Q&A: Does my child need speech therapy?

Though many normal children are late talkers, your daughter is late beyond what pediatricians would consider normal. And although children bathed in two languages often do speak a bit later than monolingual children, the degree of delay you are describing can't be accounted for by this.

Normally, children have four to six words by 14 months. This increases to more than 50 words by 22 months, at which point children begin to combine words into two-word phrases. By 26 months, the average child is carrying on short conversations and is beginning to understand prepositions. A two-year-old should also be able to follow a two-step command, for example, "Get your shoes, then your coat."

Even before speech therapy, your daughter needs an evaluation by her pediatrician as to why her speech is delayed. At minimum, this should include a hearing test, a thorough physical exam and a complete developmental assessment. The goal is to understand why she isn't speaking more.

If speech therapy is used (and it probably will be) at this age, it often involves the therapist engaging in play with the child, pointing out the words for objects, encouraging repetition, and modeling the correct pronunciation. The duration of therapy varies from a few weeks to several years.

As for your daughter's bottle, it is much easier to wean before a new baby arrives. If not, then wait until she seems well adjusted to her new family before trying to remove the bottle.