Speech and Language Development

Speech and language is an essential part of any child’s development. Language development impacts your child’s social interactions, behavior and academic skills.

How can I tell if my child’s speech and language development is on track?

Early on, babies like to make sounds of their own. As they get older, they learn to mimic sounds that they hear. If you are concerned about your child’s language development, you should talk to your pediatrician.

Milestones that demonstrate normal speech development include:

Age Language Level
Birth Cries
2-3 months Coos in response to you, smiles
6 months Babbles, turns and looks at new sounds
8 months Responds to name, pats self in mirror
10 months Shouts to attract attention, says a syllable repeatedly
12 months Says 1-2 words; recognizes name; imitates familiar sounds; points to objects
12-17 months Understands simple instructions, imitates familiar words, understands “no,” uses “mama” “dada” and a few other words
18 months Uses 10-20 words, including names, starts to combine 2 words “all gone,” “bye-bye mama,” uses words to make wants known “up” “all done” or “more;” knows body parts
2 years Says 2-3 word sentences; has >50 words, asks “what’s this” and “where’s my” vocabulary is growing; identifies body parts, names pictures in book, forms some plurals by adding “s”
2 ½ years Gives first name; calls self “me” instead of name; combines nouns and verbs; has a 450 word vocabulary; uses short sentences; matches 3-4 colors, knows big and little; likes to hear same story repeated
3 years Can tell a story; sentence length of 3-4 words; vocabulary of about 1000 words; knows last name, name of street, several nursery rhymes, can sing songs
4 years Sentence length of 4-5 words; uses past tense; identifies colors, shapes; asks many questions like “why?” and “who?” Can speak of imaginary conditions “I hope” Uses following sounds correctly: b, d, f, g, h, m, n, ng, t, w, y (as in yes)

If your child is not meeting these milestones, talk with your pediatrician. The first step is to get your child’s hearing checked. Even if they seem to hear just fine, kids are experts at picking up visual cues to get by. It’s important to catch hearing loss early, so that treatment begins as soon as possible.

Tips for supporting your child’s speech and language development

  • Start talking to your child at birth. Even newborns benefit from hearing speech.
  • Respond to your baby’s coos and babbling.
  • Play simple games with your baby like peek-a-boo and patty-cake.
  • Talk to your child a lot. Tell them what you are doing as you do it.
  • Read books aloud. Ask a librarian for books appropriate to your child’s age. If your baby loses interest in the text, just talk about the pictures.
  • Sing to your child and provide them with music. Learning new songs helps your child learn new words, and uses memory skills, listening skills, and expression of ideas with words.
  • Use gestures along with words.
  • Don’t try to force your child to speak.
  • Expand on what your child says. (For example, if your child says, “Elmo,” you can say, “You want Elmo!”)
  • Describe for your child what they are doing, feeling and hearing in the course of the day.
  • Listen to your child. Look at them when they talk to you. Give them time to respond. (It feels like an eternity, but count to 5—or even 10—before filling the silence).
  • Encourage storytelling and sharing information.
  • Play with your child one-on-one, and talk about the toys and games you are playing.
  • Plan family trips and outings. Your new experiences give you something interesting to talk about before, during, and after the outing.
  • Look at family photos and talk about them.
  • Ask your child lots of questions.
  • Don’t criticize grammar mistakes. Instead, just model good grammar.
  • Follow your child’s lead, so you are doing activities that hold their interest as you talk.
  • Have your child play with kids whose language is a little better than theirs.

What causes speech and language problems?

  • Developmental speech and language disorders are a common reason for speech/language problems in kids. These learning disorders are caused by the brain working differently. Your child may have trouble producing speech sounds, using spoken language to communicate, or understanding what other people say. Speech and language problems are often the earliest sign of a learning disability.  
  • Hearing loss is often overlooked, and easily identified. If your child is speech/language delayed, their hearing should be tested.
  • Extreme environmental deprivation can cause speech delay. If a child is neglected or abused and does not hear others speaking, they will not learn to speak.
  • Prematurity can lead to many kinds of developmental delays, including speech/language problems.
  • Auditory Processing Disorder describes a problem with decoding speech sounds. These kids can improve with speech and language therapy.
  • Neurological problems like cerebral palsy, muscular dystrophy, and traumatic brain injury can affect the muscles needed for speaking.
  • Autism affects communication. Speech/language/communication problems are often an early sign of autism.
  • Structural problems like cleft lip or cleft palate can interfere with normal speech.
  • Apraxia of speech is a specific speech disorder in which the child has difficulty in sequencing and executing speech movements.
  • Selective mutism is when a child will not talk at all in certain situations, often school.

How can I tell if my child has a language problem or is just "late-bloomer"?

It can be difficult for a parent to tell whether a child is a late bloomer or has hearing loss, an expressive language disorder or other underlying cause of speech delay. A trained specialist will be able to help you determine if your child is experiencing speech or language delays. The earlier your child gets help, the greater their progress will be. And if they turn out to be a late bloomer, the extra attention to their speech will not have hurt in any way.

Treatment for speech and language delays

It is important to identify speech/language problems early, so your child can begin treatment. Treatment should begin as soon as possible. Research shows that children know a lot about language long before the first word is ever said.  If your child needs treatment, it should be developmentally appropriate and individualized. Your child’s treatment team might include a doctor, an audiologist, a speech-language pathologist, an occupational therapist, and/or a social worker.

Non-verbal ways to communicate with children

Children who are nonverbal, or not communicating well enough due to hearing loss, autism, apraxia, or similar problems, can use other methods. These include sign language, the Picture Exchange Communication System (PECS), and Augmentative and Alternative Communication.

Additional resources

Recommended reading:

  • The Late Talker, by Marilyn Agin, Lisa Geng, and Malcolm Nicholl.
  • My Toddler Talks: Strategies and Activities to Promote Your Child's Language Development,by Kimberly Scanlon

 

Reviewed and updated by Sara Laule, MD Updated May 2017