Q: At what age should a young child be able to speak so that you can understand what they are saying? My nephew is four years old and although he chats away happily, you can’t make out more than one or two obvious words.

A: Most babies can say words like “mama” or “dada” at one year of age. Often their first real word is “no.”

By the age of two, toddlers use about 50 words and often use two words together. They usually understand more words than they can speak, which sometimes frustrates them when they are trying to ask for something.

Children who are talked to and read to more often tend to learn to talk sooner and it is thought that babies even listen when they are in the womb.

Girls generally learn to speak earlier than boys. Sometimes a young child will point to an object or toy they want rather than asking for it with words and the parent will oblige without saying anything. The child will learn quicker if the parent insists on the correct word being used.

By age four, a child should be able to name most common colours and be able to follow three instructions such as, “go to the bathroom, wash your hands and dry them with a towel.” They can use past tenses and make sentences with up to five or six words and should speak clearly enough so that even strangers can understand them most of the time.

Although there is a lot of variation in the speed of learning to speak, it is important that someone keeps track of this because unusual delays can signal something more serious, such as a developmental problem or autistic spectrum disorder-ASD.

Perhaps the child has a hearing problem. If a child was previously talking normally and then regresses to baby talk, this could be a sign of stress and a need to be cuddled and treated like a baby for a while.

My suggestion is that you discuss this with your family and see if they are willing to consult a doctor about hearing or developmental issues, and possibly make a referral to a speech therapist as well.

The sooner this is diagnosed the better the treatment outcome, or perhaps they will be reassured that nothing is wrong and it is simply a normal variation.

Be prepared to be met with some level of hostility because no one want to believe there is anything wrong with their child.