Why My Child Knows the Words but Doesn’t Use Them

Many parents notice that their child seems to understand everything that’s said to them but uses very few words to communicate. They may follow instructions, respond appropriately, or point to the right objects, yet struggle to express their own thoughts, needs, or ideas. This can feel confusing and concerning, especially when children appear to “know it” but can’t quite say it.

This pattern is often related to the difference between receptive language and expressive language, and it’s a common reason families seek speech therapy support.

Receptive vs. Expressive Language: What’s the Difference?

Receptive language refers to what a child understands. This includes following directions, recognizing words, and comprehending questions or stories. Expressive language, on the other hand, is how a child uses language to communicate through words, phrases, sentences, gestures, or signs.

Children typically develop receptive language skills faster than expressive language. In these cases, a child may understand far more than they can say. This doesn’t mean they aren’t learning language; it means the expressive side of communication needs extra support.

Why Does This Gap Happen?

There are many reasons a child may understand language but struggle to use it:

• Motor planning challenges, where the brain knows what it wants to say but has difficulty coordinating the movements needed for speech

• Limited confidence or frustration, especially if previous communication attempts haven’t been successful

• Expressive language delays, where vocabulary and sentence building develop more slowly

• Social communication differences, where children know words but don’t use them spontaneously

• Regulation or sensory factors, which can impact a child’s ability to organize and produce language

  
  

This gap is not caused by a lack of effort or motivation. Many children want to communicate but need the right strategies and environment to do so successfully.

How Speech Therapy Supports Expressive Language

Speech therapy focuses on helping children turn understanding into communication they can use in everyday life. Through play-based, child-centred approaches, speech-language pathologists work on building vocabulary, sentence structure, and confidence in a way that feels natural and motivating.

Speech therapy may also support:

• Social skills, such as initiating conversations and responding to others

• Functional communication, including requesting, commenting, and expressing emotions

• Reducing frustration, by giving children effective ways to communicate

  
  

In some cases, behaviour consultation or pediatric occupational therapy can also play a role, especially if regulation, attention, or sensory processing is affecting communication. A collaborative approach helps address the whole child, not just the words they say.

Practical Questions Parents Often Ask

Families often wonder about the cost of speech therapy in Ontario, whether funding or insurance may apply, and if a referral is needed. In Ontario, referrals are not required to access private speech therapy or pediatric OT services. Many extended health plans provide partial coverage, and some families choose in-home services for added flexibility and comfort.

Accessing an assessment can provide clarity, even if you’re unsure whether therapy is needed. Assessments help identify strengths, areas of need, and the best next steps for your child.

Supporting Your Child Moving Forward

If your child understands language well but isn’t using many words yet, you’re not alone. With the right support, many children make meaningful progress in expressive communication.

At Hello Speech, we provide speech therapy, behaviour consultation, and pediatric OT services across Toronto, the GTA, and surrounding areas, including Thornhill. Services are available in-home, in-clinic, and virtually, based on what works best for your family.

If you’d like guidance or are considering an assessment, our team is here to help you better understand your child’s communication and support their growth with confidence.