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Does My Child Need Speech Therapy?

“Johnny doesn’t say his /r/ yet.  Should I be concerned?”

“My 2-year-old hasn’t started talking.  My husband didn’t talk until he was 3 and one day he just started speaking in sentences.  Will my child do the same thing?”

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“I can understand my 5-year-old but no one else seems to understand her.  Is that normal?”

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These are all questions I have been asked. When people find out I’m a speech therapist, they usually have questions about their child’s speech and language and whether or not they should be concerned about it.  I wanted to write an article that sums up some different speech and language milestones for different ages and when you should seek out additional help from a speech therapist. Speech language pathology covers a wide spectrum of development including feeding, literacy, and pragmatics (social language skills) but for this article I will focus mainly on milestones for language development and speech sound development.

toddler pointing

Babies are pretty amazing and begin learning language at birth! They may not say much (besides the usual crying) but they are listening and learning how to distinguish the sounds of their native language.  By about 9 months, they have learned these sounds receptively and just need their motor skills to catch up so they can start practicing.  A baby’s brain is an amazing thing!

So, yes, even a young baby will have some speech and language milestones to look out for.  I will start at birth and go through age 5 and list some typical milestones for speech and language. Then I will talk about what’s normal and what isn’t normal.

mom and child talking

Milestones by Age:

Birth – 6 months
Sounds: vowel sounds
Other: May start to hear vocal play such as squeals, growls, or “raspberries”

6 months – 12 months
Words: Will start putting consonants and vowels together (i.e. “ba”) followed by reduplicated babbling (i.e “baba”) and variegated babbling (i.e. “bamaga”)
Sounds: /p, b, m/ usually followed by /h, y, n, w, d/
Other: May start responding to name

Words: 2-6 words (other than mama and dada)
Sounds: May start hearing /t, g, k, s/ (*see chart below for range of what is typical)
Other: Answers yes/no questions

Words: 50-200 words; will start combining into 2 word phrases
Sounds: Same as above as well as /ng/ as in “sing”
Intelligibility: Should be understood 50% of the time
Other: Points to objects and body parts when named, follows 1-2 step directions

Words: 300-1,000 words; uses 3-4 word phrases
Sounds: Same as above; may start to hear /f, r, l/ and other sounds*
Intelligibility: Should be understood 75% of the time
Other: Uses pronouns (i.e. I, you, he, she, they, etc.), present tense (i.e. She is running.), and prepositions (i.e. in, on, under)

Words: 1,600-2,000 words
Sounds: May start hearing later developing sounds such as /z, th, j, v, ch, sh/*
Intelligibility: Should be understood 90% of the time
Other: Can ask and answer “wh” questions, follows 3-step directions

Words: 2,200-2,500
Sounds: Same as above; may start to hear /zh/ sound as in “measure”
Intelligibility: Should be understood 100% of the time
Other: Understands opposites and time concepts (i.e. yesterday, today, tomorrow)

Here is a chart that shows speech sound development:

speech sound development chart*This can vary greatly from kid to kid so there is a range of what is considered typical. The beginning of the bar shows when 50% of kids that age are producing the given sound. The end of the bar shows when 90-100% of kids are producing the given sound.


So as you can see, if you’re 3-year-old isn’t saying the /r/ sound, that is completely normal! Most kids this age will substitute a /w/ sound (i.e. wabbit or pwane) or leave it out altogether (i.e. ca for car).  This is called a developmental error and they may develop the sound on their own in the next few years.  Some errors are not typical (such as leaving off the beginning of words) so seek out a speech therapist if you are concerned about an atypical error.

Smiling mother and child boy play with car toys together at home

Lastly, I’d like to list a few red flags that would warrant a visit to a speech therapist.

Red Flags for Communication:

  • A quiet baby that has limited or no babbling
  • Has not used first word by 15 months
  • Has vocabulary of less than 50 words at age 2
  • Does not follow simple directions at age 2
  • Strangers have difficulty understanding child at age 3 or older
  • Stutters more consistently and for longer than 6 months
  • Has a “slushy” sounding /s/ (think Sid the Sloth from “Ice Age”)
  • Has any sound error past the age of 8

I hope this helps you determine how your child is measuring up to the speech and language milestones for his/her age.  If you have any concerns, don’t be afraid to seek out a speech therapist for a screening.  If nothing else, it will give you peace of mind!


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