 years — Your child is using multi-word sentences, and you understand this speech most of the time. 3–4 years — Your child says most sounds correctly, except a few such as r, l, th and s. Jeffrey Okamoto, M.D. >> HEAR FROM THE EXPERT: ABCs of Child Development Thursday, April 29, 6:30–7:30 p.m. Click here for more information.