Issue #9 – “How To” Series


How To Determine Speech and Language Developmental Milestones: Birth to Age 5

National Institute on Deafness and Other Communication Disorders

What Are Speech and Language?


Speech and language are tools that humans use to communicate or share thoughts, ideas, and emotions. Language is the set of rules, shared by the individuals who are communicating, that allows them to exchange those thoughts, ideas, or emotions. Speech is talking, one way that a language can be expressed. Language may also be expressed through writing, signing, or even gestures in the case of people who have neurological disorders and may depend upon eye blinks or mouth movements to communicate.

While there are many languages in the world, each includes its own set of rules for phonology (phonemes or speech sounds or, in the case of signed language, handshapes), morphology (word formation), syntax (sentence formation), semantics (word and sentence meaning), prosody (intonation and rhythm of speech), and pragmatics (effective use of language).

How Do Speech and Language Normally Develop?


The most intensive period of speech and language development for humans is during the first three years of life, a period when the brain is developing and maturing. These skills appear to develop best in a world that is rich with sounds, sights, and consistent exposure to the speech and language of others.

There is increasing evidence suggesting that there are “critical periods” for speech and language development in infants and young children. This means that the developing brain is best able to absorb a language, any language, during this period. The ability to learn a language will be more difficult, and perhaps less efficient or effective, if these critical periods are allowed to pass without early exposure to a language. The beginning signs of communication occur during the first few days of life when an infant learns that a cry will bring food, comfort, and companionship. The newborn also begins to recognize important sounds in his or her environment. The sound of a parent or voice can be one important sound. As they grow, infants begin to sort out the speech sounds (phonemes) or building blocks that compose the words of their language. Research has shown that by six months of age, most children recognize the basic sounds of their native language.

As the speech mechanism (jaw, lips, and tongue) and voice mature, an infant is able to make controlled sound. This begins in the first few months of life with “cooing,” a quiet, pleasant, repetitive vocalization. By six months of age, an infant usually babbles or produces repetitive syllables such as “ba, ba, ba” or “da, da, da.” Babbling soon turns into a type of nonsense speech (jargon) that often has the tone and cadence of human speech but does not contain real words. By the end of their first year, most children have mastered the ability to say a few simple words. Children are most likely unaware of the meaning of their first words, but soon learn the power of those words as others respond to them.

By eighteen months of age, most children can say eight to ten words. By age two, most are putting words together in crude sentences such as “more milk.” During this period, children rapidly learn that words symbolize or represent objects, actions, and thoughts. At this age they also engage in representational or pretend play. At ages three, four, and five, a child’s vocabulary rapidly increases, and he or she begins to master the rules of language.

What Are Speech and Language Developmental Milestones?
Children vary in their development of speech and language. There is, however, a natural progression or “timetable” for mastery of these skills for each language. The milestones are identifiable skills that can serve as a guide to normal development. Typically, simple skills need to be reached before the more complex skills can be learned. There is a general age and time when most children pass through these periods. These milestones help doctors and other health professionals determine when a child may need extra help to learn to speak or to use language.

 

How Do I Know If My Child Is Reaching the Milestones?

Here is a checklist that you can follow to determine if your child’s speech and language skills are developing on schedule. You should talk to your child’s doctor about anything that is checked “no.”


Birth to 5 months

Yes

No

Reacts to loud sounds.

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Turns head toward a sound source.

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Watches your face when you speak.

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___

Vocalizes pleasure and displeasure sounds (laughs, giggles, cries, or fusses).

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Makes noise when talked to.

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6 – 11 months

Yes

No

Understands “no-no.”

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Babbles (says “ba-ba-ba” or “ma-ma-ma”).

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Tries to communicate by actions or gestures.

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Tries to repeat your sounds.

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12 – 17 months

Yes

No

Attends to a book or toy for about two minutes.

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Follows simple directions accompanied by gestures.

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Answers simple questions nonverbally.

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Points to objects, pictures, and family members.

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Says two to three words to label a person or object (pronunciation may not be clear).

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Tries to imitate simple words.

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18 – 23 months

Yes

No

Enjoys being read to.

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___

Follows simple commands without gestures.

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Points to simple body parts such as “nose.”

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Understands simple verbs such as “eat,” “sleep.”

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Correctly pronounces most vowels and n, m, p, h, especially in the beginning of syllables and short words. Also begins to use other speech sounds.

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Says 8 to 10 words (pronunciation may still be unclear).

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Asks for common foods by name.

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Makes animal sounds such as “moo.”

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Starting to combine words such as “more milk.”

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Begins to use pronouns such as “mine.”

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2 – 3 years

Knows about 50 words at 24 months.

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___

Knows some spatial concepts such as “in,” “on.”

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Knows pronouns such as “you,” “me,” “her.”

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Knows descriptive words such as “big,” “happy.”

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Says around 40 words at 24 months.

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Speech is becoming more accurate but may still leave off ending sounds. Strangers may not be able to understand much of what is said.

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Answers simple questions.

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Begins to use more pronouns such as “you,” “I.”

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Speaks in two to three word phrases.

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Uses question inflection to ask for something (e.g., “My ball?”).

