Overview

What is speech and language development?

Speech and language are the skills we use to communicate with others. We form these skills during the first years of life. By age 6, most children learn the basics. Try to talk and read to your child often to boost these skills.

Speech is making the sounds that become words—the physical act of talking.

Language is our system of using words to communicate. It includes using words and gestures to say what we mean, and understanding what others say.

When does speech and language development begin?

Infants start learning in the womb, where they hear and respond to familiar voices. The fastest learning occurs from ages 2 to 5 years.

Speech and language milestones help tell whether a child is developing as expected. Milestones are certain skills, such as babbling, saying "mama" or "dada," or putting two words together. Usually, a child needs to master one milestone before reaching the next.

Babies usually start cooing at around 2 months and are babbling by about 6 months. Most children speak by one year, but it may still be hard to understand what they're saying. At 15 to 18 months, a typical toddler understands much more than they are able to put into words. Starting around 18 months, many children have a burst in talking. By 24 months, children tend to use at least 50 words and are also starting to use two-word phrases.

Keep in mind that the age at which children reach milestones varies from child to child. Some children are advanced. Others develop more slowly.

Why do speech and language problems develop in some children?

Speech and language problems mean your child has trouble speaking or saying words. Or your child may find it hard to understand or explain ideas.

Hearing problems can cause speech and language delays in children. All children with speech and language delays should have their hearing tested. Certain disorders, such as autism spectrum disorder, can also cause a delay. Speech and language problems may also run in families.

A child can overcome many speech and language problems with treatment such as speech therapy. Speech therapy helps your child learn speech and language skills. Treatment works best when problems are caught early.

What You Can Expect

Birth to age 1

Here are some of the things babies may do at each age milestone.

Less than 1 month old

• Listen to the rhythm and melodies of speech.
• Pick out their mother's voice.
• Learn the rhythm of two languages when both are spoken at home.
• Use crying that sounds the same no matter what they need.

Ages 1 to 4 months

• Prefer "baby talk" and voices with a high pitch.
• Blink or widen eyes when noticing sounds.
• Become startled or turn toward a sound to look for its source.
• Become quiet to their mother's voice.
• Make cooing sounds, such as "ah-ah-ah" or "ooh-ooh-ooh." Babies may also make cooing sounds back to someone who is talking to them.

Ages 5 to 6 months

• Recognize their own name.
• Make sounds like "goo" and blow bubbles at the same time.
• Start to babble or repeat sounds, such as "ma-ma-ma" or "bah-bah-bah" to get attention or express feeling.
• Vary their cries to signal specific needs.

Ages 7 to 9 months

• Hear words as distinct sounds.
• Recognize the meaning of some facial expressions and tone of voice, such as when a parent says "No!"
• Repeat sounds that they hear.
• Mimic the rhythm of the way others talk.
• May say words like "mama" and "dada."
• May wave "bye-bye" when asked.

Ages 10 to 12 months

• Start to follow simple commands like "Give me the toy."
• Usually understand "mama" and "dada."
• Correctly refer to each parent as "mama" or "dada."
• Point to things they want or need.
• Say a few single words besides "mama" or "dada."

Ages 1 to 3

Here are some of the things children may do at each age milestone.

Ages 1 to 2 years

• Understand that words have meaning.
• Know the names of family members and familiar objects. Start to know the names of other people, body parts, and objects.
• Make simple statements and understand simple requests, such as "All gone" and "Give daddy the ball."
• Use gestures, such as pointing.
• Make one- or two-syllable sounds that stand for items they want, such as "baba" for "bottle."
• Use their own language that is a mix of made-up words and real words.
• Say 20 to 50 words that family understands.

Ages 2 to 3 years

• Recognize the names of at least seven body parts, and can name some of these.
• Increase their understanding of the names of things.
• Follow simple requests, such as "Put the book on the table."
• When asked, point to a picture of something named, such as "Where is the cow?"
• Continue to learn and use gestures.
• Develop a way to communicate using gestures and facial expressions if they are quiet and don't talk much.
• Name favorite toys and familiar objects.
• Use pronouns like "me" and "you," but may get them mixed up.
• Make phrases, such as "No bottle" or "Want cookie."
• Say 150 to 200 words by age 3. Strangers may be able to understand them about 75% of the time.

