Blog – Page 7 – Teamwork Therapies

Milestones related to speech and language

Birth to 5 months	Coos Vocalizes pleasure and displeasure sounds differently (laughs, giggles, cries, or fusses) Makes noise when talked to
6 to 11 months	Understands “no-no” Babbles (says “ba-ba-ba”) Says “ma-ma” or “da-da” without meaning Tries to communicate by actions or gestures Tries to repeat your sounds Says first word
12 to 17 months	Answers simple questions nonverbally Says 2 to 3 words to label a person or object (pronunciation may not be clear) Tries to imitate simple words Vocabulary of four to 6 words
18 to 23 months	Vocabulary of 50 words, pronunciation is often unclear Asks for common foods by name Makes animal sounds, such as “moo” Starting to combine words, such as “more milk” Begins to use pronouns, such as “mine” Uses 2-word phrases
2 to 3 years	Knows some spatial concepts, such as “in” or “on” Knows pronouns, such as “you,” “me” or “her” Knows descriptive words, such as “big” or “happy” Uses 3-word sentences Speech is becoming more accurate, but may still leave off ending sounds. Strangers may not be able to understand much of what is said. Answers simple questions Begins to use more pronouns, such as “you” or “I” Uses question inflection to ask for something, such as “my ball?” Begins to use plurals, such as “shoes” or “socks” and regular past tense verbs, such as “jumped”
3 to 4 years	Groups objects, such as foods or clothes Identifies colors 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. Uses consonants in the beginning, middle, and ends of words. Some of the more difficult consonants may be distorted, but attempts to say them Strangers are able to understand much of what is said Able to describe the use of objects, such as “fork” or “car” Has fun with language; enjoys poems and recognizes language absurdities, such as, “Is that an elephant on your head?” Expresses ideas and feelings rather than just talking about the world around him or her Uses verbs that end in “ing,” such as “walking” or “talking” Answers simple questions, such as “What do you do when you are hungry?” Repeats sentences
4 to 5 years	Understands spatial concepts, such as “behind” or “next to” Understands complex questions Speech is understandable, but makes mistakes pronouncing long, difficult, or complex words, such as “hippopotamus” Uses some irregular past tense verbs, such as “ran” or “fell” Describes how to do things, such as painting a picture Lists items that belong in a category, such as animals or vehicles Answers “why” questions
5 years	Understands time sequences (for example, what happened first, second, or third) Carries out a series of 3 directions Understands rhyming Engages in conversation Sentences can be 8 or more words in length Uses compound and complex sentences Describes objects Uses imagination to create stories

Birth to 5 months

Coos
Vocalizes pleasure and displeasure sounds differently (laughs, giggles, cries, or fusses)
Makes noise when talked to

6 to 11 months

Understands “no-no”
Babbles (says “ba-ba-ba”)
Says “ma-ma” or “da-da” without meaning
Tries to communicate by actions or gestures
Tries to repeat your sounds
Says first word

12 to 17 months

Answers simple questions nonverbally
Says 2 to 3 words to label a person or object (pronunciation may not be clear)
Tries to imitate simple words
Vocabulary of four to 6 words

18 to 23 months

Vocabulary of 50 words, pronunciation is often unclear
Asks for common foods by name
Makes animal sounds, such as “moo”
Starting to combine words, such as “more milk”
Begins to use pronouns, such as “mine”
Uses 2-word phrases

2 to 3 years

Knows some spatial concepts, such as “in” or “on”
Knows pronouns, such as “you,” “me” or “her”
Knows descriptive words, such as “big” or “happy”
Uses 3-word sentences
Speech is becoming more accurate, but may still leave off ending sounds. Strangers may not be able to understand much of what is said.
Answers simple questions
Begins to use more pronouns, such as “you” or “I”
Uses question inflection to ask for something, such as “my ball?”
Begins to use plurals, such as “shoes” or “socks” and regular past tense verbs, such as “jumped”

