Red Flags

Every child develops differently and at different rates. However, there are some red flags that may indicate your child should be evaluated by a speech-language pathologist or a related specialist (early interventionist, psychologist, etc).

Under 18 months

  • No big smiles or other warm, joyful expressions by 6 months
  • No back-and-forth sharing of sounds, smiles, or other facial expressions by 9 months or thereafter
  • No babbling by 12 months
  • Does not respond to his/her name by 12 months
  • No sharing/reciprocal interactions like pointing, sharing, reaching or waving by 12 months
  • No pointing at objects of interest by 14 months (pointing at a car driving by)
  • Does not understand simple common words like mama or milk
  • Is not using any words by 16 months
  • Does not imitate gross motor movements like clapping or stomping feet

By 18 Months

  • Does not use at least 8-10 meaningful words
  • Does not follow simple commands like “come here” “stop” “don’t” “give me the __________”  or “touch your nose”
  • Does not follow your pointing with his gaze
  • Is not playing “pretend” with items (talking on toy phone, feeding a doll)
  • Does not play in proximity to other children

By Age Two

  • No two-word meaningful phrases (without imitating or repeating) by 24 months
  • Does not follow simple two step commands such as “Get the ball and put it on the table”
  • Speech is not at least 50% understandable
  • Cannot point to pictures of items in books when asked

By Three Years

  • Is not using three and four word sentences
  • Speech is not at least 75% or more understandable
  • Child is leaving the beginnings or ends off of most words
  • Cannot accurately answer yes/no questions
  • Cannot answer simple “wh” questions like “who is that” or “where is the truck”
  • Does not play with other children
  • Is experiencing stuttering behavior for more than 6 months

By Four to Five  Years

  • Is not 90-100% understandable to strangers despite age appropriate articulation errors (may not be able to say /r, sh, ch, l, or th yet)
  • Is not consistently using 4+ word, complex  sentences
  • Is not asking a variety of questions to gain information (who, what, where, why and when)
  • Is having difficulty with grammar or pronoun use
  • Cannot tell a simple story on topic
  • Canot follow simple two step directions
  • Has difficulty answering simple who, what, where and why questions
  • Is not yet able to name a few  letters, numbers, and rhyming words

Overall Warning Signs

  • ANY loss of speech or babbling or social skills at ANY age
  • Never gestures or imitates
  • Does not appear to understand speech, or appears to be unable to hear
  • Never develops words beyond repeating others over and over


First Signs (National Nonprofit Organization). Retrieved from, 9-27-2011

Centers for Disease Control and Prevention. Retrieved from,  9-27-2011