Warning Signs

So much happens early on. Consult with a Speech-language Pathologist if you have any concerns. Here are some guidelines.

• 0-6 months-smiles when spoken to, babbles, uses eye contact, startles, responds to voice
• 6-12 months-responds to ‘no’, tries to speak, coos, squeals, for attention, laughs
• 1-2 years-talks to self during play, some verbal turns, says social words such as ‘hi, bye, please thank you’, some parallel play alongside other children
• 2-3 years-requests, uses language to pretend, repairs conversation, self-talk, helps to clean up
• 3-4 years-takes turns, expresses ideas and feelings, takes on dramatic roles
• 4-5-can be directive, invites others to play, uses words to solve conflicts, converses well
• 5-6 years, will announce topic changes, asks about word meanings, plays cooperatively

• 9 months-reaches for objects
• 6-12 months-shows, gives, and points and imitates actions
• 1-2-waves, pairs gestures with words

• 6-12 months-plays social games such as peek-a-boo and pat-a-cake
• 15 months-plays functionally with numerous toys, i.e. books, blocks, cars and dolls
• 18 months-pretends to feed dolls or talks on a phone
• 2 years-begins to sequence actions such as stirring, pouring and feeding a stuffed animal
• 2-3 years-observes peers, briefly joins in the play, plays house
• 3-4 years, plays cooperatively

• 6-12 months-responds to name and to simple commands
• 9 months-localizes sounds heard
• 12-15 months-responds to ‘give me’
• 1-2 years-follows simple commands, questions, short stories, and points to pictures named
• 2-3 years-identifies body parts named, family members, actions depicted in pictures, follows 2 part directives(get your shoes and put them on)
• 3-4 years-follows wh questions
• 4-5 years-answers questions to short stories
• 5-6 years-follows 3-step directions, may still be confused by some long, complex sentences

• 4-6 months-babbling is noted
• 1-2 years-self-talk during play
• 18 months-uses at least 10 words, imitates many words
• 18-21 months-a burst of single words (give or take 3 months)
• 21 months-at least 25 words are used and some word combinations
• 2 years-at least 50 words-the average child uses 200-300 words plus combinations
• age 3-simple sentences
• 12-50 + months-numerous grammatical markers, i.e. ‘I, ing, plural s, past ed, themselves’
• age 4-complex sentences, recounts parts of a story or events (narratives)

Muscles used for eating are required for speaking but more strength is required to chew and more control and coordination to speak.

• 0-4 months-suck-swallow reflex/tongue thrust
• 4-6 months-reflexes disappear, recognizes bottle, takes liquid from spoon
• 6-9 months-takes strained foods, bites biscuit, up and down jaw motion (munches)
• 9-12 months-eats lumpy food, emerging lateral jaw movement, drinks from cup with help
• 12-18 months-uses spoon, holds cup with 2 hands but spills often
• 15-18 months-chewing well established
• 2 years-uses spoon, holds cup, plays with food, understands what is edible, begins straw drinking

• 4-6 months-repeats strings of sounds (babbling)
• age 1-imitates many sounds
• age 2-3, about 75% of children master about two-thirds of their sound system
• intelligibility of speech: 18-24 months-25-50%, 2-3 years-50-75%; 4-5-75-90%, 5+-90-100%

Most speech sounds are produced through the mouth, except for nasal /m n ng/. One should not sound chronically congested as though obstructed, nor sound as though there is too much air shunted through the nose, commonly seen in children with unrepaired cleft palate.

A voice should not stand out with respect to loudness, pitch or quality, i.e. too loud, soft, voice breaks or loss, too high or low in pitch, hoarse, breathy or harsh.

About a third of all normally developing children will be dysfluent or trip over their words. These normal dysfluencies sound easy, are between words, and include interjections (um), repetition of a word or phrase (jumping, jumping, go back go back), revisions (I want-I went to the..). Stuttering or abnormal dysfluencies occur within words and include repetitions of single syllable words, parts of words, sound prolongations, audible or visible tension and struggle.

• 3-12 months-pats books, focuses on pictures, shares books with adults
• 1-2 years-listens to short stories, turns pages, attends to books for a few minutes, labels pictures
• 2-3 years-increased attention to books, shows a difference between writing and drawing
• 3-4 years-attends to some print, identifies some letter-sounds, rhymes, talks about book characters, pretends to read stories
• 4-5 years-claps/segments syllables, understands story sequence, recites and prints the alphabet, blends sounds together that are heard, writes name, copies, learns sound-symbols, reads some words, predicts patterns in stories, understands stories read, attempts phonetic spellings, understands reading is from left to right and top to bottom, retells simple stories, tries to spell
• identifies or recognizes some words instantly, writes some words, first and last name and upper and lowercase letters, reads some picture books from memory
• end of first grade-reads grade level material, expresses himself through writing, spells many words, begins using punctuation, writes in a journal, understands what is read, prints clearly