Pediatric Speech Therapy Services

Milestones for Speech and Language Development 

Early signs of communication occur when an infant cries for food and/or wants comfort. The infant begins to recognize his or her mother’s voice. As they grow, they learn to make the sounds of their language. By 6 months of age, babies recognize the basic sounds of their native language. Although children vary in their development, they do follow a natural progression of mastering language skills. Achieving Developmental Milestones are indicators of a progression in language skills mastery. Some children are delayed in their speech and/or language sometimes because of a hearing loss, or perhaps a speech or language disorder. It should also be noted that healthy hearing is essential for normal speech and language development.

Speech-Language Developmental Milestones

Birth – 3 Months
Hearing and Understanding

• Startles to loud sounds.
• Quiets or smiles when spoken to.
• Seems to recognize your voice and quiets if crying.
• Increases or decreases sucking behavior in response to sound.

Talking

• Makes pleasure sounds (cooing, gooing).
• Cries differently for different needs.
• Smiles when sees you.

4 – 6 Months
Hearing and Understanding

• Moves eyes in direction of sounds.Responds to changes in tone of your voice.
• Notices toys that make sounds.
• Pays attention to music.

Talking

• Babbling sounds more speech-like with many different sounds, including p,b, and m.
• Chuckles and laughs.
• Vocalizes excitement and displeasure.
• Makes gurgling sounds when left alone and when playing with you.

6 Months – 12 Months
Hearing and Understanding

• Enjoys games like peek-a-boo and pat-a-cake.
• Turns and looks in direction of sounds.
• Listens when spoken to.
• Recognizes words for common items like cup, shoe, juice.
• Begins to respond to requests (“Come here,” “Want more?”).

Talking

• Babbling has both long and short groups of sounds such as “tata upup bibibibibi.”
• Uses speech or non-crying sounds to get and keep attention.
• Uses gestures to communicate (e.g. waving, holding arms to be picked up).
• Imitates different speech sounds.
• Has one or two words (Hi, dog, dada, mama) around first birthday, although sounds may not be clear.

12 Months
Hearing and Understanding

• Responds to their name.
• Understands simple directions with gestures.

Talking

• Uses a variety of sounds.
• Plays social games like “peek-a-boo.”

15 Months
Hearing and Understanding

• Plays with different toys.
• Understands simple directions.

Talking

• Uses a variety of sounds and gestures to communicate.
• Uses some simple words to communicate.

18 Months
Hearing and Understanding

• Understands several body parts.
• Attempts to imitate words you say.
• Uses at least 10–20 words.

24 Months
Hearing and Understanding

• Follows simple commands and understands simple questions (“roll the ball,” “kiss the baby,” “Where’s your shoe?”).
• Listens to simple stories, songs, and rhymes.
• Points to pictures in a book when named.

Talking

• Says more words every month.
• Uses at least 50 words.
• Puts two words together (“more cookie,” “no juice,” “mommy book”).
• Uses many different consonant sounds at the beginning of words.

2 to 3 Years
Hearing and Understanding

• Understands differences in meaning (“go-stop,” “in-on,” “big-little,” “up-down”).
• Follows two requests (“Get the book and put it on the table”).
• Combines three or more words into sentences.
• Understands simple questions.
• Recognizes at least two colors.
• Understands descriptive concepts.

Talking

• Has a word for almost everything.
• Uses two or three-words to talk about and ask for things.
• Uses k, g, f, t, d, and n sounds.
• Speech is understood by familiar listeners most of the time.
• Often asks for or directs attention to objects by naming them.
• Asks why?
• May stutter on words or sounds.

3 to 4 Years
Hearing and Understanding

• Hears you when you call from another room.
• Hears television or radio at the same loudness level as other family members.
• Understands words for some colors like red, blue, and green.
• Understands words for some shapes like circle and square.
• Understands words for family like brother, grandmother, and aunt.

Talking

• Talks about activities at school or at friends’ homes.
• Talks about what happened during the day. Uses about 4 sentences at a time.
• People outside of the family usually understand child’s speech.
• Answers simple “who?” , “what?”, and “where?” questions.
• Asks when and how questions.
• Says rhyming words like hat-cat.
• Uses pronouns like “I, you, me, we,” and “they.”
• Uses some plural words such as toys, birds, and buses.
• Uses many sentences that have 4 or more words.
• Usually talks easily without repeating syllables or words.

4 to 5 Years

• Understands words for order such as first, next, and last.
• Understands words for time like yesterday, today, and tomorrow.
• Follows longer directions such as “Put your pajamas on, brush your teeth, and then pick a book to read.”
• Follows classroom directions such as “Look at the pictures. Draw a circle on your paper around something you eat.”
• Hears and understands most of what is said at home and in school.

Talking

• Says all speech sounds in a word. May make mistakes on sounds that are harder to say such as l, s, r, v, z, ch, sh, th.
• Responds to “What did you say?”
• Talks without repeating sounds or words most of the time.
• Names letters and numbers.
• Uses sentences that have more than 1 action word like “jump, play, and get.” May make some mistakes such as “Zach gots 2 video games, but I got one.”
• Tells a short story.
• Keeps a conversation going.
• Talks in different ways depending on the listener and place. May use short sentences with younger children or talk louder outside than inside.

Compiled from www.asha.org, “How Does Your Child Hear and Talk?”

What are the Warning Signs of a communication disorder in any young child?

Here are some of the common warning signs of a communication disorder by age range:

Birth to 6 Months

• Developmental or medical problems.
• Lack of response to sound.
• Lack of interest in speech.
• Limited eye contact.
• Very limited vocalizations.
• Difficulties with attachment.
• Lack of interest in socializing.
• Feeding problems.

6 to 12 Months

• Limited sound production, lack of variety or amount.
• Groping oral movements when attempting to make or imitate sounds.
• Oral-motor problems such as excessive drooling, trouble with solid foods, intolerance to touch in and around the mouth.
• Lack of interest in sound-making toys, radios, T.V., music, voices.
• Developmental or medical problems.
• Lack of response to sound.
• Lack of interest in speech.
• Limited eye contact.
• Feeding problems.
• Very limited vocalizations.
• Difficulties with attachment.
• Lack of interest in socializing.

12 to 18 Months

• Easily distractible.
• Does not understand any words or directions.
• Limited sound production, lack of variety or amount.
• Oral groping movements when attempting to make or imitate sounds.
• Oral-motor problems such as excessive drooling, trouble with solid foods, intolerance to touch in and around the mouth.
• Lack of interest in sound-making toys, radios, T.V., music, voices.

18 to 24 Months

• Not using words some of the time to communicate.
• No interest in imitation.
• Won’t play games.
• No jargon.
• Grunting and pointing as primary means of communication.
• Easily distractible.
• Does not understand any words or directions.
• Limited sound production, lack of variety or amount.

2 to 3 Years Old

• Not combining words.
• Must be told and retold to carry out simple directions (not just non-compliance).
• Using only nouns.
• Poor eye contact.
• No rapid increase in number of words understood and used.
• Does not tolerate sitting for listening activity/looking at books, etc.

3 to 4 Years Old

• Not speaking in full sentences (not necessarily correct grammar, but nice variety of word types).
• Not using “I” to refer to self.
• Cannot relate experiences, even in simple telegraphic sentences.

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