Ages 3 to 5

Here are some of the things children may do at each age milestone.

Age 3 years

• Follow two-part requests, such as "Put your pajamas in the hamper and your slippers in the closet."
• Learn new words quickly.
• Know the names of most common objects.
• Understand the concept of "two."
• Understand the differences between girls and boys.
• Know their own full name.
• Begin correctly using plurals, pronouns, and prepositions more consistently.
• Frequently ask "why" and "what."
• Often use complete sentences of 3 to 4 words.

Age 4 years

• Know the names of colors.
• Understand the difference between things that are the same and things that are different, such as the difference between children and grown-ups.
• Follow three-step instructions, such as "Go to the sink, wash your hands, and dry them on the towel."
• Use the past tense of words.
• Use sentences of 5 to 6 words.
• Describe something that has happened to them or tell a story.
• Speak clearly enough so that strangers can understand them almost all of the time.

Age 5 years

• Understand relationships between things, such as "the girl who is playing ball" and "the boy who is jumping rope."
• Carry on a conversation with another person.
• Call people or things by their relationship to others, such as "Bobby's mom" instead of "Mrs. Smith."
• Define words such as "spoon" and "cat."

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Common Concerns

It's common for parents to have questions about their child's speech and language development.

Speech and language delays

Many different things affect a child's speech development. Some of these things may cause a child to start speaking a little later than others of the same age. For example:

• Children who have older siblings may start to talk slightly later than their older brothers or sisters did.
• Children raised in bilingual homes may have a slight delay in starting to speak. But they don't have more trouble learning to talk, read, and write than those who learn only one language. In fact, learning two or more languages may boost a child's overall ability to learn.

True delays are related to developmental or health issues, such as some types of hearing loss or a family history of speech and language delay.

Signs of speech or language delays are generally based on standard speech and language milestones. For example, if your child is not babbling by 9 months or not saying any words by 15 months, talk with your doctor. The first step may be a hearing test.

Talk to your child's doctor anytime you have concerns. It's important to find speech and language delays early and rule out other conditions. Early treatment can help prevent long-term problems.

Behavioral issues

While they learn and master new language skills, children sometimes talk in ways that are demanding or impolite. For example, a child may say "Give me!" when they want a toy. Often this behavior is because children can't find the words that fit their feelings. Or they may simply repeat what is being said around them. Gently remind your child to use an appropriate voice and manners. And always model polite speech and behavior.

Some parents think that their child is constantly talking or chattering. This is a child's way of practicing. Parents don't have to listen and respond to everything a talkative child says. But don't completely tune out your chatterer either. Singing and dancing with your child and playing music or reading stories geared toward children will help your child learn to listen and to express themself.

Common mistakes

Most children make "mistakes" when they first learn to talk. This is a natural part of language development. For example, children commonly mispronounce words, such as saying "pasghetti" for "spaghetti." As children listen to other people, they often correct their mistakes. They learn to say words clearly and use grammar correctly through practice.

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Routine Checkups

Regularly scheduled checkups begin shortly after birth and last through the teen years. They are often called well-child visits.

These visits let your doctor keep a close watch on your child's general health and development. Finding possible problems early gives your child the best chance for proper and successful treatment. Also, any concerns you have about your child can be discussed at these visits.

During the visits, the doctor examines your child. The doctor also asks you questions about your child's development and behavior. And immunizations and screenings are either given or scheduled at this time.

Your child's doctor will recommend a schedule for well-child visits.

Checking for speech and language delays

Mild and temporary speech delays can happen. And some children learn to communicate faster than others do.

Your doctor will check your child's speech and language skills during regular well-child visits. But call your doctor anytime you have concerns about how your child is developing. A child can overcome many speech and language problems with treatment, especially when you catch problems early.

Screening for hearing problems

Almost all 50 states require newborn hearing tests for all babies born in hospitals. Hearing should be checked by a doctor at each well-child visit and anytime you or your child may notice changes. Some hearing problems can delay your child's speech and language development. Be sure your child has regular hearing exams.

