Only an evaluation can tell. A speech or language problem mainly affects how a child talks or understands, while autism also affects communication without words and relating to others. At 3, ask your pediatrician for a speech-language evaluation with a hearing test and a diagnostic evaluation, and ask the school district's Child Find for a free screening.
What do most children do by age 3?
According to the CDC checklists, most 3-year-olds:
- Talk with you using at least two back-and-forth exchanges.
- Ask “who,” “what,” “where” or “why” questions.
- Say their first name when asked.
- Talk well enough for others to understand, most of the time.
- Notice other children and join them to play.
Speech delay, language disorder or autism?
NIDCD, part of the National Institutes of Health, describes them this way:
- Speech disorder: trouble producing speech sounds correctly, or hesitating or stuttering when talking.
- Language disorder: trouble understanding what others say or sharing thoughts.
- Autism: it often affects communication without words too. A child may not point, may avoid eye contact or not respond to their name, and may find it hard to relate to children their age.
Which evaluations do I ask for in Palm Beach County?
- From your pediatrician: a referral to a speech-language pathologist. NIDCD says a hearing test is often part of that evaluation, because a hearing problem can affect speech and language.
- If autism worries you: a diagnostic evaluation. Our autism evaluation guide explains where to go.
- From the school district's Child Find: if your child is 34 months to 5 years old and not in public school, FDLRS/Alpha does free developmental screenings, with no insurance or doctor's referral needed (561-434-8975).
What if my child was in Early Steps?
Early Steps serves children up to 36 months. Florida law (section 391.3081) created an Extended Option to stay until the school year after the fourth birthday, but it needs state and federal approval and funding. Early Steps says it does not have the resources to start it in the upcoming fiscal year.
Speech therapy, ABA or both?
They are different services: speech therapy works on communication; ABA therapy works on behavior and everyday skills. NIDCD says the best program for a child with autism starts early, addresses both behavior and communication, and involves the family. So the two can fit in one plan; the evaluation will say what your child needs.
Paramount Behavior provides ABA therapy at home and at school across Palm Beach County, in English and Spanish: (561) 421-0047.
Is it normal for a child to start talking at 4?
There is no way to know without an evaluation. NIDCD says some children with developmental language disorder may not begin to talk until their third or fourth year, and a speech-language pathologist may recommend therapy. Don't wait to ask.
Does Child Find cost anything?
FDLRS/Alpha Child Find screenings are free and need no insurance or doctor's referral. They are for children from 34 months to 5 years old who are not enrolled in public school.
Can my child stay in Early Steps after age 3?
Not for now. The Extended Option is in Florida law, but Early Steps says it does not have the resources to start it in the upcoming fiscal year and keeps serving enrolled children up to age 3.
General information, not a diagnosis. If your child loses words or skills they once had, call the pediatrician promptly; in an emergency, call 911.
Sources
- Indicadores del desarrollo a los 3 años (Milestones by 3 Years). Centers for Disease Control and Prevention (CDC), accessed October 30, 2026.
- Speech and Language Developmental Milestones. National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health, accessed October 30, 2026.
- Autism Spectrum Disorder: Communication Problems in Children. National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health, accessed October 30, 2026.
- Child Find. FDLRS/Alpha (Florida Diagnostic and Learning Resources System), West Palm Beach, accessed October 30, 2026.
- Eligibility and Screening (Early Steps Extended Option program update). Florida Department of Health, Early Steps Program, accessed October 30, 2026.