A common concern I hear from parents is whether or not their child is developing speech appropriately. In this blog I will discuss the development of speech, common milestones to expect and what to to do if a speech or language delay is suspected.
Voice is the sound made from the vibration of air passing from the lungs through the vocal cords in our larynx. Speech is the coordination of muscles of the jaw, tongue, lips and vocal tract to make sounds that we recognize as language. Language is a set of rules that allow the expression of ideas in a meaningful way.
The first 3 years of life is critical for acquiring speech and language skills. Therefore the developing, maturing brain of your child thrives in a world that is rich with sounds, sights, and consistent exposure to the speech and language of others.
Infants learns that a cry will bring food and comfort. Newborns also begin to recognize the voice of their mother or primary caretaker. Most babies recognize the basic sounds of their native language by 6 months.
Children develop speech and language at different rates. However, they follow a natural progression for learning the skills of language. Milestones help determine if a child is on track or if he or she may need extra help due to hearing loss or a speech or language disorder.
Birth to 3 months
Recognizes your voice and quiets down if crying
Reacts to loud sounds with a startle reflex
Vocalizes with coos, cries, or fusses
Makes noise and smiles when spoken to
Responds to sound of rattle
4 to 6 months
Looks or turns toward a new sound
Responds to “no” and changes in tone of voice
Enjoys rattles and other toys that make sound
Vocalizes back when talked to
Begins to repeat sounds: “ooh,” “aah,” and “ba-ba”
7 to 11 months
Responds to his or her own name, ringing sounds, or someone’s voice even when not loud
Knows words for common things: “cup” or “shoe” and recognizes, “bye-bye”
Babbles: "ba-ba-ba," "ma-ma" or "da-da"
Tries to communicate by actions or gestures
Looks at things or pictures when someone talks about them
Begins to respond to requests: “come here”
Enjoys games like peek-a-boo and pat-a-cake
Makes babbling sounds, even when alone
Imitates simple words and sounds; may use a few single words or baby signs meaningfully
12 to 17 months
Understands simple commands: “put the ball in the box” or “put the car on the table”
Enjoys being read to
Follows one-step commands when shown by a gesture
Shakes head to respond yes or no
Imitates simple words
Uses four to six words or more
Says more words as each month passes
18 to 23 months
Understands the meaning of action words: clap, sit or jump
Points to some body parts when asked
Understands and answers simple “yes-no” questions: “Are you hungry?”
Understands “not now” and “no more”
Chooses things by size: “big” or “little”
Uses a vocabulary of 50 words
Asks for common foods by name
Makes animal sounds: "moo"
Starts to combine words into 2- to 3-word phrases to talk about and ask for things: "more milk"
Begins to use pronouns: "mine"
2 to 3 years
Knows some spatial concepts: "in" or "on"
Understands and uses more pronouns "you," "me" or "her"
Knows descriptive words , "big" or "happy"
Answers many simple questions
Follows two-step commands : “Get your shoes and come here.”
Uses three- to four-word sentences
Uses at least 100 words by 2 years of age
Uses question inflection to ask for something "My ball?
Begins to use plurals: "shoes" or "socks" and regular past tense verbs: "jumped"
Speech pronunciation is improving, but may still leave off ending sounds; strangers may only understand 50-75% of what is said
3 to 4 years
Answers simple questions: "What do you do when you are hungry?"
Groups objects into categories: foods or clothes
Recognizes colors
Uses 300 to 500 words by 3 years of age
Describes the use of objects "You eat with a fork"
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
Uses verbs that end in "ing": "walking" or "talking"
Uses most speech sounds, may distort more difficult sounds: l, r, s, sh, ch, v, z, th
Uses consonants in the beginning, middle, and ends of words. Some of the more difficult consonants may be distorted, but tries to say them
Strangers are able to understand much of what is said
4 to 5 years
Answers "why" questions
Lists items that belong in a category (such as, animals or vehicles)
Understands more abstract spatial concepts (such as, "behind" or "next to")
Understands complex questions
Uses some irregular past tense verbs (such as, "ran" or "fell")
Describes how to do things (such as, painting a picture)
Speech is understandable, but makes mistakes pronouncing long, difficult, or complex words (such as, "hippopotamus")
Strangers understand 100% of what is said
5 years
Understands time sequences: what happened first, second, or third
Carries out a series of three directions
Understands rhyming
Engages in conversation
Produces sentences that can be eight or more words in length
Uses compound and complex sentences
Describes objects
Uses imagination to create stories
What should I do if my child’s speech or language appears to be delayed?
Your child may need to be evaluated by an audiologist and speech-language pathologist. Depending on the result of the evaluation, the speech-language pathologist may suggest activities you can do at home to stimulate your child’s development, group or individual therapy or further evaluation by a developmental psychologist.
Research is being conducted on developmental speech and language problems by the National Institute on Deafness and Other Communication Disorders. They have discovered a genetic link to specific language impairment, a disorder that delays children’s use of words and slows their mastery of language skills throughout their school years. Further research is exploring the role this genetic variant may also play in dyslexia, autism, and speech-sound disorders.