“My child talks all day. Why does the speech therapist say they have communication difficulties?”

This is a common question from parents.

A child may know hundreds of words. They may name animals, colours, vehicles, characters, or objects. They may even speak in long sentences.

Yet when someone asks, “What did you do today?” the child may not answer.

They may change the topic, repeat the question, talk only about their favourite interest, or walk away.

This can be confusing for parents.

The reason is simple: speaking and communicating are not exactly the same thing.

A child can have many words but still find social communication difficult.

What Is Pragmatic Language?

Pragmatic language is the way we use language in social situations.

It includes skills such as:

• Starting a conversation
• Taking turns
• Staying on the same topic
• Answering questions
• Asking questions
• Understanding what another person means
• Asking for clarification
• Changing the way we speak depending on the situation
• Repairing a communication breakdown
• Sharing information and experiences
• Understanding some non-verbal information

These skills develop alongside vocabulary and grammar, but they are not the same as simply knowing words.

Research describes pragmatics as the appropriate use of language during social interaction. Difficulties can occur in autistic children, but they are not limited to autism. Children with developmental language disorder can also experience pragmatic and social communication difficulties.

“But My Child Knows So Many Words”

Vocabulary is only one part of communication.

Consider two children.

Child A:
Can name 50 animals but does not ask another person questions.

Child B:
Knows fewer animal names but can say:

“Look! I saw a dog today.”

Then asks:

“Did you see a dog?”

Child B is demonstrating more conversational skills, even though Child A may have a larger vocabulary in that particular area.

This is why a speech-language assessment should look beyond the number of words a child can say.

Talking To Someone vs Talking With Someone

One of the clearest differences can be seen in conversation.

A child may talk to someone without actually having a conversation with them.

For example:

Child: “I have a dinosaur.”
Parent: “What colour is it?”
Child: “Dinosaurs eat meat.”
Parent: “What did you do at school?”
Child: “T-Rex is big.”

The child is producing language, but the conversation is not moving back and forth.

A conversation requires reciprocity.

One person communicates.

The other person responds.

Then the first person responds again.

This back-and-forth exchange is an important part of social communication.

Common Signs of Pragmatic Language Difficulties

Parents may notice that a child:

• Talks mostly about one favourite topic: Difficulty shifting topics
• Gives very long answers to simple questions: Difficulty judging how much information is needed
• Does not ask questions about others: Difficulty with reciprocal conversation
• Repeats the same question: May have difficulty processing or maintaining the interaction
• Answers questions but does not continue the conversation: Limited conversational reciprocity
• Interrupts frequently: Difficulty with conversational turn-taking
• Gives unrelated answers: Possible difficulty understanding the question
• Does not know how to respond when communication breaks down: Difficulty with communication repair

These signs do not automatically mean that a child has a disorder.

Children develop at different rates, and communication must always be considered in the context of the child's age, language abilities, development and environment.

Why Does This Happen?

There is no single reason.

A child may have difficulty with pragmatic language because of broader language difficulties. Some autistic children experience significant social communication differences. Children with developmental language disorder may also experience pragmatic difficulties.

Sometimes the problem is not that the child does not know the words.

The child may know exactly what the words mean but have difficulty deciding:

“What should I say here?”

For example, a child may understand the question:

“What did you do at school?”

but not know which information is relevant.

They may answer:

“School has a playground.”

That answer is related to school, but it does not answer the question.

This is a language-use problem, not simply a vocabulary problem.

How Can Speech Therapy Help?

Speech-language therapy can target specific communication skills.

Instead of only teaching more vocabulary, therapy may work on:

1. Answering and Asking Questions

The child can learn to answer different types of questions and gradually learn to ask questions themselves.

For example:

Adult: “What did you eat?”
Child: “Rice.”

Later:

Child: “What did you eat?”

The goal is to develop a two-way exchange.

2. Staying on Topic

A therapist may teach a child how to stay with a topic for several conversational turns.

For example:

“I went to the park.”

Instead of immediately changing the subject, the child can learn to add:

“I went on the slide.”

Then:

“My brother came too.”

