When should speech therapy be considered?

Is your child frustrated when trying to communicate? Are familiar people unable to understand what your child says? Does your child have difficulty producing some speech sounds or true words by 12-18 months? Is it challenging for your child to follow directions by 2 years of age? Does your child have difficulty communicating with or playing with peers?

Consider the established basic milestones below and whether or not your child is experiencing frustration or negatively impacted social interactions. These milestones are established by the American Speech-Language-Hearing Association, based upon research. More information is available at www.asha.org

By 1 Year of age:

  • Reaches for objects
  • Points, waves, and shows or gives objects
  • Imitates and initiates gestures for engaging in social interactions and playing games, like blowing kisses or playing peek-a-boo
  • Tries to copy sounds that you make
  • Responds appropriately to simple words and phrases like “Go bye-bye” and “Look at Mommy
  • Says one or two words—like mama, dada, hi, and bye

By 18 Months of age:

  • Looks around when asked “where” questions—like “Where’s your blanket?”
  • Follows directions—like “Give me the ball,” “Hug the teddy bear,” “Come here,” or “Show me your nose.”
  • Points to make requests, to comment, or to get information
  • Shakes head for “no” and nods head for “yes.”
  • Understands and uses words for common objects, some actions, and people in their lives.
  • Identifies one or more body parts.
  • Uses gestures when excited, like clapping or giving a high-five, or when being silly, like sticking out their tongue or making funny faces.
  • Uses a combination of long strings of sounds, syllables, and real words with speech-like inflection.
By 2 Years of age:
  • Uses and understands at least 50 different words for food, toys, animals, and body parts. Speech may not always be clear—like du for “shoe” or dah for “dog.”
  • Puts two or more words together—like more water or go outside
  • Follows two-step directions—like “Get the spoon, and put it on the table
  • Uses words like me, mine, and you
  • Uses words to ask for help
  • Uses possessives, like Daddy’s sock

By 3 Years of age:

  • Uses word combinations often but may occasionally repeat some words or phrases, like baby – baby – baby sit down or I want – I want juice
  • Tries to get your attention by saying, Look at me!
  • Says their name when asked.
  • Uses some plural words like birds or toys.
  • Uses –ing verbs like eating or running. Adds –ed to the end of words to talk about past actions, like looked or played.
  • Gives reasons for things and events, like saying that they need a coat when it’s cold outside.
  • Asks why and how.
  • Answers questions like “What do you do when you are sleepy?” or “Which one can you wear?”
  • Correctly produces p, b, m, h, w, d, and n in words.
  • Correctly produces most vowels in words.
  • Speech is becoming clearer but may not be understandable to unfamiliar listeners or to people who do not know your child

By 4 Years of age:

  • Compares things, with words like bigger or shorter
  • Tells you a story from a book or a video
  • Understands and uses more location words, like inside, on, and under
  • Uses words like a or the when talking, like a book or the dog
  • Pretends to read alone or with others
  • Recognizes signs and logos like STOP
  • Pretends to write or spell and can write some letters
  • Correctly produces t, k, g, f, y, and –ing in words
  • Says all the syllables in a word
  • Says the sounds at the beginning, middle, and end of words.
  • By age 4 years, your child talks smoothly. Does not repeat sounds, words, or phrases most of the time
  • By age 4 years, your child speaks so that people can understand most of what they say. Child may make mistakes on sounds that are later to develop—like l, j, r, sh, ch, s, v, z, and th
  • By age 4 years, your child says all sounds in a consonant cluster containing two or more consonants in a row—like the tw in tweet or the –nd in sand. May not produce all sounds correctly—for example, spway for “spray."

By 5 Years of age:

  • Produces grammatically correct sentences. Sentences are longer and more complex
  • Includes (1) main characters, settings, and words like and to connect information and (2) ideas to tell stories
  • Uses at least one irregular plural form, like feet or men
  • Understands and uses location words, like behind, beside, and between
  • Uses more words for time—like yesterday and tomorrow—correctly
  • Follows simple directions and rules to play games
  • Locates the front of a book and its title
  • Recognizes and names 10 or more letters and can usually write their own name
  • Imitates reading and writing from left to right
  • Blends word parts, like cup + cake = cupcake. Identifies some rhyming words, like cat and hat
  • Produces most consonants correctly, and speech is understandable in conversation

Speech Sound Development - What sounds should my child be able to produce at each age?

2-3 years: p, b, m, d, n, h, w

3-4 years: t, k, g, ng, f, y

4-5 years: v, s, z, sh, ch, j, l

5-6 years: r, voiced th (as in father)

6-7 years: voiceless th (as in bath)

According to Crowe, K. & McLeod, S. (2020). Children's English consonant acquisition in the United States: A Review. American Journal of Speech-Language Pathology.