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Watch

When to Call a Doctor

Call your doctor anytime you or another caregiver has concerns about your child's speech and language development. Be aware of signs that point to a possible developmental delay, such as when your child does not make sounds that are expected for your child's age.

Your doctor will do a physical exam and ask questions about your child's medical history. This information can help your doctor identify developmental patterns and assess whether any other conditions, such as hearing loss, are interfering with development.

Your doctor may also recommend other tests to:

• Rule out other conditions. For example, hearing tests done by an audiologist may be recommended to rule out hearing loss.
• Assess speech and language developmental progress. Questionnaires and evaluations by a speech-language pathologist can help define where your child's abilities are in relation to other children of the same age.
• Find out whether other problems, such as behavioral difficulties or developmental delays in other areas, are also occurring.

Building Skills at Home

To help your child develop speech and language skills, make sure to talk and read to your baby. Later, encourage conversation with your child. The size of a 2-year-old's vocabulary is directly related to how much parents and other caregivers have spoken to that child since the child was born.

Newborn babies are programmed to learn. And parents are naturally excellent language teachers. The kinds of interactions and conversations parents normally have with their children, from "baby talk" to repeating words, are perfect language lessons. Talking, reading, listening, and responding to babies and young children usually are all that they need to help them learn to talk.

Teaching sign language to babies 6 months or older could also help them in several ways. Signing gives babies a way to express their wants and needs when they can't talk. And it gives you another way to bond with your child.

Start reading to your child before he or she is 6 months old. Read to your child each day. Reading to your young child is a very important learning activity for several reasons. While reading, you and your child share a comforting closeness. You also both focus on the same picture and the same concept. Your child can ask you questions, and you can reinforce his or her observations. Reading gives children a chance to learn new words that they wouldn't normally hear in everyday conversation. If you often read to your child, you may help with his or her speech development. It may also help your child's later reading abilities and school performance.

If you have concerns about your own reading skills, seek out an adult reading program at your local library or public school system. You can also go to America's Literacy Directory at www.literacydirectory.org to find reading programs in your area.

Helping your baby, birth to age 1

These are some things you can do to help your baby develop speech and language.

• Talk, read, sing, and play with your baby.

  Interacting with your baby and sharing a loving environment will help make your baby more curious, build confidence, and help your baby get familiar with language. These traits will provide a strong foundation for speech and language development.

• Turn off the TV.

  When you play or read with your child, leave the TV off. Even a show playing in the background can distract you and your baby.

Helping your child, ages 1 to 2

There are things you can do to encourage and support your child's speech and language development.

• Involve your child in conversations.
• Talk about the names of favorite toys and other common objects around the house.
• Speak slowly and clearly, and praise your child's attempts to speak.
• Play or read together.

  To help your child's brain develop, play and read together instead of letting your child watch TV, watch movies, or play games on a screen.

• Leave the TV off.

  When you play or read with your child, leave the TV off. Even a show playing in the background can distract you and your child. For children younger than 18 months, the American Academy of Pediatrics advises parents to avoid screen time.

Helping your child, ages 2 to 4

These are some things you can do to help your 2- to 4-year-old learn new words and say sentences.

• Encourage your child to talk to others.

  When you can, gently encourage your child to talk to others, including other children near the same age.

• Correct your child's speech in positive ways.

  When your child makes a language mistake, gently rephrase, repeat, or relabel.

• Read to your child every day.
• Set limits on TV and video viewing.

  The American Academy of Pediatrics advises parents to limit screen time to an hour or less each day of high-quality programs.

Helping your child, ages 3 to 5

The best way to help your child learn is to talk and read to your child. Doing these things will help your child learn language skills faster. Try these ideas:

• Read books to your child that tell stories with a beginning, middle, and end.
• Choose stories about your child's interests. Stories about facing fears and solving problems are also good.
• As you read, talk with your child about the story. Ask questions like "What's going to happen next?" and "Why do you think the character did that?"
• Listen to and talk with your child every day.
• Play games that require listening and following instructions.
• Speak clearly and correctly. Avoid "baby talk."

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