Speech Development In Children: When Should You Be Concerned?

Watching your child learn to communicate is just one of the many exciting things about being a parent. Hearing your baby or toddler progress to speak his or her first words or sing to a song for the first time can be a memorable experience. But what if your child isn’t developing speech or language like other children?

Hearing problems may be suspected in children who are not responding to sounds or who are not developing their language skills appropriately. The following are some age-related guidelines that may help to decide if your child has hearing problems.

Consult your child's doctor if you are suspicious that your child is not properly developing speech and language skills. The National Institute on Deafness and Other Communication Disorders (NIDCD) and other experts list the following age-appropriate speech and language milestones for babies and young children.

Milestones related to speech and language:

Birth to 5 Months

Coos
Vocalizes pleasure and displeasure sounds (laughs, giggles, cries or fusses)
Makes noise when talked to

6 to 11 Months

Understands "no-no"
Babbles (says "ba-ba-ba")
Says "ma-ma" or "da-da" without meaning
Tries to communicate by actions or gestures
Tries to repeat your sounds
Says first word

12 to 17 months

Answers simple questions nonverbally
Says two to three words to label a person or object (pronunciation may not be clear)
Tries to imitate simple words
Vocabulary of four to six words

18 to 23 months

Correctly pronounces most vowels and n, m, p, h, especially in the beginning of syllables and short words; also begins to use other speech sounds
Vocabulary of 50 words, pronunciation is often 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"
Uses two-word phrases

2 to 3 years

Knows some spatial concepts, such as "in," "on"
Knows pronouns, such as "you," "me," "her"
Knows descriptive words, such as "big," "happy"
Uses three word sentences
Speech is becoming more accurate, but may still leave off ending sounds; strangers may not be able to understand much of what is said
Answers simple questions
Begins to use more pronouns, such as "you," "I"
Uses question inflection to ask for something, such as "my ball?"
Begins to use plurals, such as "shoes" or "socks" and regular past tense verbs, such as "jumped"

3 to 4 years

Groups objects, such as foods and clothes
Identifies colors
Uses most speech sounds, but may distort some of the more difficult sounds, such as l, r, s, sh, ch, y, v, z, th and these sounds may not be fully mastered until age 7 or 8
Uses consonants in the beginning, middle, and ends of 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 recognizes language absurdities, such as, "is that an elephant on your head?"
Expresses ideas and feelings rather than just talking about the world around him or her
Uses verbs that end in "ing," such as "walking" and "talking"
Answers simple questions, such as "What do you do when you are hungry?"
Repeats sentences

4 to 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"
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 and vehicles
Answers "why" questions

5 years