Is what you’re seeing just part of growing up, or worth a closer look? These are the situations parents bring to us most. Find the one that sounds like your child, then take one small next step.
Below are the 8 situations parents describe to us most often at our children’s therapy centre in Multan — late talking, speech strangers can’t follow, early autism signs, attention and impulsiveness, sensory overwhelm, reading and writing struggles, stammering, and a child who talks at home but not at school. Each one sets out what parents notice, what may be behind it, and how we would usually help.
Parents usually put it to us in their own words first: bacha bolta nahi (بچہ بولتا نہیں), zaban saaf nahi (زبان صاف نہیں), aik jagah nahi baithta (ایک جگہ نہیں بیٹھتا). Say it however it comes out — Urdu, Saraiki, Punjabi or English. Nobody needs the clinical word for it.
These are illustrative examples, not real children. Every child is their own person, and a sign or two on its own rarely means something’s wrong. The only way to really know what your child needs is an assessment. Still, these examples can help you decide whether a conversation is worth having.
Around 2 years
My 2-year-old isn’t really talking yet — should I worry?
What parents often notice
Fewer than about 50 words, and no two-word pairs like “more milk” yet
Clearly understands everything you say, but hands very little back
Points, pulls you by the hand or cries instead of using words
What might be going on
Plenty of late talkers just need a bit of a nudge; for some, there’s a speech or language delay sitting underneath. The thing I always reassure parents about is that this is one of the most treatable areas going — and the sooner you start, the quicker most children close the gap.
How we’d usually help
We’d begin with a gentle, play-based assessment to tell a real delay apart from a slow start, and check that hearing isn’t the culprit. After that it’s short, fun sessions with us, plus a few easy things you can do at home to coax the words out.
My child talks a lot but strangers can’t understand them
What parents often notice
Says “wabbit” for “rabbit” or “tup” for “cup”, or drops sounds off the ends of words
You and close family follow them fine, but teachers and shopkeepers often don’t
Getting cross, or giving up, when they’re not understood
What might be going on
This usually points to an articulation or phonological difficulty — the thoughts and the words are all there, it’s just that certain sounds aren’t landing clearly yet. Some slip-ups are perfectly normal at a given age; others are worth a proper look.
How we’d usually help
An assessment pins down exactly which sounds are off and whether that’s still fine for their age. From there we teach the tricky ones through play, games and heaps of encouragement — never drills at a table.
My child avoids eye contact, lines up toys and repeats phrases
What parents often notice
Not much eye contact, and often no answer when you call their name
Repeating words or whole lines from cartoons (we call this echolalia)
Lining toys up in rows, spinning things, or big upset when a routine changes
What might be going on
These can be early signs of autism — though every autistic child is their own person, and plenty of children show one or two of these and aren’t autistic at all. What actually matters is understanding your child, not rushing to a label.
How we’d usually help
A developmental assessment gives us a clear picture of your child’s strengths as well as their needs. From there, support might blend speech work, our autism programme and a handful of simple strategies that make everyday life calmer for the whole family.
My child can’t sit still, won’t focus and is very impulsive
What parents often notice
Always on the go, and waiting or taking turns feels near impossible
Struggles to see a task through, or to follow more than one instruction
It’s starting to bite into their learning or their friendships
What might be going on
When the energy and the flitting attention go well past ordinary toddler bounce and start getting in the way of daily life, it’s worth looking a bit closer — sometimes that turns out to be ADHD, sometimes it sits alongside other needs.
How we’d usually help
We work out what’s driving it, then build focus, self-control and calmer routines through behavioural support — while coaching you on the strategies that actually hold up at home and at school.
My child melts down at loud sounds, textures or busy places
What parents often notice
Clamps hands over their ears, and refuses certain clothes or food textures
Craves movement — spinning, crashing, squeezing into tight spaces
Has meltdowns (which aren’t the same as tantrums) when it all gets too much
What might be going on
This often comes down to a sensory processing difficulty — the brain is turning the volume up too high, or too low, on everyday sights, sounds, textures and movement, and that shows up in how a child behaves and how comfortable they feel.
How we’d usually help
Occupational therapy and sensory integration help your child’s system feel more settled, and we build a simple “sensory diet” of little activities into the day so they can cope and join in far more comfortably.
My child is bright but really struggles with reading and writing
What parents often notice
Reading and spelling are miles harder for them than everything else
Handwriting is messy and effortful, with letters sometimes back to front
Clearly bright and capable, yet slipping behind at school
What might be going on
A specific learning difficulty like dyslexia or dysgraphia can make reading, spelling or handwriting genuinely hard even when a child is sharp as anything elsewhere. It’s about the way they learn, not how clever they are.
How we’d usually help
An assessment pinpoints exactly where the gaps are, then remedial teaching and occupational therapy build the skills back up — usually with an Individualised Education Plan so home and school are working off the same page.
