Parents who are concerned with their child’s speech and language development may not know what to do or where to go for help. With the help of a speech-language pathologist, it is possible to evaluate both receptive and expressive speech and language skills.
Receptive skills include a child’s ability to listen and understand, and expressive skills include a child’s ability to speak and use language, such as sounds, gestures and/or words.
Keep in mind that children learn at different rates. Watch for language skills that develop steadily, not whether they are fast or slow. Below is a list of basic speech and language milestones to look for, as well as some red flags, and the next steps to take if you are concerned.
A child’s common speech and language milestones include:
Six months
• Babbles, laughs, coos.
• Turns to look at new sounds.
• Recognizes familiar people.
12 months
• Uses simple gestures, such as waving, pointing and clapping.
• Begins to understand the meaning of simple words and daily routines, such as eating and bedtime.
• Follows some basic instructions.
• Begins to imitate sounds and may say two or three words.
18 months
• Uses 10 to 20 words.
• Recognizes pictures of familiar people and objects.
• Points out several body parts on self or a doll.
Two years
• Has a vocabulary of at least 100 words.
• Combines several words.
• Understands simple questions and instructions.
• Can be understood 50 to 75 percent of the time.
Three years
• Sings simple songs and nursery rhymes.
• Asks and answers simple questions.
• Follows two- and three-step directions.
Four to five years
• Identifies colors and shapes.
• Can be understood 90 percent of the time.
• Asks “who” and “why” questions.
• Can retell a story.
When to seek help
Children who have one or more of the following issues may need to be evaluated by a speech-language pathologist.
• No babbling, pointing or gesturing by 12 months.
• Frequent ear infections with middle ear fluid.
• No single words by 16 months.
• Difficulty with or reluctance to imitate new sounds or words by age 2.
• No two-word spontaneous phrases by 24 months.
• Difficulty sucking, chewing or swallowing.
• Poor voice quality.
• Failure to answer simple questions and follow two-step directives by age 2½.
• Stuttering that causes a child embarrassment, frustration or difficulty with peers.
• Regression in language or social skills at any age.
Referral process
If you are concerned about your child’s speech-language development, discuss your concerns with your pediatrician. The Masters Family Speech and Hearing Center at Children’s Hospital of Wisconsin offers speech, language and hearing assessments for children from infancy through adolescence.
Susan W. Haessler, MS/CCC-SLP, is a pediatric speech-language pathologist at Children's Hospital of Wisconsin Clinics-North Shore.
FAST FACT: Parents don’t have to rely on the predictions of others or guess whether their child will be just like a friend’s and eventually catch up in language development. (“My son was slow, too. Now he won’t stop talking.”) If you are concerned about you child’s speech and language development, talk to your pediatrician or a speech-language pathologist.