Sunday, May 29, 2016

Speech and Language Development Milestones: Children 0-4 years

Babies, toddlers and children all go through various stages when it comes to learning language  and vary in their development of speech and language skills. However, they follow a natural progression or timetable for mastering the skills of language. 

A checklist of milestones for the normal development of speech and language skills in children from birth to 4 years of age is included below. We definitely haven’t covered everything here, but this should give you a general idea about the stages infants, toddlers and children go through with regards to language development up to the age of 4.  

  How do speech and language develop?

The first 3 years of life, when the brain is developing and maturing, is the most intensive period for acquiring speech and language skills. These skills develop best in a world that is rich with sounds, sights, and consistent exposure to the speech and language of others.
There appear to be critical periods for speech and language development in infants and young children when the brain is best able to absorb language. If these critical periods are allowed to pass without exposure to language, it will be more difficult to learn.

What are the milestones for speech and language development?

The first signs of communication occur when an infant learns that a cry will bring food, comfort, and companionship. Newborns also begin to recognize important sounds in their environment, such as the voice of their mother or primary caretaker. As they grow, babies begin to sort out the speech sounds that compose the words of their language. By 6 months of age, most babies recognize the basic sounds of their native language.
The checklist of milestones for the normal development of speech and language skills in children from birth to 4 years of age is included below,  helps doctors and other health professionals determine if a child is on track or if  may need extra help. Sometimes a delay may be caused by hearing loss, while other times it may be due to a speech or language disorder.

What is the difference between a speech disorder and a language disorder?

Children who have trouble understanding what others say (receptive language) or difficulty sharing their thoughts (expressive language) may have a language disorder. Specific language impairment (SLI) is a language disorder that delays the mastery of language skills. Some children with SLI may not begin to talk until their third or fourth year.
Children who have trouble producing speech sounds correctly or who hesitate or stutter when talking may have a speech disorder. Apraxia of speech is a speech disorder that makes it difficult to put sounds and syllables together in the correct order to form words.

What should I do if my child’s speech or language appears to be delayed?

Talk to your child’s doctor if you have any concerns. Your doctor may refer you to a speech-language pathologist, who is a health professional trained to evaluate and treat people with speech or language disorders. The speech-language pathologist will talk to you about your child’s communication and general development. He or she will also use special spoken tests to evaluate your child. A hearing test is often included in the evaluation because a hearing problem can affect speech and language development. Depending on the result of the evaluation, the speech-language pathologist may suggest activities you can do at home to stimulate your child’s development. They might also recommend group or individual therapy or suggest further evaluation by an audiologist (a health care professional trained to identify and measure hearing loss), or a developmental psychologist (a health care professional with special expertise in the psychological development of infants and children).

What are voice, speech, and language?

Voice, speech, and language are the tools we use to communicate with each other.
Voice is the sound we make as air from our lungs is pushed between vocal folds in our larynx, causing them to vibrate.
Speech is talking, which is one way to express language. It involves the precisely coordinated muscle actions of the tongue, lips, jaw, and vocal tract to produce the recognizable sounds that make up language.
Language is a set of shared rules that allow people to express their ideas in a meaningful way. Language may be expressed verbally or by writing, signing, or making other gestures, such as eye blinking or mouth movements.
Language Development: Milestones
Here is a list of things you can look for with your own child(ren).   Please remember that these are averages.  However, if you have any concern with regards to your child’s language development please contact a Speech-Language Pathologist. 
 Birth to 6 Month
  • turns to source of sound
  • startles in response to loud and sudden noises
  • watches speakers face
  • smiles and laughs in response to speakers smiles and laughs
  • imitates coughs or other early vocalizations (e.g. ah, eh, buh)
6 to 12 Months
  • responds to name
  • responds to common sounds (e.g. phone ringing,  doorbell)
  • understands being told “no”
  • gets basic needs met through gesturing (e.g. lifting arms up to be picked up)
  • plays social games (e.g. peek-a-boo)
  • babbles and repeats sounds (e.g. babababa, duhduhduh)
  • follows simple one step directions (e.g. sit down) – this happens closer to 12 months
  • looks across room to something being pointed at
  • uses 2-3 words (not necessarily clear) – by approximately 12 months
  • uses some gestures socially (e.g. waving “bye”, shaking head “no”, blowing a kiss)
  • gets caregivers attention using sounds, gestures and pointing while making eye contact
  • brings toys to show you
  • “performs” for attention and praise
  • By 12 months combines variety of sounds to sound like “talking” (e.g. abada duhba abee)
  • shows interest in simple picture books
 12 to 18 Months
  • understands basic concepts “in” and “out”, “off” and “on”
  • points to several body parts when asked (e.g. nose, eyes, ears, mouth, hair, hands, feet, belly)
  • uses approximately 20 words (around 18 months)
  • responds to simple questions with words and/or gestures (e.g. “where is the ball?” “what’s that?”)
  • demonstrates simple pretend play (e.g. gives doll a drink, feeds bear)
  • makes at least 4 different consonant sounds (e.g. b, p, m, n, d, w, h)
  • enjoys being read to and looks through simple books with caregiver
  • points to pictures using one finger
 18 to 24 Months
  • follows two-step directions (e.g. “go find the ball and bring it to dad”)
  • uses at least 2 pronouns (e.g. mine, me, you, my)
  • uses 100+ words (by 24 months)
  • consistently combines words into 2 or more word phrases (e.g. “daddy shoe”, “car go up”)
  • enjoys being with others
  • begins offering toys to peers and imitates peers actions/words
  • holds books right way up and turns pages
  • pretends to “read”
  • unfamiliar listeners can understand approximately 50-60% of child’s words
 24 to 36 Months
  • Understands differences in meaning (e.g. “go-stop”, “in-on”, “big-little”)
  • Enjoys listening to books for longer periods of time
  • Has a word for almost everything in their environment
  • Speech becomes clearer (by age 3, 75% of speech should be understood by an unfamiliar listener)
  • Asks “why”
  • By 36 months language contains grammar (not always correct) and sentences take on a more “adult” form.
 3 to 4 Years
  • Hears when you call them from another room
  • Listens to TV/Radio at same loudness level as others
  • Recognizes 2-3 colors (e.g. red, blue, green)
  • Recognizes a few basic shapes (e.g. square, circle, triangle)
  • Tells small stories using approximately 4 sentences
  • Unfamiliar listeners understand approximately 90% of child’s speech (by age 4)
  • Answers simple questions (e.g. “who is coming over?”, “where is the ball?”, “what is that?”)
  • Asks “when” and “how”
  • Starts making basic rhymes (e.g. “hat-cat”, “mitt-sit”)
  • Uses more pronouns including “I, you, me, we and they”
  • Uses some simple plurals (e.g. birds, shoes, trees)
  • Majority of sentences contain 4+ words


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