What should I do if a three-year-old does not talk or follow instructions?

Not speaking or following instructions by age three may be caused by factors such as the "curious phase," attention deficit hyperactivity disorder (ADHD), hearing impairment, autism, or abnormalities in speech organs. Treatment should be based on specific circumstances. Detailed analysis is as follows:

1. Curious Phase

If the child is mischievous, hyperactive, and highly curious about things around them, this is generally considered a normal developmental stage and does not require treatment.

2. Attention Deficit Hyperactivity Disorder (ADHD)

If inattention due to ADHD and susceptibility to external distractions is the cause, follow medical advice to treat with medications such as atomoxetine hydrochloride capsules or doxapram hydrochloride injection to improve attention deficits.

3. Hearing Impairment

If hearing loss or speech dysfunction results from hearing impairment, it is recommended to use hearing aids or undergo cochlear implantation as advised by a physician. Additionally, language training should be conducted to restore hearing and improve speech abilities.

4. Autism

Most individuals with autism experience communication difficulties. Due to impaired language comprehension, they may remain nonverbal. In such cases, parents should demonstrate extra patience and attentiveness, strive to understand their child's inner world, and build a friendship with the child, thereby providing meaningful support.

5. Speech Organ Abnormalities

Speech disorders caused by structural abnormalities such as cleft palate or short lingual frenulum may result in a three-year-old still being unable to speak. In such cases, visit a reputable hospital for thyroplasty—a surgical procedure that corrects abnormal shape or position of the vocal cords, restores normal laryngeal function, and improves voice production.

In addition, cerebral palsy could also be a potential cause. It is advisable to seek timely medical evaluation and follow prescribed treatments accordingly.