First words: when

The arrival of first words is one of the most watched milestones of early childhood — and one of the most widely variable. This page walks you through what is expected, what counts as a word, what delay looks like, and the specific Australian speech pathology pathway if intervention is warranted.

The expected picture

Most children produce their first true word somewhere between 10 and 15 months. The average is around 12 months, but a healthy spread sits either side of that. By 18 months, most children have between 10 and 50 words. By 24 months, most children are using 50+ words and beginning to combine two words ('more milk', 'daddy gone').

These are averages. Individual variation is enormous. A child speaking at 10 months is not precocious; a child first speaking at 16 months is not delayed. The clinical question is not 'are they at the mean?' — it is 'are they showing the pre-linguistic and linguistic signs of language development?'

What counts as a word

A word, clinically speaking, is a consistent spoken approximation the child uses to refer to a specific thing. The sound does not have to be a perfect adult pronunciation — 'ba' for ball counts if they use it consistently for ball. The criteria are:

• Used spontaneously (not only imitated immediately after a parent says it).
• Used consistently to refer to the same thing or category.
• Recognisable as an approximation of an adult word.

Animal noises ('moo', 'woof'), exclamations ('uh-oh', 'wow'), and personal names ('mama', 'dada' used specifically) all count. Jargoning — the melodic pseudo-speech that sounds like language without being language — does not yet count, but is a strong positive sign that language is coming.

The pre-linguistic building blocks

Before first words, a child needs to have a set of foundational skills. The absence of these, not the absence of words alone, is what catches a speech pathologist's eye. By 12 months, you should see:

• Joint attention — the child looks at what you are looking at, points to share something, follows your pointed finger.
• Responsive smiling and engagement with your face.
• A range of consonant sounds in babble — 'b', 'd', 'm', 'p', 'n' should all be in there.
• Varied babble intonation — the melody of language.
• Responding to their name (consistently by 12 months).
• Understanding some words — 'bye-bye', 'milk', 'bath' — before producing them.
• Imitation of sounds, gestures, or actions.

When to consider a speech pathology assessment

The Royal Children's Hospital Melbourne and Speech Pathology Australia use the following thresholds, alongside clinical judgment:

• No babble with varied consonants by 10–12 months.
• No words at all by 18 months.
• Fewer than 50 words by 24 months — especially if not combining two words.
• Regression — loss of words or skills that were previously present. This is always a reason for immediate assessment.
• Concerns with hearing, swallowing, or feeding alongside the language delay.
• Limited joint attention or social engagement at any age.

Importantly: do not wait-and-see when you have concerns and the child is under 3. Early intervention during the peak language-learning window (18 months to 3 years) has the best outcomes, and speech pathology assessment carries no risk.

The Australian speech pathology pathway

Through the GP

Book a long appointment. Ask for a referral to a speech pathologist under a Chronic Disease Management Plan (CDM, MBS 721/723), which provides up to 5 Medicare-rebated sessions per year. For children with significant communication concerns, ask also whether your child is eligible under items 135/137/139 for children with eligible disabilities — these provide 20 Medicare-rebated allied health sessions lifetime.

Through the NDIS Early Childhood Approach (under 9)

A child with developmental communication concerns does not need a diagnosis to access the NDIS Early Childhood Approach. An Early Childhood Partner can connect the family to speech pathology supports while an assessment runs in parallel. Find your local Early Childhood Partner on the NDIS website.

Privately

Private speech pathology in Australia typically runs $180–$250 per 45-minute session. Private health cover with extras may rebate a portion. Bulk-billing speech pathology is rare but sometimes available through community health services.

Through public services

State-based early intervention services vary. Call your local Child and Family Health service (the name varies by state — MCHN in Victoria, CFH in NSW, community health in WA) for a referral. Waitlists can be several months.

Bilingual children

Children raised in bilingual or multilingual households are not language-delayed because of the exposure — and plenty of monolingual children are delayed. A bilingual 18-month-old should have roughly the same total vocabulary across both languages combined as a monolingual peer; if you count only one language, you can miss the picture. If your child is raised in two languages, assessment should be done in both, ideally by a pathologist fluent in the home language.

What you can do at home

• Narrate. Describe what you are doing, what they are doing, in short simple sentences. 'Hat on. Shoes on. Out the door.'
• Read every day. Short books, often. Point to pictures. Pause and let them respond.
• Face-to-face. Get down to their level when you talk.
• Limit screens — especially before 18 months. Screens are a less effective language environment than a person.
• Expand their utterances. When they say 'dog', you say 'big dog'. When they say 'big dog', you say 'big black dog runs fast'. One step up, not five.
• Let silence exist. Count to five after asking a question before jumping in with another.

Late talking is sometimes just late talking — about half of 'late talkers' (children with limited words at 2 but otherwise typical development) catch up spontaneously by 4. The other half do not. You do not know in advance which half your child is in. Assessment costs nothing in risk and opens doors early if doors need opening.