My child has started repeating sounds and getting “stuck”
What parents often notice
Repeating sounds or words (“b-b-ball”), or stretching them right out
Visible effort, blinking or a bit of tension when the words won’t come
Starting to dodge talking, or getting upset about the way it sounds
What might be going on
A bit of early stammering often rides along with a big burst of language and settles by itself; other times it does better with some help — especially if it’s sticking around, runs in the family, or is upsetting your child.
How we’d usually help
We take a proper look at the stammer, then coach both your child and you on gentle, no-pressure ways to build smooth, confident talking — and with this one, the earlier we start, the better it tends to go.
My child talks happily at home but won’t speak at school
What parents often notice
A proper chatterbox at home, yet completely silent elsewhere
Freezes, or drops to a whisper, when they’re expected to speak in other places
It’s gone on more than a month and it’s affecting school
What might be going on
This pattern can point to selective mutism — an anxiety-based difficulty, not stubbornness or shyness a child can simply decide to switch off. The reassuring bit is that it responds really well to the right, gentle approach.
How we’d usually help
We move at your child’s pace, easing the anxiety down and slowly widening the places they feel able to talk — working hand in hand with you and, wherever we can, the school too.
Waiting a few weeks is reasonable when one mild sign has only just appeared and your child is otherwise playing, connecting and learning. Ask for an assessment now if the difficulty has gone on for months rather than weeks, shows up in more than one area of development, is frustrating your child, or if skills they already had have faded.
“Wait and see” used to be standard advice, and for a genuinely late starter it is often right. What has changed is that we no longer wait when the picture is broader than that — because the years when children learn fastest are the years when help does the most, and because a few weeks of watching costs you nothing if you are also writing down what you see.
The most useful thing you can bring us is your own noticing. Keep a note on your phone for a fortnight: how many different words your child uses (in every language together), who understands them apart from you, what set off the last big meltdown, how long they stayed with one activity. Parents are almost always right that something is different, even when they can’t name it — and a page of real examples is worth more to an assessment than any checklist.
Watching and waiting is a real option — but it has conditions, and a few signs sit outside it. If you are unsure which side you are on, that itself is a good reason to ask.
If you would like something more concrete than “months rather than weeks”, our age-by-age milestone checklists set out what most children are doing from six months through to five years. And if your child has already been given a diagnosis, what to do in the first weeks after a diagnosis is the calmer place to start.
Don’t see your child here?
These are only the situations we see most often; we help with plenty more. If something feels off to you, trust that. You don’t need the right word for it to reach out.
The questions parents ask us most once they have recognised their child on this page.
My child ticks one or two of these — does that mean something is wrong?
Usually not. A single sign on its own is a very ordinary part of childhood, and children move at their own pace. What matters more is the pattern: how long it has gone on, whether it shows up in more than one area of development, and whether it is getting in the way of playing, learning or family life. If the pattern is there, ask.
My child has signs from more than one situation on this page. Which one do I go with?
That is common, and it does not mean your child has several conditions. Difficulties overlap — a child who cannot make himself understood often looks impulsive or withdrawn as well. Start with whichever difficulty is affecting daily life most, and mention the others when you message. Sorting out what is driving what is exactly what an assessment is for.
Do I need a doctor’s referral or a diagnosis before I contact you?
No. You can come to us directly — no referral letter, no diagnosis, no paperwork. The first consultation is free and you will not be asked to commit to anything during it. If your child already has a report from a paediatrician, psychologist or school, bring it, as it saves repeating things. And if we do not think your child needs therapy, we will say so.
We speak Urdu, Saraiki and English at home. Is that why my child isn’t talking?
Growing up with more than one language does not cause a speech or language delay. When you count your child’s words, count them across every language — a child with ten Urdu words and five English words has fifteen words, not five. Keep speaking the language you are warmest and most natural in; that is the one your child learns most from.
What actually happens at a first visit?
Mostly play, and a lot of listening to you. We watch how your child plays, communicates, moves and copes with a new room, and we ask about hearing, milestones, school and what an ordinary day looks like at home. You leave with our honest impression in plain words and a suggested next step — which is sometimes simply to come back in a few months.
Will what I tell you about my child stay private?
Yes. Information about your child is used to understand and support them, and is shared only with the professionals directly involved in their care. We do not publish names, photos or stories from real families — every situation on this page is a composite example we wrote ourselves. Our privacy policy sets out exactly how your details are handled.
We’re at MPS Road, Block A Model Town, Multan (near Bloomfield Hall School, Street No. 2), open Monday – Saturday, 10:00 AM – 7:00 PM. Message or call +92 314 6040262, or see all the ways to reach us.
Take the first step
Recognised your child in one of these?
A short, friendly conversation is the best next step. Tell us what you’re seeing and we’ll help you understand it, and work out what (if anything) to do.
