Is she normal? Understanding child speech development.

The first “mama” or “dada” is a wonderful milestone in a child’s development—in the same way the first “no” can be an irritating one. From smiles to head shakes to words and phrases, a child’s ability to communicate begins as soon as he is born and continues throughout their childhood. The first three years of life, when the brain is developing and maturing, is the most intensive period for acquiring speech and language skills.


So it is quite normal for a parent or caregiver to wonder if their child is developing at a “normal” rate. Children vary in how they develop speech and language skills, but there are a series of natural milestones that parents can use to determine if their own child’s speech development may benefit from professional intervention.


Milestones for speech and language development

Any parent of a newborn knows the first sign of communication well — the cry. Infants learn that a cry will bring food, comfort, and mom’s reassuring face. Newborns begin to recognize sounds in their environment, such as the voice of their caregiver. As they grow, babies begin to sort out sounds that make up language. By six months of age, most babies recognize the basic sounds of their native language.


Do you wonder if your child is developing normally? The checklist below can serve as a general guide. Milestones help doctors and other health professionals determine if a child is on track or if he or she may need extra help. Sometimes a delay may be caused by hearing loss, while other times it may be due to a speech or language disorder.


Hearing and communicative development checklist

Birth to 3 Months

[  ] Reacts to loud sounds

[  ] Calms down or smiles when spoken to

[  ] Recognizes your voice and calms down if crying

[  ] When feeding, starts or stops sucking in response to sound

[  ] Coos and makes pleasure sounds

[  ] Has a special way of crying for different needs

[  ] Smiles when he or she sees you

4 to 6 Months

[  ] Follows sounds with his or her eyes

[  ] Responds to changes in the tone of your voice

[  ] Notices toys that make sounds

[  ] Pays attention to music

[  ] Babbles in a speech-like way and uses many different sounds, including sounds that begin with p, b, and m

[  ] Laughs

[  ] Babbles when excited or unhappy

[  ] Makes gurgling sounds when alone or playing with you

7 Months to 1 Year

[  ] Enjoys playing peek-a-boo and pat-a-cake

[  ] Turns and looks in the direction of sounds

[  ] Listens when spoken to

[  ] Understands words for common items such as “cup,” “shoe,” or “juice”

[  ] Responds to requests (“Come here”)

[  ] Babbles using long and short groups of sounds (“tata, upup, bibibi”)

[  ] Babbles to get and keep attention

[  ] Communicates using gestures such as waving or holding up arms

[  ] Imitates different speech sounds

[  ] Has one or two words (“Hi,” “dog,” “Dada,” or “Mama”) by first birthday

1 to 2 Years

[  ] Knows a few parts of the body and can point to them when asked

[  ] Follows simple commands (“Roll the ball”) and understands simple questions (“Where’s your shoe?”)

[  ] Enjoys simple stories, songs, and rhymes

[  ] Points to pictures, when named, in books

[  ] Acquires new words on a regular basis

[  ] Uses some one- or two-word questions (“Where kitty?” or “Go bye-bye?”)

[  ] Puts two words together (“More cookie”)

[  ] Uses many different consonant sounds at the beginning of words

2 to 3 Years

[  ] Has a word for almost everything

[  ] Uses two- or three-word phrases to talk about and ask for things

[  ] Uses k, g, f, t, d, and n sounds

[  ] Speaks in a way that is understood by family members and friends

[  ] Names objects to ask for them or to direct attention to them

3 to 4 Years

[  ] Hears you when you call from another room

[  ] Hears the television or radio at the same sound level as other family members

[  ] Answers simple “Who?” “What?” “Where?” and “Why?” questions

[  ] Talks about activities at daycare, preschool, or friends’ homes

[  ] Uses sentences with four or more words

[  ] Speaks easily without having to repeat syllables or words

4 to 5 Years

[  ] Pays attention to a short story and answers simple questions about it

[  ] Hears and understands most of what is said at home and in school

[  ] Uses sentences that give many details

[  ] Tells stories that stay on topic

[  ] Communicates easily with other children and adults

[  ] Says most sounds correctly except for a few (l, s, r, v, z, ch, sh, and th)

[  ] Uses rhyming words

[  ] Names some letters and numbers

[  ] Uses adult grammar


This checklist is based upon How Does Your Child Hear and Talk?, courtesy of the American Speech–Language–Hearing Association.


We may have a problem—now what?

If your child is missing key milestones on this list, or you just have concerns about their speech development, talk to their doctor. Causes of delayed speech are varied from poor hearing to facial muscles that don’t work quite right to cognition challenges to hearing loss.


Hearing loss can be temporary, caused by ear wax, middle ear fluid, or infections. Many children with temporary hearing loss can have their hearing restored through medical treatment or minor surgery.


Your doctor may refer you to a speech-language pathologist to evaluate your child. Depending on the result of the evaluation, the speech-language pathologist may suggest activities you can do at home to stimulate your child’s development, a group or individual therapy, evaluation by an audiologist, or a developmental psychologist.


Whether you suspect your child is struggling with a hearing problem, you are battling chronic ear infections, or have other ear, nose and throat issues, Sierra Nevada ENT and Sierra Nevada Hearing Aid Center have the expertise to address your needs. Call 775.883.7666 to make your appointment with a member of our knowledgeable and skilled care team.

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