Speech delay is one of the commonest presentations seen in children living in the UAE. However, it is only an indicator of a specific underlying neurological/pervasive/psychiatric disorder. It requires a thorough assessment by a neurologist, child psychiatrists and Speech therapist before therapy can be instituted. Usually, the cause is either familial, constitutional or associated with an underlying pervasive disorder like Autism. However, in some cases underlying epilepsy, inherited metabolic problems or a genetic diagnosis is picked up.