Which of the following might be considered a red flag for speech and language delays in toddlers?

Difficulty following simple directions is indeed considered a red flag for speech and language delays in toddlers. This is because the ability to comprehend and respond to simple instructions is a fundamental aspect of language development. When a toddler has trouble understanding and acting upon basic directions, it may indicate issues with their receptive language skills, which are crucial for communication development.

In contrast, an extensive vocabulary use suggests that a toddler is acquiring and using language effectively, which is a positive indicator of speech and language development. Active social interactions demonstrate that a child is engaging with others, which is essential for practicing and using language in context. High engagement in play often reflects cognitive and language skills, as play can incorporate aspects of communication such as turn-taking, vocabulary use, and narrative skills. Therefore, while these other options indicate healthy development, difficulty following directions may signal the need for further assessment by a speech-language pathologist.