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Begins to use plurals such as “shoes” or “socks” and regular past tense verbs such as “jumped.”

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3 – 4 years

Yes

No

Groups objects such as foods, clothes, etc.

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___

Identifies colors.

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___

Uses most speech sounds but may distort some of the more difficult sounds such as l, r, s, sh, ch, y, v, z, th. These sounds may not be fully mastered until age 7 or 8.

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Uses consonants in the beginning, middle, and ends of words. Some of the more difficult consonants may be distorted, but attempts to say them.

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Strangers are able to understand much of what is said.

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Able to describe the use of objects such as “fork,” “car,” etc.

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Has fun with language. Enjoys poems and recognizes language absurdities such as, “Is that an elephant on your head?”

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Expresses ideas and feelings rather than just talking about the world around him or her.

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Uses verbs that end in “ing,” such as “walking,” “talking.”

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Answers simple questions such as “What do you do when you are hungry?”

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Repeats sentences.

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4 – 5 years

Yes

No

Understands spatial concepts such as “behind,” “next to.”

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Understands complex questions.

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Speech is understandable but makes mistakes pronouncing long, difficult, or complex words such as “hippopotamus.”

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Says about 200 – 300 different words.

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Uses some irregular past tense verbs such as “ran,” “fell.”

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Describes how to do things such as painting a picture.

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Defines words.

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Lists items that belong in a category such as animals, vehicles, etc.

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Answers “why” questions.

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5 years

Yes

No

Understands more than 2,000 words.

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Understands time sequences (what happened first, second, third, etc.).

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Carries out a series of three directions.

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Understands rhyming.

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Engages in conversation.

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Sentences can be 8 or more words in length.

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Uses compound and complex sentences.

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Describes objects.

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Uses imagination to create stories.

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    How To Distinguish Emotional Disturbance vs. Social Maladjustment

    A student who receives special education services under the category of Emotional Disability has emotional problems of some kind that are adversely affecting his/her educational performance. Usually schools look at grades, discipline records, and performance on achievement tests to quantify educational impact. In determining eligibility for Emotional Disability, several evaluations are typically completed.

    A school will conduct psychological testing by a school psychologist, which will include cognitive testing and social/emotional measures (rating scales, interviews, observations). Educational testing is typically completed to determine current levels of achievement in reading, writing, math, and other educational areas. Additionally, a Sociocultural evaluation or interview by a school social worker is typically completed with a parent to rule out environmental factors and obtain a developmental history. (See SPED testing for more information)

    Often, the most difficult part of determining eligibility for special education services in this category is determining if the student has an emotional disability or social maladjustment. The following is adapted from a chart that was shown at a training I attended by Bruce Bracken. He adapted it from Social Maladjustment: A Guide to Differential Diagnosis and Educational Options (Wayne County Regional Educational Service Agency – Michigan, 2004).

    Behavior Area

    Emotional Disturbance

    Socially Maladjusted

    School Behavior

    Unable to comply with teacher requests; needy or has difficulty asking for help

    Unwilling to comply with teacher requests; truancy; rejects help

    Attitude Toward School

    School is a source of confusion or angst; does much better with structure

    Dislikes school, except as a social outlet; rebels against rules and structure

    School Attendance

    Misses school due to emotional or psychosomatic issues

    Misses school due to choice

    Educational Performance

    Uneven achievement; impaired by anxiety, depression, or emotions

    Achievement influenced by truancy, negative attitude toward school, avoidance

    Peer Relations and Friendships

    Difficulty making friends; ignored or rejected

    Accepted by a same delinquent or socio-cultural subgroup

    Perceptions of Peers

    Perceived as bizarre or odd; often ridiculed

    Perceived as cool, tough, charismatic

    Social Skills

    Poorly developed; immature; difficulty reading social cues; difficulty entering groups

    Well developed; well attuned to social cues

    Interpersonal Relations

    Inability to establish or maintain relationships; withdrawn; social anxiety

    Many relations within select peer group; manipulative; lack of honesty in relationships

    Interpersonal Dynamics

    Poor self-concept; overly dependent; anxious; fearful; mood swings; distorts reality

    Inflated self concept; independent; underdeveloped conscience; blames others; excessive bravado

    Locus of Disorder

    Affective disorder; internalizing

    Conduct disorder, externalizing

    Aggression

    Hurts self and others as an end

    Hurts others as a means to an end

    Anxiety

    Tense; fearful

    Appears relaxed; “cool”

    Affective Reactions

    Disproportionate reactions, but not under student’s control

    Intentional with features of anger and rage; explosive

    Conscience

    Remorseful; self critical; overly serious

    Little remorse; blaming; non-empathetic

    Sense of Reality

    Fantasy; naïve; gullible; thought disorders

    “Street-wise”; manipulates facts and rules for own benefit

    Developmental Appropriateness

    Immature; regressive

    Age appropriate or above

    Risk Taking

    Avoids risks; resists making choices

    Risk taker; “daredevil”

    Substance Abuse

    Less likely; may use individually

    More likely; peer involvement

    Adapted from Social Maladjustment: A Guide to Differential Diagnosis and Educational Options (Wayne County Regional Educational Service Agency – Michigan , 2004)

     


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