3. Taking Turns

Conversation can be treated almost like a social game.

My turn.

Your turn.

My turn.

Your turn.

Games, pretend play, shared books and everyday activities can create natural opportunities to practise this skill.

4. Expanding Responses

A child who normally answers with one word may gradually learn to provide more information.

For example:

Adult: “Where did you go?”
Child: “Park.”

Later:

Child: “I went to the park.”

Eventually:

Child: “I went to the park with Mama. We played on the swings.”

The goal is not simply longer sentences.

The goal is useful and meaningful communication.

Parents Can Practise Conversation at Home

Parents do not need to turn every interaction into a lesson.

Everyday activities are enough.

During dinner, ask:

“What was your favourite part of today?”

During play:

“What should we build?”

While reading:

“What do you think will happen next?”

When the child answers, try to respond to the answer rather than immediately asking another question.

For example:

Child: “I went to the park.”

Instead of:

“What did you do? Who was there? What did you play?”

Try:

“You went to the park! I like going to the park too.”

Then pause.

The child may add another piece of information.

This creates a real conversation rather than a question-and-answer exercise.

Don't Measure Communication Only by Words

One of the biggest mistakes is assuming that more speech always means better communication.

A child can learn many new words while still struggling to:

• Share an experience
• Ask for help
• Tell someone what happened
• Respond appropriately
• Maintain a topic
• Understand another person's perspective
• Repair a misunderstanding

This is why comprehensive assessment matters.

Speech-language professionals may consider receptive language, expressive language, speech production, play, social communication and functional communication rather than looking at vocabulary alone.

Research on pragmatic interventions suggests that conversation and social communication can be specifically targeted in therapy. However, the evidence base is still developing, and outcomes can vary between children.

The Goal Is Not “Perfect Conversation”

Every child communicates differently.

The goal of therapy should not be to make a child sound exactly like a typically developing adult or to force a particular social style.

The goal is to help the child communicate effectively, independently and meaningfully.

That may mean learning to:

• Tell someone what happened
• Ask for help
• Join an activity
• Share an interest
• Answer a question
• Ask another person a question
• Tell someone when they do not understand
• Continue a conversation
• End a conversation appropriately

These are functional communication skills.

When Should Parents Seek Help?

Consider a speech-language evaluation if a child:

• Has difficulty participating in conversations despite having many words
• Rarely responds to questions
• Does not ask questions
• Frequently gives unrelated answers
• Has difficulty maintaining a topic
• Struggles to communicate needs or experiences
• Has difficulty understanding social language
• Frequently experiences communication breakdowns
• Has noticeable differences in social communication compared with peers

A child does not need to have a large vocabulary before these skills can be assessed.

Final Thought

If your child talks all day but still cannot have a conversation, it does not mean that the child is not communicating.

It may mean that they need support with a different layer of communication.

Words give us something to say.

Language helps us put those words together.

Pragmatic language helps us know how to use them with other people.

Understanding this difference can help parents and professionals move away from simply counting words and start looking at what matters most:

Can the child use communication to connect, participate, express themselves and understand others?

References

• Parsons, L., Cordier, R., Munro, N., Joosten, A., & Speyer, R. (2017). A systematic review of pragmatic language interventions for children with autism spectrum disorder. PLOS ONE, 12(4), e0172242.
• Andreou, G., Lymperopoulou, V., & Aslanoglou, V. (2022). Developmental Language Disorder (DLD) and Autism Spectrum Disorder (ASD): Similarities in pragmatic language abilities. International Journal of Developmental Disabilities, 70(5), 777–791.
• Jensen de López, K. M., Kuvač Kraljević, J., & Bang Struntze, E. L. (2022). Efficacy, model of delivery, intensity and targets of pragmatic interventions for children with developmental language disorder: A systematic review. International Journal of Language & Communication Disorders, 57(4), 764–781.
• Pereira, T., Lopes, A. C., Ramalho, A. M., & Lousada, M. (2025). Psychometric properties of the standardised instruments that are used to measure pragmatic intervention effects in autistic children: A systematic review. Autism & Developmental Language Impairments.