Episode #46
46. What Counts as a Word? Toddler Speech Milestones, Late Talkers, and When Not to Wait with Pediatric SLP Caley Nunnally
Does "bah" count as a word? What about the sign for more? And if you're told to wait and see, but something in your gut is telling you not to...then what? My son has been in speech therapy since he was about 17 months old, so this one is personal. As a physical therapist, motor milestones have always felt pretty concrete to me. If a baby isn't rolling, we see it. Speech never felt that clear, and looking back at old videos now, I can see things I didn't know to look for at the time. I'm joined by my friend Caley Nunnally, pediatric speech-language pathologist, mom of two, and founder of Learn with Chatterboxes. Caley has spent 13 years working with late talkers and early diagnosed autistic kids, with a specialty in AAC (augmentative and alternative communication). We talk about why word count is really just the tip of the pyramid, the three things that make a word "count" (signs included), what Caley looks for at the two-year checkup, and why some kids with strong understanding don't qualify for early intervention before age three. We also get into one of the biggest worries she hears from parents: that AAC or sign language will keep a child from talking. Caley explains why the research actually points the other way. She wraps up with the simple, everyday strategies she gives parents, starting with which words to focus on first. If you've ever sat there counting your toddler's words and wondering if you're overthinking it, this one's for you. About Caley: Caley Nunnally is a pediatric speech-language pathologist with 13 years of experience and a mom of two. She works primarily with late talkers and early diagnosed autistic children, with a specialty in augmentative and alternative communication (AAC). She splits her time between a children's hospital and her private practice, and shares speech and language education on Instagram at Learn with Chatterboxes. Connect with Caley: Instagram: @learnwithchatterboxes Caley answers questions in the comments on her posts, so that's the best place to ask questions. Connect with me: Website: milestonesandmotherhood.com Instagram: @milestones.and.motherhood and @more.than.milestones ✍️ Substack: https://substack.com/@morethanmilestones Tummy Time Masterclass: https://milestonesandmotherhood.com/tummy-time ️ Amazon storefront: https://a.co/d/03ucPZbo ✉️ For sponsorship or guest inquiries: podcast@milestonesandmotherhood.com If this conversation was helpful, follow More Than Milestones so you never miss an episode, and leave a rating or review. It really does help other parents find the show. Timestamps ⏱️ 00:00 Welcome and meet Caley 01:18 KC's side of this conversation: parenting a child in speech therapy 02:05 Looking at the whole child: joint attention, understanding, and gestures 03:50 Is there a timeline for first words? 06:28 Do signs count as words? 07:30 Why speech milestones feel harder to spot than motor milestones 08:22 Early intervention and why some kids don't qualify before age 3 09:52 Receptive vs. expressive language 11:22 Does AAC, sign language, or bilingualism delay speech? 14:42 What to look for at two years: 50 words and two-word combinations 19:17 Words vs. utterances (and why "all done" is one word) 21:12 When your gut says don't wait: outpatient therapy options 24:39 Caley's top tips for supporting speech at home 29:16 Where to find Caley
