Q: My 2.5 years old daughter has not started speaking. She says only 'mama' for her mother when she wants her attention. She is otherwise a non-fussy child who is always happy and playful. As both parents are working she stays with her grandparents. She does understand some commands like 'come here, give me a kiss' which she promptly comes and gives, if asked to say 'hello' she will stretch her hands out to give handshake, when asked she will point to nose and teeth, but these are very few things/commands. She does respond to her name often and also looks at us when called but only for few seconds. She does not maintain eye contact when I try to speak to her in order to make her learn to talk but when I play with her she maintains eye contact. We tried to put her in a play school where she is generally playing alone. Should we go for any speech therapist or any other evaluation regarding autism, etc?

A:A normal child of your daughters' age should have a vocabulary of more than a word. Certainly your child needs an evaluation. Speech therapy is not the first step. She needs to be evaluated for the cause of delay in speech. It is also pertinent to keep in mind whether she achieved her other developmental milestones like sitting, standing, walking etc at the normal time or were they also delayed. A hearing evaluation is also needed as is a careful evaluation of past medical history. The best person to consult initially would be an ENT surgeon to exclude a hearing impairment, which if present even in mild degree, can hamper speech development. An evaluation by a paediatrician is also needed before a definite opinion can be reached regarding the diagnosis & further management.