Recognizing Delays in a Child's Speech and Language Development

Children vary in their development of speech and language. There is, however, a natural progression or "timeline" for mastery of these skills for each area of development. Milestones are identifiable skills that can serve as a guide to normal development. Typically, simple skills need to be reached before the more complex skills can be learned. There is a general age and time when most children pass through these periods. These milestones help doctors and other healthcare professionals determine when a child may need extra help to learn to speak or produce sounds more clearly. Below are some of the typical speech and language milestones and “red flags” that might indicate a child is having challenges that might require the support of a pediatric Speech-Language Pathologist (SLP).

Speech and Language Developmental Milestones

General milestones for speech and language development for children ages 0 to 3 years

By Age 1

• Recognizes name
• Startles to a very loud sound (example: a pot falling)
• Turns and looks in direction of sounds
• Says one to two words (examples: “no,” “car,” “mama”)
• Recognizes words for common items (examples: “cup,” “shoes,” “juice”)
• Begins to respond to requests (examples: “come here,” “want more?”)
• Uses speech or non-crying sounds to get and keep attention
• Imitates different speech sounds
• Uses communicative gestures such as pointing and pulling
• Follows 1-step commands (examples: “roll the ball,” “where’s your shoe?”)

Red flags: A quiet baby – few vocalizations, no sound play or babbling; no pointing or gesturing; uses only vowels in vocalizations; does not respond to voice or sounds

By Age 2

• Follows 2-step commands (examples: “pick it up and throw in trash,” “get your cup and put it in the sink”)
• Understands simple questions (examples: “do you want to go outside?” “do you want more?”)
• Points to basic body parts when named
• Listens to simple stories, songs, and rhymes
• Points to pictures in a book when named
• Produces many different consonant sounds at the beginning of words
• Asks questions (examples: “what’s that?” “go bye-bye?”)
• Puts two words together (examples: “more cookie,” “no juice,” “mommy book”)
• Spoken vocabulary should consist of at least 50 words

Red flags: No imitative skills; limited spoken vocabulary; limited variety of consonants; distortions of vowels sounds; little response to name, directions or questions

By Age 3

• Understands differences in meanings of words (examples: in/out, go/stop, up/down)
• Follows 3-step directions (examples: “get the cup, put it on the table, and sit down”)
• Uses words to label objects and actions
• Uses 2 to 3 words to talk about and ask for things (examples: “all gone juice,” “I want more”)
• Speech is understood by familiar listeners most of the time
• Answers simple “who,” “what,” and “where” questions
• Begins to retell simple stories
• Produces vowel sounds correctly
• Correctly produces “m,” “n,” “p,” “b,” “h,” and “w,” in the beginning, middle, and ends of simple words

Red flags: Unintelligible speech; limited vocabulary; short utterances (only 1-2 words); little response to questions or directions

The earlier a child’s speech and language problems are identified and treated, the less likely the problem will persist or get worse. If you think your child may have a delay in his/her speech or language skills, contact your physician for more information regarding pediatric speech and language therapy services.

PVHMC’s Milestones Center for Child Development is dedicated exclusively to the developmental needs of children. Our focus is to help our patients succeed in reaching the developmental milestones that will allow them to enjoy more independence as they continue to grow. Our pediatric Speech and Language Pathologists (SLPs) evaluate and treat a broad range of communicative disorders and delays. If you have any questions or concerns, feel free to contact Milestones at 909-621-7956.

Milestones Center for Child Development is located in Claremont, CA at the Pomona Valley Health Center. We will soon be opening our second location at the Pomona Valley Health Center in Chino Hills, CA.