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Milestones and warning signs for speech and language development

Have you ever wondered how your child is growing and developing compared to other children of the same age? How do you know if your child is "on the right track"?

Your child is going through many physical and mental changes. Although no two children grow at the same rate, experts agree there are "normal" signs of development. There is, however, a natural progression or "timetable" for mastery of these skills for each language. The 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 health professionals determine when a child may need extra help to learn to speak or to use language.

Watch for the following signs in your child over a one-month period. Remember each child is different and may learn and grow at a different rate. However, if your child cannot do many of the skills listed for his or her age group, you should consult your pediatrician. If your child was born sooner than expected, be sure to deduct the number of months early from his or her age. A 5-month-old born 2 months early would be expected to show the same skills as a 3-month-old who was born on his or her due date.

You are the most important observer of your child's development. If your child has special needs, early help can make a difference!!!

By Asha Gopinath, Speech Language Pathologist

First 3 Months of Life

Becomes startled at loud noises
Is soothed by calm, gentle voices
Likes to cuddle and enjoys being held
Cries, gurgles, grunts, says "ah"
Has strong muscles in cheeks and tongue
Warning sign - Shows no reaction to sound?

4 to 6 Months

Watches your face with interest when you talk
Tries to "talk" with you
Enjoys "talking" with you, smiles at you
Has a special cry when hungry
Coos and squeals for attention
Warning sign - Are any of the above behaviors absent?

6 Months to Age 1 Year

Understands some common words when used with gestures e.g... "bye, bye", "up","give me" and own name
Tries to say sounds and words - "ba, ba", "na, na"
Tries to sing along with radio/TV
Laughs and may imitate a cough
Warning sign - Are you concerned about your child's responsiveness or babbling?
Warning sign - Does your child have recurrent ear infections?

12 to 18 Months

Babbles - sounds like sentences
Understands simple questions/statements e.g.. "where is your nose?", "give me"
Says words (not clearly)
Nods "yes" and shakes head for "no"
Enjoys rhythm and likes to "dance" to music
Warning sign - Does your child not talk at all?
Warning sign - Is your child sociable?

18 to 24 Months

Says some 2 word sentences such as"more milk", "all gone", "me go"
Asks for a cookie or toy
Says "whatssat" a lot at about age 2
Understands "where is mommy/daddy?"
Understands simple directions "get your coat"
Understands more words than can speak/say
Warning sign - Does your child use more gestures than words?
Warning sign - Are you concerned about your child's ability to talk and/or understand?

Age 2 to 3 Years

Combines words in 2-3 word sentences such as "me do it"
Follows simple directions e.g. "put the teddy-bear to bed"
Answers simple questions e.g. "what's your name?", "Which one is the big doll?"
Can put a toy "in", "on", "under" when asked
Answers simple questions about objects e.g. "which one do we eat with?"
Warning sign - Does your child show frustration when trying to talk?
Warning sign - Do you have difficulty understanding your child's speech?
Warning sign - Does your child put 2 words together?

Age 3 to 4 Years

Follows 2 related directions e.g. "close the book and give it to me"
Tells first and last name
Understands questions about a picture story e.g. "Where did the bunny go?"
Reasons - answers "What do you do when you're hungry/cold?"
Tells a short story e.g. "two kids played ball"
Sentences are usually 3 and 4 words long
Gives directions such as "Fix this for me"
Asks many questions: "what", "where","why"
Warning sign - Is your child's speech difficult to understand?
Warning sign - Are your child's speech skills not at age level described?

Age 4 to 5 Years

Follows 3 related directions such as "get your crayons, make a picture and give it to the baby"
Speaks sounds accurately except perhaps for l, r, s, k, th, ch, sh (The 'r', 'l', and 'y' (as in yellow) are difficult and can come as late as 8 years old)
More reasoning - answers questions such as "What do you do when you are sleepy/thirsty?" or "What should you do if you hurt yourself?"
Describes objects and events
Can show you "top", "bottom", and several colors
Can give meanings of words
Warning sign - Does your child not use complete sentences?
Warning sign - Does your child stutter?
Warning sign - Does your child not seem to be able to follow directions?

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