Is my child speaking enough?

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.