“He’ll grow out of it”
“Don’t worry, he is just a late talker”
“Oh my uncle didn’t talk until he was three and he is brilliant! Don’t worry!”
It is not uncommon for parents of toddlers to worry about their child’s development at different stages. As parents, we all want our children to thrive and it is easy to find ourselves comparing little Johnny to the other toddlers at the park. And it is all too common to have well meaning friends and family reassure you that your child is fine. But whenÂ should you be concerned about your toddler’s speech development?
The Range of “Normal” Is Very Wide
The first thing that is very important to know, is that the range of “normal” or “typical” development is rather wide between 12-24 months. While one 18 month old may be talking in short sentences, another may have only a handfull of words and yet they are still considered to be in the average range of development. This is important to keep in mind as you compare your child to other children. That said, there are some red flags to be aware of that may indicate that it is time to consider a speech and language evaluation.
Here are some general red flags to look out for in terms of speech, language and social development. If your child is demonstrating some of these red flags, I suggest consulting with a licensed speech-language pathologist.
Children 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
Children at 18 Months
- Does not use at least 8-10 meaningful words
- Does not follow simple commands like â€œcome hereâ€ â€œstopâ€ â€œdonâ€™tâ€ â€œgive me the __________â€Â or â€œtouch your noseâ€
- Does not follow your pointing with his gaze
- Is not playing â€œpretendâ€ with items (talking on toy phone, feeding a doll)
- Is not playing with toys appropriately (playing with toys in odd ways)
- Does not play in proximity to other children
Children at Age Two
- No two-word meaningful phrases (without imitating or repeating) by 24 months
- Does not follow simple two step commands such as â€œGet the ball and put it on the tableâ€
- Speech is not at least 50% understandable
- Cannot point to pictures of items in books when asked
- Is not using his language/words for a variety of ways to get his/her needs met: (Does he use his speech/language to request things? Protest? Show you something? Ask a simple question?)
- Demonstrating inappropriate toy play: not playing “pretend” with toys, not playing correctly with toys as intended (like lining cars up rather than rolling the along a play road), or getting “stuck” playing with one toy over and over again in a repetitive fashion.
Children at 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 â€œwhâ€ questions like â€œwho is thatâ€ or â€œwhere is the truckâ€
- Does not play with other children
- Is demonstrating any of the red flags mentioned above for ages 18 months-3 years.
Overall Warning Signs in Toddlers
- 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
What Else do We Look For?
It is so important to know, that speech/language development is so much more than words, which you may have gathered by looking at the red flags above. To get a better understanding of what this means, check out these posts:
Is Communication Only About Speech?Â (by me, over at The Friendship Circle Special Needs Blog)
Language Basics: More Than Words by Stephanie, fellow SLP and mom to twins, at Twodaloo. Excellent, must read post if you suspect your child has speech/language delays.
What should I do if my child demonstrates some red flags?
I recommend you find a speech-language pathologist for a screening to determine whether an evaluation is necessary. All states have some kind of early intervention services, or you can pursue an evaluation through your medical insurance or through a private practice. For more information on how to find an SLP, check out my post How Can I Find a Speech Pathologist.
For recommendations on how to help your child, be sure to check out my How to Help Your Child Talk page!
Rady Childrenâ€™s Hospital, San Diego. Retrieved from http://www.rchsd.org/ourcare/programsservices/s-t/speechlanguagepathology/redflags/index.htm, 9-27-2011
First Signs (National Nonprofit Organization). Retrieved from http://www.firstsigns.org/concerns/flags.htm, 9-27-2011
Centers for Disease Control and Prevention.Â Retrieved from http://www.cdc.gov,Â 9-27-2011