3 to 4 years

Groups objects, such as foods or clothes
Identifies colors
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.
Uses consonants in the beginning, middle, and ends of words. Some of the more difficult consonants may be distorted, but attempts to say them
Strangers are able to understand much of what is said
Able to describe the use of objects, such as “fork” or “car”
Has fun with language; enjoys poems and recognizes language absurdities, such as, “Is that an elephant on your head?”
Expresses ideas and feelings rather than just talking about the world around him or her
Uses verbs that end in “ing,” such as “walking” or “talking”
Answers simple questions, such as “What do you do when you are hungry?”
Repeats sentences

4 to 5 years

Understands spatial concepts, such as “behind” or “next to”
Understands complex questions
Speech is understandable, but makes mistakes pronouncing long, difficult, or complex words, such as “hippopotamus”
Uses some irregular past tense verbs, such as “ran” or “fell”
Describes how to do things, such as painting a picture
Lists items that belong in a category, such as animals or vehicles
Answers “why” questions

5 years

Understands time sequences (for example, what happened first, second, or third)
Carries out a series of 3 directions
Understands rhyming
Engages in conversation
Sentences can be 8 or more words in length
Uses compound and complex sentences
Describes objects
Uses imagination to create stories

What Is Early Intervention?

Children grow and develop at their own rate. Although some children walk and talk early, others may be delayed in learning certain skills. If you have any concerns about your child’s development, the earlier you seek help, the better.

Early intervention is for children ages birth to 3 and their families. Early intervention is available in every state under federal law. In some states, early intervention programs may continue until a child is age 5.

Families and professionals, including audiologists and speech-language pathologists, are part of an early intervention team. They help children develop skills such as

cognitive skills (thinking, learning, problem-solving);
communication skills (gesturing, talking, listening, understanding);
physical and sensory skills (crawling, walking, climbing, seeing, hearing);
social–emotional skills (playing, understanding feelings, making friends); and
adaptive or self-help skills (eating, bathing, dressing).

Early intervention is different for each child and family depending on the child’s needs and the family’s priorities. The most important step is to start early.

How Can I Get Early Intervention Services for My Child?

Health care providers, parents, child care staff, teachers, and social service workers are just some of the people who can refer an infant or toddler for early intervention.

If you are concerned about your child’s development, you may contact your local early intervention program directly to ask for an evaluation. Families do not have to wait for a referral from professionals.

You can find your community’s early intervention office by

asking your child’s pediatrician, child care provider, or teacher for a referral;
calling your state department of health or education;
reaching out to the Parent Training and Information Center in your state;
contacting the pediatrics department of a local hospital; or
visiting the Early Childhood Technical Assistance Center’s state-by-state contacts page.

What Happens After My Child Is Referred for Early Intervention?

After your child is referred to your local early intervention program, a service coordinator will meet with you and your child to gather information and explain next steps. They will evaluate your child’s skills to see if your child and family are eligible for services. They will ask you for written consent before they begin.

If your child is eligible for services, a more in-depth assessment (i.e., tests, observations, interviews) will be completed. This assessment determines how early intervention can help your child and family.

Next, the early intervention team writes an Individualized Family Service Plan. This plan includes goals, services, and supports for your child and family. You are part of the team, and you help decide what is included in the plan.

Early intervention services must be in the language(s) your child and your family use. If necessary, an interpreter will work with you and the early intervention providers.

What Happens When My Child Turns 3?

A few months before your child’s third birthday, you and the early intervention team will develop a transition plan to meet the needs of your child and family. Part of this plan involves deciding if your child needs services after age 3.

Some states will extend early intervention services beyond your child’s third birthday if needed. Children older than 3 may be eligible for services from the local school district.

What If My Child Is Not Eligible for Early Intervention Services?

If your child does not qualify for services, but you feel they still need help, let the team know right away. You can request another evaluation at that time or in the future. You can also seek services outside of the early intervention program. These services are usually billed to you or your insurance.

If your child is already 3, you can still get help through your local school district. Each school district has a program called Child Find that can help.

A lot happens in the first few years of life. For children who are not where they need to be with development, getting help early can make a big difference.

Resources

ASHA Resources

See these ASHA resources for more information about typical development and early signs of speech, language, and hearing disorders:

You can also browse ASHA’s Online Store for brochures and booklets related to infants and toddlers.