Before words, there is pointing. The small gesture of "look at that!" is one of the most important things a toddler does for language — which is why Japanese health checks ask about it at 18 months, and why we look at it closely when a family first comes to us.
The "look!" point shows that a child can direct your attention to the same thing and share the pleasure of it. That shared attention is the ground that words grow in: a word is only useful if you and I are looking at the same thing. This is why the sharing point is so closely tied to the growth of language and communication — and why its absence is worth noticing.
The 18-month health check in Japan looks at pointing. If a child shows almost no pointing by around 18 months, that is a reason to talk to someone — especially together with difficulty meeting your gaze, or concerns about understanding. For a child growing up with two languages, pointing is a useful sign precisely because it is not about any particular language.
Little or no pointing around 18 months, difficulty with eye contact or following your gaze, or worry about understanding — together, these are a good reason for an assessment. Start with your ward's public health centre or child development support centre, or come and see us; our speech-language therapists look at exactly this. No diagnosis is needed to visit.
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You do not need a diagnosis, a certificate, or fluent Japanese to take the first step. Send us a message in English, tell us your child's age and what you are noticing about their speech and language, and we will take it from there.