Language Development and Speech Therapy for Young Children

Language Milestones in Young Children

The following milestones are what would be considered “typical” within an anticipated age range. Use the recommendations below to determine if a child is on track or needs further intervention.

Birth to 3 Months

• Calms down/smiles when spoken to
• Child makes cooing sounds
• Recognizes caregiver’s voice
• Cries differently depending on differing needs

4-6 Months

• Babbles in a way that sounds like speech; these are consonant-vowel combinations like “baba” or “mama”
• Laughs or giggles
• Looks in the direction of sounds
• Responds to variations in tone of voice
• Attends to music
• Makes babbling or gurgling sounds when alone or playing with a caregiver

7 Months – 1 Year

• Says one- two words by age 1
• Likes simple games, like playing peek-a-boo
• Understands basic words in their everyday life, like “milk”
• Responds to simple requests like “come to mama”
• Communicates with gestures, like waving or holding up hands to be picked up
• Imitates different speech sounds

1-2 Years Old

• Learns new words all the time and build vocabulary
• Starts to put two word phrases together, such as “mama come” or “more milk”
• Says words that begin with different consonant sounds
• Follows simple directions 
• Likes rhymes, songs, and stories
• Points to pictures in a book when named

2-3 Years Old

• Has a vocabulary of about 400+ words
• Uses two-three word phrases, like “gimme more cookie” or “doggie go out”
• Family and friends understand what a child says more of the time
• Uses /k/ /g/ /f/ /t/ /d/ and /n/ sounds in words
• Names common objects in their life to make requests or comments

3-4 Years Old

• Responds when called by name
• Answers simple “WH” questions, like “Who?” “What?” “Where?” and “Why?”
• Can talk about their day, including activities at school what they did with a friend
• Puts 4 or more words together to create sentences, like “I want more bubbles.”

4-5 Years Old

• Uses full sentences with more detail and descriptive language
• Most sounds are said correctly but some are still developing (i.e., /r/ /ch/ /sh/ /th/)
• Listens to a story and answers simple questions about what happened
• Understands most verbal communication
• Has short conversations and stays on topic
• Uses more adult grammar
• Follows more complex directions
• Asks “why” questions often

Risk Factors for Language Delay in Young Children

Some language disorders are caused by medical issues like traumatic brain injuries, genetic disorders like Fragile X Syndrome, Autism Spectrum Disorder, hearing impairments and other disabilities.  Yet there are developmental language issues that have no known cause.

There are a number of indicators or “red flags” that raise – or appear to increase – the chance of a child having a language delay. These are some of them:

• Male Gender: Boys are about 2-3 times more likely than girls to have language delays
• Family History: If anyone else in the family has had a language delay there is higher risk factor for language delay in a child
• Little Babbling: Not babbling very much as a baby is correlated with a greater risk for continued language delays
• Minimal Gesture Use: Children that do not use many gestures may not learn language as well. Some common gestures are waving bye-bye, and holding up arms to be picked up
• Late Talking: Children with fewer than 50 words at 2 years old are at a higher risk for later language impairments. Approximately half of late talkers without receptive language issues outgrow the delay; whereas others do not 
• Low birth weight
• Having other sensory disorders
• Severe toxic exposure;
• Chronic medical illnesses
• Chronic ear infections
• Abuse or neglect

What is Pediatric Speech Therapy and Early Intervention and Why is it So Important?

Early intervention focusing on pediatric speech therapy is critical to getting the best results for a child with language delays. The CDC reports that “early intervention services can change a child’s developmental path and improve outcomes for children, families, and communities.”

Some parents may feel that their child’s language delay will simply pass, causing them to take a “wait and see” approach. Yet the longer parents wait to intervene, the more likely a child will fall farther behind. Children are at danger of losing valuable time during one of their most critical learning periods.

Early intervention is frequently provided to children and their families between the ages of birth and three years of age, with the possibility of continuing until the age of five. A speech-language pathologist works in conjunction with other providers who make up each child’s early intervention team to address the child’s language and developmental goals depending on their needs and priorities.

Pediatric speech therapy can address:

• Communication skills:  like increasing. gesturing, imitating, speaking, listening, and understanding language
• Cognitive skills: like learning and problem-solving
• Social–emotional skills: including empathy, understanding feelings, playing with other kids, making and maintaining relationships
• Academics: such as working on phonemic and phonological awareness

Early intervention also has a positive impact on a child’s educational progress as well as their self-esteem. Speech and language therapy can help a child be a confident communicator and interact with peers as well as other adults in their life. It decreases the chances they might shy away from social situations, forming relationships or participating in academic activities. When these critical skills are not addressed early on, they compound and are made worse over time. 

How Can Parents Help Their Child’s Language Development?

It’s difficult to overstate the importance of parental participation in a child’s early language development. Parents are the ones that spend the most time with a child and simply talking helps to create a language-rich environment that promotes language development.

Here are some ideas for what parents can do at home to support their child:

• Encourage Imitation First: If a child is not interested in imitating speech, you can encourage imitation of sounds and actions. This helps them understand that the goal is imitation of what you are doing.
• Narrate What is Happening: Even when a child isn’t talking, they are listening. Talk about what you are doing and what is going on. For example, parents can say, “I’m washing my hands,” or “Let’s see who rang the bell.” 
• Give Choices for Everything: Even if you know what your child would choose, give them a choice of two. Verbalize the choice and show it as well. For example, “Do you want juice… or milk?” Show the items when you name them. 
• Reading Often: Children are exposed to more vocabulary when reading in comparison to just listening to their parents talk. Help them improve their vocabulary, comprehension and imagination. Create a habit to read regularly and talk about what you read. Ask your child to point to photos or ask questions appropriate to their level like, “what is going to happen next?” or “why do you think they did that?” 
• Playtime: This opportunity should not be underestimated. Playtime is a child’s job and when they learn the most. Parents can work on turn-taking by rolling a ball back and forth, and cause and effect by knocking down a tower of blocks. Focusing on the same activity improves a child’s joint attention (when two people focus on the same thing) which is one the earliest forms of communication a child develops. 

How Can Pediatric Speech Therapy Help with Language Development in Young Children?

A speech therapist who is specialized in early intervention and is trained to assess and treat developmental problems in children can help improve a child’s skills. 

The most successful strategy at this age is to teach parents how to utilize speech therapy techniques throughout the day and  to include language-building practices into their child’s everyday interactions.

Even with speech therapy online sessions are designed to provide parent coaching and support so that a child can improve communication skills at home. When a child gets older, they can attend sessions with the parent and both learn communication skills from the speech therapist.