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The aim of this paper is to examine the natural history of early speech and language delay in preschool children over a 12-month period.The study reports data on 69 children under the age of 3.5 years who were referred for speech and language therapy because of early speech and language delay. The children were monitored over a 12-month period but received no direct intervention during that time. Assessment of their comprehension, expressive language and their phonology took place at baseline and again at 6 and 12 months after baseline.The results show a general picture of improvement, although there was considerable individual variation. By the end of the 12 months, two-thirds of the children were still eligible on the study intake criteria. Therapist's rating of a child's functional communication at the outset was a significant predictor of the child's outcome at the end of the 12-month period.The paper discusses the appropriateness of a ‘monitoring’ approach to the management of early language delay and highlights the need to consider the social issues and views of parents as well as the severity of a child's difficulties.