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Speech and Language

Developmental Milestones


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Speech, Language and Hearing Problems

speech language developmentChildren vary in their development of speech and language. There is, however, a natural progression or "timetable" for mastery of these skills for each language.

These milestones help doctors and other health professionals determine when a child may need extra help to learn to speak or to use language.

Birth - 5 Months

Reacts to loud sounds.

Turns head toward a sound source.

Watches your face when you speak.

Vocalizes pleasure and displeasure sounds (laughs, giggles, cries, or fusses).

Makes noise when talked to.

6-11 Months

Understands "no-no."

Babbles (says "ba-ba-ba" or "ma-ma-ma").

Tries to communicate by actions or gestures.

Tries to repeat your sounds.

12-17 Months

Attends to a book or toy for about two minutes.

Follows simple directions accompanied by gestures.

Answers simple questions nonverbally.

Points to objects, pictures, and family members.

Says two to three words to label a person or object (pronunciation may not be clear).

Tries to imitate simple words.

18-23 Months

Enjoys being read to.

Follows simple commands without gestures.

Points to simple body parts such as "nose."

Understands simple verbs such as "eat," "sleep."

Correctly pronounces most vowels and n, m, p, h,especially in the beginning of syllables and shortwords. Also begins to use other speech sounds.

Says 8 to 10 words (pronunciation may still be unclear).

Asks for common foods by name.

Makes animal sounds such as "moo."

Starting to combine words such as "more milk."

Begins to use pronouns such as "mine."

2-3 Years

Knows about 50 words at 24 months.

Knows some spatial concepts such as "in," "on."

Knows pronouns such as "you," "me," "her."

Knows descriptive words such as "big," "happy."

Says around 40 words at 24 months.

Speech is becoming more accurate but may still leaveoff ending sounds. Unfamiliar listeners may not be able to understand much of what is said.

Answers simple questions.

Begins to use more pronouns such as "you," "I."

Speaks in two to three word phrases.

Uses question inflection to ask for something (e.g., "My ball?").

Begins to use plurals such as "shoes" or "socks" and regular past tense verbs such as "jumped."

3-4 Years

Groups objects such as foods, clothes, etc.

Identifies colors.

Uses most speech sounds but may distort someof the more difficult sounds such as l, r, s, sh,ch, y, v, z, th. These sounds may not be fully mastered until age 7 or 8.

Uses consonants in the beginning, middle, and endsof words. Some of the more difficult consonants may be distorted, but attempts to say them.

Strangers are able to understand much of what is said.

Able to describe the use of objects such as "fork," "car," etc.

Has fun with language. Enjoys poems and recognizeslanguage absurdities such as, "Is that an elephant on your head?"

Expresses ideas and feelings rather than just talkingabout the world around him or her.

Uses verbs that end in "ing," such as "walking," "talking."

Answers simple questions such as "What do you dowhen you are hungry?"

Repeats sentences.

4-5 Years

Understands spatial concepts such as "behind," "next to."

Understands complex questions.

Speech is understandable but makes mistakes pronouncing long, difficult, or complex words such as "hippopotamus."

Says about 200 - 300 different words.

Uses some irregular past tense verbs such as "ran," "fell."

Describes how to do things such as painting a picture.

Defines words.

Lists items that belong in a category such as animals, vehicles, etc.

Answers "why" questions.

5-6 Years

Understands more than 2,000 words.

Understands time sequences (what happened first,second, third, etc.).

Carries out a series of three directions.

Understands rhyming.

Engages in conversation.

Sentences can be 8 or more words in length.

Uses compound and complex sentences.

Describes objects.

Uses imagination to create stories.

Talk to your family doctor if you have any concerns about your child's speech or language development.

Your doctor may decide to refer you to a speech-language pathologist, a health professional trained to evaluate and treat people who have speech, language, voice or swallowing disorders (including hearing impairment) that affect their ability to communicate.

The speech-language pathologist will talk to you about your child's communication and general development.

He or she will also evaluate your child with special speech and language tests. A hearing test is often included in the evaluation because a hearing problem can affect speech and language development.

Depending upon the test results, the speech-language pathologist may suggest activities for home to stimulate speech and language development. These activities may include reading to your child regularly; speaking in short sentences using simple words so that your child can successfully imitate you; or repeating what your child says, using correct grammar or pronunciation. For example, if your child says, "Ball baybo" you can respond with, "Yes, the ball is under the table." This allows you to demonstrate more accurate speech and language without actually "correcting" your child which can eventually make speaking unpleasant for him or her.

The speech-language pathologist may also recommend group or individual therapy or suggest further evaluation by other health professionals such as an audiologist, a health care professional who is trained to identify and measure hearing loss, or a developmental psychologist.

Related Articles
Your Child's Hearing (Ears)
Your Baby's Hearing Checklist
Ear Infections
Auditory Processing Disorder
Speech, Language and Hearing Problems


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Speech and Language Developmental Milestones


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