UNDERSTANDING NORMAL SPEECH AND LANGUAGE DEVELOPMENT
It’s important to discuss early speech and language development, as well as other developmental concerns, with your doctor at every routine well-child visit. It can be difficult to tell whether a child is just immature in his or her ability to communicate or has a problem that requires professional attention. These developmental norms may provide clues:
1. Before 12 Months
It’s important for kids this age to be watched for signs that they’re using their voices to relate to their environment. Cooing and babbling are early stages of speech development. As babies get older (often around 9 months), they begin to string sounds together, incorporate the different tones of speech, and say words like “mama” and “dada” (without really understanding what those words mean). Before 12 months, children should also be attentive to sound. Babies who watch intently but don’t react to sound may be showing signs of hearing loss.
2. By 12 to 15 Months
Kids this age should have a wide range of speech sounds in their babbling and at least one or more true words (not including “mama” and “dada”). Nouns usually come first, like “baby” and “ball.” Your child should also be able to understand and follow single directions (“Please give me the toy,” for example).
3. From 18 to 24 Months
Kids should have a vocabulary of about 20 words by 18 months and 50 or more partial words by the time they turn 2. By age 2, kids should be learning to combine two words, such as “baby crying” or “Daddy big.” A 2-year-old should also be able to follow two-step commands (such as “Please pick up the toy and bring me your cup”).
4. From 2 to 3 Years
Parents often witness an “explosion” in their child’s speech. Your toddler’s vocabulary should increase (to too many words to count) and he or she should routinely combine three or more words into sentences.
Comprehension also should increase — by 3 years of age, a child should begin to understand what it means to “put it on the table” or “put it under the bed.” Your child also should begin to identify colors and comprehend descriptive concepts (big versus little, for example).
THE DIFFERENCE BETWEEN SPEECH AND LANGUAGE
Speech and language are often confused, but there is a distinction between the two:
- Speech is the verbal expression of language and includes articulation, which is the way words are formed.
- Language is much broader and refers to the entire system of expressing and receiving information in a way that’s meaningful. It’s understanding and being understood through communication — verbal, non-verbal, and written.
Although problems in speech and language differ, they frequently overlap. A child with a language problem may be able to pronounce words well but be unable to put more than two words together. Another child’s speech may be difficult to understand, but he or she may use words and phrases to express ideas. And another child may speak well but have difficulty following directions.
An infant who isn’t responding to sound or who isn’t vocalizing is of particular concern. Between 12 and 24 months, reasons for concern include a child who:
- isn’t using gestures, such as pointing or waving bye-bye by 12 months
- prefers gestures over vocalizations to communicate by 18 months
- has trouble imitating sounds by 18 months
- has difficulty understanding simple verbal requests
Seek an evaluation if a child over 2 years old:
- can only imitate speech or actions and doesn’t produce words or phrases spontaneously
- says only certain sounds or words repeatedly and can’t use oral language to communicate more than his or her immediate needs
- can’t follow simple directions
- has an unusual tone of voice (such as raspy or nasal sounding)
- is more difficult to understand than expected for his or her age. Parents and regular caregivers should understand about half of a child’s speech at 2 years and about three quarters at 3 years. By 4 years old, a child should be mostly understood, even by people who don’t know the child.