As a pediatric speech-language pathologist, I get this question from parents all the time. Every child develops at their own pace, but there are general milestones you can look for that help can you understand typical speech and language development and figure out where your child is at with their speech and language.

Here's what I typically see:

• 12-15 months: First words like "mama," "dada," or "bye-bye"

• 18 months: At least 20 different words, including names of familiar people and objects

• 24 months: 100+ words and starting to combine two words together ("more milk," "daddy up")

• 30 months: 300+ words, using 2-3 word phrases regularly

• 3 years: Speaking in sentences, mostly understood by strangers
  

When I recommend an evaluation: If your 18-month-old isn't saying any words, or your 2-year-old has fewer than 20 words, these may be signs your child could benefit from my services. I also know that some children are naturally quieter or focus their energy on other developmental areas like walking or problem-solving first.

The most important thing I tell parents is that your child should be trying to communicate. Even if it's through gestures, pointing, or their own sounds. As a mom of two myself, I understand the worry, and I always encourage parents to trust their instincts. If you have concerns about your child's communication development, reach out to me for a consultation.

This is probably the question I hear most from families, and I completely understand wanting to know what to expect.

The timeline varies significantly depending on your child's individual needs, their age when we start working together, and how consistently we practice, both at home and in-session.

What I typically see in my practice:

• Most of my late talker clients show some progress within the first 4-6 weeks

• Families usually notice significant improvements in 3-6 months

• Many late talkers need 6-18 months of consistent therapy with me, though some children graduate sooner

What influences how long therapy takes:

• Age when we start (earlier intervention often means faster progress)

• Severity of the delay

• Other developmental factors

• Family involvement and home practice

• How often we meet

What progress looks like in my sessions:

• First month: I see increased attempts to communicate, new gestures or sounds

• 2-3 months: First new words or improved clarity

• 6+ months: Expanding vocabulary, beginning to combine words

I always keep families informed about their child's progress and adjust my approach based on how each child responds. My goal is effective, efficient therapy that gets your child communicating confidently as quickly as possible. Having worked with hundreds of Baltimore families, I know every child's journey is different.

As someone who worked as a Registered Behavior Technician before becoming a speech therapist, I have experience with both late talkers and children on the autism spectrum.

When I see speech delay alone:

• Limited vocabulary for age

• Difficulty with speech sounds

• Challenges putting words together

• Social interest, and typical play skills

When I might have concerns about autism:

• Communication differences (which can include speech delays)

• Social communication challenges

• Repetitive behaviors or intense interests

• Sensory sensitivities

• Differences in social interaction patterns

What I want you to know: Not all children with speech delays have autism, and not all autistic children have speech delays. Many late talkers I work with catch up completely and show no other developmental differences.

My approach during evaluations: I look at your child's overall communication, play skills, social interaction, and development. If I have concerns about autism, I'll discuss this openly with you and can help connect you with appropriate resources for further evaluation.

What matters most to me: Regardless of the cause, early speech therapy helps children communicate more effectively.

My background as a former RBT means I'm comfortable working with all children, including those on the autism spectrum, and I use approaches that support each child's unique learning style.

Yes! I work directly with Maryland Medicaid, and I'm happy to help families navigate this process. Most of my Baltimore families have Medicaid coverage for their children's speech therapy.

Here's what I know about coverage:

• Evaluations and ongoing therapy sessions are generally covered

• Prior authorization may be required (I handle this for you)

What I need from you:

• Active Maryland Medicaid card

• Referral from your pediatrician (usually required)

How I handle billing: I work directly with Maryland Medicaid. My billing team will handle all the insurance paperwork for families. This means you won't need to pay upfront and wait for reimbursement. We’ll verify your benefits and get prior authorization before we begin our work together.

Important note: Coverage can vary slightly depending on your specific Medicaid plan or Managed Care plan. During our free 15-min consultation, my billing team will verify your exact benefits and let you know what to expect before we start therapy.

If you have questions about your coverage, my team of billing experts are always happy to help you understand your benefits and navigate the process.

Absolutely!

I regularly provide services at daycares, preschools, and other community settings throughout the Baltimore area.

Why I love daycare therapy:

• Your child gets therapy in their natural environment where they spend their day

• I can work on social communication with their actual peers

• I collaborate directly with your child's teachers

• It's convenient for working families

• Less disruption to your child's routine

How I make it work:

• I coordinate directly with your daycare director

• Sessions typically happen during regular program hours

• I work with daycare staff to carry over strategies throughout the day

• I share progress updates with both family and teachers

Insurance coverage: Most insurance plans, including Maryland Medicaid, cover my community-based speech therapy services. We will discuss your benefits in our free 15-min consultation call.

Where I provide services: I work at daycares and preschools throughout Baltimore City and surrounding areas including Catonsville, Owings Mills, Ellicott City, and Pikesville.

Getting started: Just let me know your daycare location during our consultation, and I'll handle all the coordination with your program. Many daycares are familiar with speech therapy services and welcome the collaboration.

I love this approach because children get to practice their new communication skills in the environment where they spend most of their day, with the peers and teachers they see regularly. It often leads to faster progress and better generalization of skills.