Given what we learned about language development, should we be concerned if by 21 months a child is not uttering any words?

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BlackTom AI · Accepted Answer

Starting with the question itself: the prompt asks whether we should be concerned if, by 21 months, a child is not uttering any words. This invites evaluation against typical language development milestones.
Option 1: Yes. This option states that there should be concern when a child has not produced any words by 21 months. In standard developmental guidelines, many children start using simple words by around 12–18 months, and by 18–24 months a growing vocabulary and some two-word phrases are expected. A child with zero words at 21 months may indicate a potential language delay or speech-language pathology need, and warrants evaluation for hearing issues, developmental screening, and possibly early intervention services. Taking a proactive stance helps identify needs early and supports better outcomes. 
Option 2: No. This option claims there is no cause for concern at 21 months. While there is natural variation in language acquisition, a complete absence of spoken words at 21 months is generally not considered within typical developmental variation; guidelines usually encourage screening and monitoring rather than assuming all is well. It risks missing early opportunities for support and may overlook contributing factors such as hearing problems, autism spectrum considerations, or other developmental concerns. 
To compare the two, the core misconception in the ‘No’ argument is assuming that minimal or no language output at this age is harmless or within normal limits for all children, which contradicts standard milestones and best practices for early identification. The reasoning behind adopting a cautious stance emphasizes early assessment, not alarmistic diagnosis, but targeted observation and potential referral. 
In sum, the more plausible stance aligned with developmental guidance is that there should be concern and a follow-up with appropriate professionals if a child has no words by 21 months, whereas the ‘No’ option underestimates the significance of early language milestones and misses recommended action steps. 
If we contextualize further, a clinician would consider hearing screening, speech-language evaluation, and developmental screening regardless of other factors, to determine whether intervention is beneficial. The emphasis is on timely assessment and support rather than assuming typical development at this stage. 
This helps explain why the correct approach is to treat such a milestone gap as a potential red flag and pursue formal evaluation, rather than accepting silence as normal variation. The alternative would be to delay action, which could prolong a delay in services and potentially impact later language, social, and academic outcomes.

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Given what we learned about language development, should we be concerned if by 21 months a child is not uttering any words?

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