Q and A: Ask a Speech Therapist: Developmental Milestones
Confused about speech and language developmental milestones? I’m here to answer questions that I’m often asked as a speech therapist.
The Low-down on Developmental Milestones from Your Resident Speech Therapist
As a speech therapist, I love to talk about developmental milestones. I reference them frequently whenever I’m evaluating a child, making a treatment plan, or consulting with a family.
When I talk with parents, though, I always attempt to strike a balance.
“Pay attention,” I tell them, “but don’t obsess.”
I remind parents that milestones are guidelines, not hard-and-fast rules. They represent ages at which most children –– but certainly not all –– master specific skills.
Remember, too, that speech and language skills are pieces of an enormous (and complicated!) puzzle. Kids are developing skills across all different areas: motor, social interaction, thinking and reasoning, communication, emotional regulation, and more. There’s a lot for little ones to focus on!
Here, I’m chatting specifically about speech and language developmental milestones. (You might’ve guessed!
Although problematic if applied without care, having general expectations around ages and stages can help us monitor progress, stay on track, and seek professional advice in a timely manner. So today, I’m giving the honest answers to your most frequently asked questions around speech and language developmental milestones.
When should my child start communicating with me?
Believe it or not, your child starts communicating with you as a newborn. However, it’s not intentional communication just yet. Motivated by internal factors like hunger and thirst, your baby cries and fusses to let you know what he needs.
Within the first 3-6 months, your baby should begin to pay more attention to people’s faces and voices. He’ll also smile and show enjoyment while interacting with you. Your baby might even cry when a fun game stops. (1)
By 9-12 months, your little one should start communicating purposefully. Even without words! Look for intentional communication behaviors like pointing, reaching, clapping, waving, babbling, and gesturing, especially when these behaviors are combined with eye contact. (2)
At what age should my child start talking?
In general, I expect a child to begin saying words around the time of his first birthday. (If you missed it, check out this post; it’s all about first words, how to identify them, and when to expect them!)
I like to see early two-word combinations by a child’s second birthday and simple sentences of 3-6 words by his third year. (3)
When should my child start talking clearly?
If your child’s words sound a bit different than adult productions of the same words, don’t worry! You might notice that some of the sounds your child makes are adult-like, but others are imperfect. There’s a reason for this. Some sounds in a language develop earlier than others.
For example, in English, words with sounds like “m,” “b,” and “p” (e.g., “mama,” “baby,” “papa,” etc.) tend to be easiest for early speakers. Others are trickier. The notorious “r” and “s” sounds, and sound blends like “st” and “gl,” typically come later. Therefore, you might notice that words with those sounds (e.g., “star,” “rabbit,” “glue,” “scissors,” etc.) are articulated immaturely. It’s not uncommon for a child in early elementary school to continue with imperfect productions of these sounds.
A good rule of thumb with little ones is to focus on how understandable they are overall –– even with the speech sound errors. I expect to understand a 2-year-old around 50% of the time and a 3-year-old 75% of the time or more. By the time a child is 4 years old, I expect to understand him nearly all of the time. I also pay attention to a number of other factors. Is a great deal of effort required to understand? Do listeners frequently rely on gestures and environmental cues? (3)
How many words should my child have?
I like to see a child saying at least 10 words on a regular basis by 18 months and 50 consistent words by his second birthday. Remember to focus on the words he is saying by himself; words he repeats after you say them don’t count. (3)
By a child’s 3rd birthday, I like to see at least 200 words. And before long, when I ask about vocabulary, I expect parents to say “too many words to count.”
My child is late meeting developmental milestones. Should I be concerned?
Don’t panic. Remember that there’s some wiggle room with milestones. It’s possible that your child’s first word won’t come until 16 months, but that he’ll have made up the mileage by the time he reaches his second birthday. However, dump the “wait and see” approach if the signs are pointing to delayed or disordered speech and language development.
Trust your gut. If you notice that your child isn’t meeting developmental milestones promptly, if communication feels like a struggle, or if you begin to observe delays across different areas of communication (e.g., speech, understanding, using words, social interactions, etc.), take action. (See below!)
What can I do if I’m concerned?
If you’re concerned, you’re in the right place. I’m dedicated to providing many of the resources you need to help your little one succeed. That’s why I created the Early Intervention Notebook. Within it, you’ll find all my best guidance for getting started on the early intervention journey. This includes:
Information. As they say, “Knowledge is power.” I like to empower families with the information they need to make educated conclusions around their child’s development. I’ve broken down the speech therapy basics so no one is left wondering What is “pragmatics”?
Simple tips. Make small changes to daily life that will have a tremendous impact on your child’s development. I’ll walk you through how to engage your little one, which toys to buy, how to limit screen time, and more.
Progress tracking. Keep track of how your child is developing; I’ve made it easy! In the notebook, I’ve included an early skills checklist and forms to document signs, sounds, and first words. You’ll also get goal-setting prompts and data-taking skills so you’ll feel well prepared.
Try communication-rich activities. Get intentional with the activities you do, the communication you use, and the language targets you choose for your child. In the notebook, I’ve recommended lots of daily activities as well as things to try within each to get your little one communicating!
Looking for more ideas on how you can boost early communication? Click here for more tips.
What questions do you have for a speech therapist?
Do you have a burning question about speech and language developmental milestones? Or other questions related to speech therapy? If so, send them my way!
