What are the reasons why a two-year-old child does not talk?

Under normal circumstances, possible reasons why a two-year-old child may not speak include delayed language development, insufficient language environment, short lingual frenulum, intellectual disability, autism, and other factors. If any abnormalities are observed, medical attention should be sought promptly and symptomatic treatment should be carried out under the guidance of a qualified physician. The specific analysis is as follows:

1. Delayed Language Development

Delayed language development is a phenomenon that occurs during a child's language acquisition process, referring to children who learn language at a slower rate than peers. It may be caused by various factors such as genetics, physiology, and environment, resulting in delayed language expression in two-year-olds, manifested as not speaking or speaking very little. Professional one-on-one speech therapy with a licensed speech therapist is required to help improve the child’s language expression abilities.

2. Insufficient Language Environment

An insufficient language environment refers to a lack of stimulation and diversity in the child’s language-learning surroundings—for example, limited communication among family members or monotonous linguistic input. Without adequate language exposure and stimulation, a two-year-old may lack opportunities and motivation to learn language, leading to delayed speech. Parents should engage more frequently with the child, using rich and varied language expressions to provide sufficient linguistic input.

3. Short Lingual Frenulum

A short lingual frenulum refers to an abnormally short tissue band connecting the tongue to the floor of the mouth, which restricts the tongue’s range of motion. This can affect tongue flexibility, cause difficulty in articulation, and consequently impair verbal expression in two-year-olds. Symptoms may also include unclear pronunciation, limited tongue movement, and difficulties with chewing or swallowing. Under medical guidance, a frenuloplasty or frenotomy may be performed to release the tight frenulum and improve tongue mobility.

4. Intellectual Disability

Intellectual disability refers to significantly delayed cognitive development compared to peers, potentially caused by genetic, disease-related, or environmental factors. It affects a two-year-old’s learning and comprehension abilities, including language acquisition, often resulting in no speech or limited speaking ability. Other common symptoms include poor learning capacity, difficulty concentrating, and impaired self-care skills. Treatment should follow medical advice and may include medications such as Zhierling Granules, Xiao'er Zhili Syrup, or Yangxue Qingnao Granules.

5. Autism

Autism is a neurodevelopmental disorder characterized by deficits in social interaction and communication, as well as repetitive behaviors and restricted interests. It may lead to severe impairments in social and language skills in two-year-olds, manifesting as absence of speech or significant language delay. Additional symptoms may include difficulties with social interaction, lack of eye contact, repetitive movements or interests, and either over-sensitivity or under-responsiveness to sensory stimuli. Under medical supervision, treatments may include Shugan Yipi Granules, Zhiqu Granules, or Jingling Oral Liquid.

Parents should closely monitor their child’s language development in daily life, ensure a rich and diverse language environment, and engage in frequent verbal interaction with the child.