• Speech is easily understood by all listeners
  • Talks in complete sentences
  • Says first and last name
  • Asks and answers a wide variety of questions
  • Can now carry on simple conversation with others

4-5 Years

  • Speaks in complex sentences using phrases, such as "If . . . then" and ". . . because . . ."  
  • Can speak of imaginary conditions, such as "I hope . . . "
  • Understands common opposites (hot/cold, up/down)
  • Carries on elaborate conversations
  • Tells jokes that may not make any sense to adults

Now that you have a basic knowledge of communication milestones, let me provide you with some warning signs about when to be concerned about your child's speech and language development.

When to Be Concerned

  • No back and forth sharing of sounds and smiles by 6 months of age
  • No babbling by 9 months of age
  • No true words by 12-15 months of age
  • Limited eye contact at any age
  • No pointing to request something or identify things of interest by 15 months of age
  • Does not follow simple one-step commands by 18 months of age
  • Does not verbally imitate the names of familiar objects by 18 months of age
  • Uses mostly vowel sounds and very few consonant sounds after 18 months of age
  • Relies primarily on gestures and grunting to communicate after 18 months of age
  • Does not say at least 25-50 words by age 2
  • No two-word meaningful phrases by age 2
  • Excessive drooling even when not teething
  • Leaves off many sounds at the beginnings or ends of words after age 3
  • Not using three-word phrases by age 3
  • Does not ask or answer "wh" questions by age 4
  • Not using complete sentences by age 4
  • Stuttering after age 4
  • Voice quality is always hoarse, even when not sick
  • Consistently sounds as if talking through the nose (hyper-nasal)
  •  Child is frustrated, embarrassed, or disturbed by own speech at any age

If you suspect a speech and language delay, there are two initial steps you should take. First, it is always a good idea to have your child's hearing formally evaluated by a pediatric audiologist. If your child has a history of frequent ear infections or fluid in the middle ear, this can contribute to speech and language delays.

Second, if you have significant concerns about your child's speech and language development, it may be beneficial to have an evaluation completed by an ASHA (American Speech-Language-Hearing Association) certified Speech-Language Pathologist (SLP). Every state has an early intervention program for infants and toddlers (ages birth to 3), and every school district has an early childhood program for 3- to 5-year-old children. You also can contact your local hospital or a private speech therapy clinic in your area for an evaluation.

As a parent and your child's primary teacher, there are many things you can do to help your child learn to communicate more effectively. Below are ten strategies you can use to stimulate your child's speech and language development. The main goal of these strategies is to instill in your child the need and the desire to talk. Many children can make their wants and needs known by pointing and grunting. They need to be shown that language is a critical component in influencing the actions of others.

Language Stimulation Strategies

Don't anticipate your child's needs. Wait for him to communicate to you that he wants something. When your child walks into the kitchen, don't automatically assume he wants a drink.